EKG Practicum COMPLETE

how many seconds are shown in a rhythm strip

6 secs

how many big boxes do you count in a 6 sec rhythm strip

30 big boxes

one big box is how many secs

0.2 secs

what is dis

regular sinus rhythm w a rate of 80

how did you know this was a regular sinus rhythm

each QRS has a p before it at the same rate. also normal HR

what is dis

regular sinus rhythm w a rate of 90

what is dis

sinus bradycardia w a rate of 40

how did you know this was sinus bradycardia

sinus bc there is a p for every QRS and it is at the same rate. bradycardia bc the HR <60

what is dis

sinus tachycardia w a rate of 120

how did you know this was sinus tachycardia

sinus bc there is a p for every QRS and it is at the same rate. tachycardia bc the rate is >100

Sinus Tachycardia HR

>100bpm (100-150)

what is dis

atrial fibrillation

how did you know this was a fib

irregularly irregular rhythm

no discernible P-waves

atrial rate of 300-600 (count 1 minute)

***(that’s the criteria, but when you look at A fib it’s all squiggles besides the QRS complexes)

what is dis

supraventricular tachycardia

howd you know this was SVT

you see narrow QRS and no clear P waves (p waves combine w t waves)

what is dis

Supraventricular tachycardia

how did you know this was SVT

every lead has really narrow QRS complexes and in lead 2 the p and T waves are squished into each other

what is this

first degree heart block

how’d you know this was first degree HB

PRi bigger than 1 big box (>0.2s)

what is dis

1st Degree heart Block

what is dis

Mobitz Type 1 atrioventricular block/Wenckebach/2nd degree heart block type I

howd you know this was a mobitz type 1 HB

PRi gets progressively longer and longer then drops a QRS (so you see p w no QRS)

what is dis

Mobitz Type 1 atrioventricular block/Wenckebach/2nd degree heart block type I

what is dis

Mobitz II atrioventricular block w sinus rhythm

howd you know this was mobitz II atrioventricular block w sinus rhythm

each QRS has a p wave (so its sinus), then random p wave not followed by QRS w no prior pattern

what is this

mobitz II atrioventricular block w sinus rhythm

what is dis

3rd degree atrioventricular block

howd yk this was 3rd degree atrioventricular block

p and QRS have independent activity (no relation b/w the 2)

what is dis

3rd degree atrioventricular block

what is dis

Mobitz II atrioventricular block

what is dis

atrial escape rhythm

howd yk this was an Atrial Escape Rhythm

1 weird looking p-wave

rate of 60-80, never >100

narrow QRS

what is dis

junctional escape rhythm with a rate of 50

howd yk this was a junctional escape rhythm

missing p waves, lone QRS

criteria for Junctional Escape Rhythm

HR of 40-60, narrow QRS, and 1 of the following:

• missing P wave

• upside down P

• P in QRS

• P after QRS

what is dis

junctional escape rhythm w a rate of 40

howd you know that it was a junctional escape rhythm

retrograde p wave, HR b/w 40-60, narrow QRS

what is dis

sinus rhythm with a unifocal premature ventricular complex with a rate of 60

how do yk this is a unifocal PVC

narrow QRS besides 1 wide QRS that squiggles down that doesn’t show again

what is this

Wolff Parkinson White syndrome

how do yk this is Wolff-Parkinson-White syn

delta wave, wide WRS, short PRi

what is this

sinus rhythm with unifocal premature ventricular complexes with a rate of 90

howd yk this was sinus rhythm with unifocal premature ventricular complexes with a rate of 90

all other QRS’s have a p wave, then a QRS squiggles out and then strip is nl again. unifocal = only one weird shape

what is dis

sinus rhythm with a run of ventricular tachycardia

howd you know this had a run of ventricular tachycardia

wide QRS, fast rhythm but still kinda organized

what is this

ventricular tachycardia

what is this

Ventricular Fibrillation

howd yk that is v fib

chaotic unorganized squiggles with no QRS seen. pulseless pt

anterior leads

V1-V4

lateral leads

I, AVL, V5, V6

inferior leads

II, III, AVF

what sign shows ischemia

inverted T wave

what sign shows active injury

ST elevation

what sign shows previous infarction

Q wave

what is dis

anterior wall acute myocardial infarction with injury

why is this an ant wall AMI w injury

bc there is ST segment elevation (injury/acute) in leads V2, V3, and V4 which are the anterior wall

what is dis

anterior wall myocardial injury

howd yk this was an ant wall MI injury

tombstone appearance showing big ST seg elevation in leads V2-v6

what is this

inferior wall acute myocardial infarction w injury

howd yk that was an inferior wall acute MI w injury

ST segment elevation (acute/injury) in II, III, and AVF (inferior

what is dis

antero-lateral wall acute myocardial infarction with injury

howd yk this is antero-lateral wall acute myocardial infarction with injury

ST segment elevations (acute/injury) in I, aVL (lateral), and V1-V6 (anterior)

what is dis

Lateral Wall Myocardial Injury

howd you know thats Lateral Wall Myocardial Injury

ST elevations in leads I, avL, V5, V6

what is dis

inferior wall myocardial injury

howd yk this was Inferior Wall Myocardial Injury

ST elevations in leads II, III, avF

what is dis

pericarditis

howd yk this is pericarditis

global ST segment elevation (the slope) and PR depression

what is dis

ventricular tachycardia

howd yk this is v tach

everything is hella wide and fast

what is dis

hyperkalemia

howd yk this was Hyperkalemia

tall T wide QRS

what is dis

hypokalemia

howd yk this was Hypokalemia

T waves flatten

U waves

what is dis

hypercalcemia

howd yk this was Hypercalcemia

shortened QT interval that they’re almost on top of each other (spec. this image)

what is dis

hypocalcemia

howd yk this is Hypocalcemia

prolonged QT interval

what is dis

digoxin toxicity

howd yk this is dig tox

Shortening of QT interval

"Scooped" or "sagging" ST depressions diffusely

Flattened/inverted/Biphasic T wave

***salvador daaali

what is dis

pacemaker rhythm with a rate of 60

howd yk this is a pacemaker rhythm

there is a line before every QRS

what is dis

sinus rhythm with bigeminy w a rate 60

how did you know this is sinus rhythm with bigeminy w a rate 60

nl QRS’s have p waves (sinus), every other beat is a PVC OR 2 back to back (bigeminy)

what is dis

sinus rhythm w bigeminy w a rate of 70

howd you know this was bigeminy

bc there are 2 wonky QRS’s next to each other where everything else looks the same

what is dis

sinus rhythm with trigeminy w a rate of 80

how did you know this was Trigeminy

every third beat is a PVC (wonky QRS)

what is dis

sinus rhythm with Quadrigeminy with a rate of 80

howd yk this was quadrigeminy

every 4th beat was a PVC

what is dis

sinus rhythm with multifocal premature ventricular complexes w a rhythm of 50

Osborn J Wave => Hypothermia

Little hump after S

what is dis

Torsades de Pointes

howd yk thats torsades de pointes

party streamer appearance. dangerous V tach WITH PULSE

what is dis

torsades de pointes

what is dis

wandering atrial pacemaker

howd yk that is a Wandering Atrial Pacemaker

different p wave shapes. rate <100

what is dis

multifocal atrial tachycardia

howd yk this was Multifocal Atrial Tachycardia

rate >10 with different p wave shapes

what is dis

pulmonary embolism