Shadechapter04.ppt [read only]
- 1. Q I A 4 Fast & Easy ECGs – A Self-Paced Learning Program Regularity
- 2. Regularity • Second step of analyzing an ECG rhythm is determining its regularity Q
- 3. Regularity • Normally the heart beats in a regular, rhythmic fashion • Distance between consecutive P waves and consecutive QRS complexes should be the same I
- 4. Regularity • If the distance of the R-R intervals and P-P intervals is the same the rhythm is regular • If the distance differs, the rhythm is irregular • Irregular rhythms are considered abnormal I
- 5. Regularity
- 6. Determining Irregularity • Several methods can be used to determine rhythm regularity including: – Caliper Method – Paper and Pen Method – Counting the Small Squares Method I
- 7. Caliper Method • Place ECG tracing on a flat surface • Position one point of caliper on a starting point • Open calipers by pulling the other leg until the point is positioned on the next R wave or P wave • With the calipers open in that position and keeping the point positioned over the second P wave or R wave rotate the calipers across to the peak of the next consecutive (the third) P wave or R wave I
- 9. Paper and Pen Method • Place the straight edge of a piece of paper above or over the ECG tracing so that the intervals are still visible • Identify a starting point and place a mark on paper in the corresponding position above it • Find peak of the next consecutive R wave or P wave and place a mark on the paper in the corresponding position above it. • Move the paper across the ECG tracing, aligning the two marks with succeeding R-R intervals or P-P intervals I
- 10. Paper and Pen Method
- 11. Counting the Small Squares Method • Count the number of small squares between the peaks of two consecutive R waves (or P waves) and then compare to the other R-R (or P-P) intervals • If the number is the same, the rhythm is regular, if it isn’t it is irregular I
- 13. Occasionally or Very Irregular Occasionally irregular • Mostly regular but from time to time there is an area of irregularity Very irregular • Has many areas of irregularity I
- 14. Slightly Irregular • Pacemaker changes location from site to site producing a slightly irregular rhythm • Referred to as wandering atrial pacemaker Q
- 15. Sudden Heart Rate Acceleration • A normal rate that suddenly accelerates to a rapid rate producing an irregularity in the rhythm • Referred to as paroxysmal tachycardia
- 16. Patterned Irregularity • Irregularity repeats itself in a cyclic fashion • Examples are sinus dysrhythmia, 2nd-degree AV heart block, Type I
- 17. Totally Irregular • No consistency to the irregularity • Typically atrial fibrillation I
- 18. Another Type of Irregularity • Irregularity can also be seen in dysrhythmias with a varying atrial to ventricular conduction ratio I
- 19. Practice Makes Perfect • Determine the regularity I
- 20. Practice Makes Perfect • Determine the regularity I
- 21. Practice Makes Perfect • Determine the regularity I
- 22. Practice Makes Perfect • Determine the regularity I
- 23. Practice Makes Perfect • Determine the regularity I
- 24. Summary • Determining regularity is the second step of analyzing an ECG rhythm. • Irregular rhythms are considered abnormal and can be caused by a variety of conditions. • If the distance of the R-R intervals or P-P intervals is the same, the rhythm is regular – if the distance differs, the rhythm is irregular.
- 25. Summary • Several methods can be used to determine rhythm regularity, including using calipers, marking a paper with a pen, and counting the small squares between each R- R interval. • Irregularity may be occasionally irregular, very irregular, or slightly irregular. • A normal rate that suddenly accelerates to a rapid rate produces irregularity in the rhythm.
- 26. Summary • Patterned irregularity is where the irregularity repeats in a cyclic fashion. • A totally irregular rhythm has no consistency to the irregularity (atrial fibrillation). • Irregularity can also be seen in dysrhythmias that have a varying atrial-to-ventricular conduction ratio.