ECG) Flashcards
(90 cards)
Systematic approach
- rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS
QRS complex:
T wave:
U wave:
QT segment:
= ventricular depolarization
= ventricular depolarization
= “late bloomer
= all ventricle’s action
Rs 6sec strip method:
big box method:
Small box method:
Triplicate method:
= # of Rs x 10
= 1R to R BB#s then 300/BB#
= 1R-R SB#s then 1500/ SB#
= descend W/ SB 300, 150, 100, 75, 50, 43, 38
Re-entry loops
= stuck in nascar loop in a chambers pathway causing SVT / no P waves
Preexcitation Syndromes Arrhythmias Resulting from Most Common:
= Extra/s conduction pathways impulses used in assessory
= (WPW) bundle of Kent
= 2nd Lown-GanongLevine
= 3rd Mahaim Fiber
WPW definer:
Name of assessory pathway:
= has delta wave “wave leaning into R wave”
= Bundle of Kent
Lown-Ganong) definer:
Pathway name & path:
= has short PRI interval
= Bundle of James connects posterior internodal pathway to bundle of his
Paroxysmal Supraventricular Tachycardia (PSVT);
= SVT rules w/ stop or start; no P waves in SVT can be any rhythm before/after SVT
Heart blocks are
blocks in AV node partial or complete
“Putting a rock or pebble on a cable”
Propranolol, Labetalol, Metoprolol) class
Labetalol
Metoprolol
= class 2 Beta Blockers
= 2nd line med for SVT after Adenosine, A-fib/flutter w/RVR, Reduce myocardical ischemia in AMI PT’s w/elevated HR, Antihypertensive
= Hypertension, 2nd line med for A-Fib/A-Flutter w/ RVR, & SVT
(Procainamide & Lidocaine) class
= class 1A&B Na Channel Blockers
= Alterative to Amiodarone in cardiac arrest V-Fib/pVT, Stable monomorphic Ventricular TachyC w/ presserved LVF
= V-Tach with a pulse, pre-excitation rhythms (WPW) >50% QRS width
Amiodarone class & indication
Class 3 K channel blocker> VF/Pulseless VT unresponsive to shock, CPR & Epi, BradyCs to include AV blocks, Recurrent, hemodynamically unstable VT w/ pulse
(Diltiazem & Verapamil) class
Diltiazem
Verapamil
= class 4 Ca channel blocker
= 1st line med for A-Fib/Flutter w/ RVR >150 bpm, 2nd line med for SVT
refractory to adenosine
= 2nd line med for A-Fib/Flutter w/ RVR. May use as alterative after adenosine, narrow QRS complex tachycardia w/ preserved LV fn.
(Refractory periods) Absolute:
Relative:
= end of P to apex of T wave- cells absolute Beginning of repolarization
= “some really could happen” lot of cells repolar but not all so can throw out of rhythm Commodo cordis
When obtaining a 12 lead ECG, where do you place V2?
When obtaining a 12 lead ECG, where do you place V5?
When obtaining a 12 lead ECG, where do you place V6?
When obtaining a 12 lead ECG, where do you place V3?
When obtaining a 12 lead ECG, where do you place V1?
When obtaining a 12 lead ECG, where do you place V4?
When obtaining a 15 lead ECG, where do you place V4R?
= 4th ICS just left of Sternum
= Left 5th ICS anterior of auxiliary
= 5th ICS midaxillary
= ½ in between V2 & V4
= Right of Sternum 4th ICS
= 5th ICS left Midclavicular
= Right ICS midclavicular
Leads V3 & V4 view
Leads V1 & V2 view
Leads 2,3, & aVF view
Leads 1, aVL, V5, V6 view
= Anterior
= Septal
= Inferior
= Lateral
Orthodromic Re-entry loop:
Antidromic Re-entry loop
= Clockwise rentry conduction loop >narrow QRS
= counterclockwise reentry conduction loop > wide QRS
w/ (PJC) Premature Junctional Contraction) 1Rules:
2CANNOT HAVE B/C:
3Compensatory pause
4Non-compensatory pause
1= rate by rhythm, usually slightly irregular, P waves are either inverted before, +after, or hidden w/in QRS
2=have upright P wave (up P= PAC)
3= keeps cadence
4= doesn’t keep cadence
(Heart Blocks Raps) If the R is far from the P, then you have a:
Longer, longer, longer, drop, then you have a:
If some Ps don’t get through, then you have a:
If Ps and Qs don’t agree, then you have a:
= FIRST DEGREE!
= WENCKEBACH!
= MOBITZ II!
= THIRD DEGREE!
(Heart Blocks Raps) If the R is far from the P, then you have a:
FIRST DEGREE!
(Heart Blocks Raps) Longer, longer, longer, drop, then you have a
= WENCKEBACH!
(Heart Blocks Raps) If some Ps don’t get through, then you have a:
= MOBITZ II!
(Heart Blocks Raps) If Ps and Qs don’t agree, then you have a:
= THIRD DEGREE!
