Ecg basics 2 pdf
- 1. ECG BASICS 2 HOW TO DETERMINE THE RHYTHM
- 2. THERE ARE MANY ABNORMAL RHYTHMS THOUGH DETERMINING A NORMAL RHYTHM IS EASY • IN THIS SESSION WE WILL CONCENTRATE ON LOOKING AT A NORMAL RHYTHM • WE WILL THEN LOOK AT SOME COMMON ABNORMAL RHYTHMS • HOPEFULLY YOU WILL THEN BE MORE COMFORTABLE IN ASSESSING AN ECG RHYTHM STRIP
- 3. ALSO NOTE THAT THE SPACE FROM THE START OF EACH P TO EACH QRS IS 3-5 BLOCKS NOTE THAT A QRS COMPLEX FOLLOWS EACH P-WAVE
- 4. THIS IS REFERRED TO AS A SINUS RHYTHM
- 5. THERE ARE 4 CRITERIA TO CONFIRM A SINUS RHYTHM YOU MUST HAVE? 1. NORMAL P WAVES, NEITHER TOO WIDE OR BIPHASIC 2. NARROW QRS COMPLEXES, WIDE COMPLEXES IMPLY VENTRICULAR ORIGIN OF THE IMPULSE 3. DOES A QRS FOLLOW EACH P WAVE 4. DO THESE BATCHES OF P-WAVE/QRS- WAVE COMPLEXES OCCUR REGULARLY
- 6. LETS CHECK OUR STRIP AGAIN
- 7. 1 2 33 4 4 4 4 4 1-NORMAL P’S 2-NARROW COMPLEXES 3-QRS AFTER EVERY P 4- REGULAR COMPLEXES
- 8. SO LETS TRY A FEW DECIDE IF THESE ARE NORMAL OR ABNORMAL DON’T STRESS ABOUT DIAGNOSIS
- 9. REMEMBER LOOK FOR ALL 4 CRITERIA
- 10. CORRECT THATS A NORMAL STRIP
- 12. ITS ABNORMAL CORRECT • THE PWAVES ARE NORMAL • THE COMPLEXES ARE NARROW • BUT THERE ISN’T A QRS AFTER EACH PWAVE • THE GROUPS OCCUR IRREGULARLY
- 14. IT IS ABNORMAL CORRECT • THE COMPLEXES ARE NARROW • THE GROUPINGS ARE REGULAR • BUT THERE ARE NO P WAVES!
- 16. IT IS ABNORMAL CORRECT • THE PWAVES ARE NORMAL SHAPE • THE QRS GROUPINGS ARE REGULAR • BUT THE COMPLEXES ARE WIDE • AND EACH P IS NOT FOLLOWED BY A QRS
- 18. IT IS ABNORMAL CORRECT • NO DISCERNIBLE P WAVES • THE GROUPINGS ARE IRREGULAR • NO ASSOCIATION BETWEEN P’S AND QRS • BUT COMPLEXES ARE NARROW
- 20. IT IS ABNORMAL CORRECT • NOTE THAT THE COMPLEXES ARE NARROW • THE P WAVES ARE NORMAL • NOT EVERY P WAVE HAS A QRS • THE GROUPINGS ARE IRREGULAR • NOTE THE WIDENING PR INTERVAL
- 21. • NOW THAT YOU’VE LEARNT HOW TO CHECK A RHYTHM STRIP, YOU SHOULD GO AND READ ABOUT • 1ST DEGREE HEART BLOCK • MOBITZ TYPE 1 AND 2 BLOCK • GRADE 3 HEART BLOCK AND AV DISSOCIATION • ATRIAL FIBRILLATION AND FLUTTER • MAT • AV JUNCTIONAL RHYTHMS • ECTOPIC BEATS