Paramedicine 2nd year ECG rhythm things to know

Normal Sinus Rate

60-100

Sinus Tachycardia rate

>100

Sinus Bradycardia Rate

<60

Sinus Dysrhythmia rhythm

Irregular waxing/waning pattern

Atrial Flutter key characteristics

Sawtooth pattern with regular RRI

Atrial Fibrillation key characteristics

Chaotic pattern with irregularly irregular RRI

Rapid AF ventricular rate

> or = 100

Atrial bradycardia key characteristics

rate of <60 and uniform Ps

Atrial Rhythm key characteristics

rate of 60-100 and uniform Ps

Atrial tachycardia key characteristics

rate of >100 and uniform Ps

Multifocal atrial bradycardia key characteristics

rate of <60 and varying Ps

Wandering atrial rhythm key characteristics

rate of 60-100 and varying Ps

Multifocal atrial tachycardia key characteristics

rate of >100 and varying Ps

Key characteristics of junctional rhythms

• Inverted P waves

• short PRI

• P waves that are pre, mid or post QRS

• Absent P waves

Characteristics of all atrial rhythms

abnormal P waves

Junctional Bradycardia rate

<40

junctional escape rhythm rate

<60

accelerated junctional rhythm rate

60-100

junctional tachycardia rate

>100

when a junctional rhythm is too fast to see P waves

SVT

Supraventricular tachycardia criteria (4 points)

Regular, Rate >150 BPM, no discernible P wave or PR interval, Narrow QRS

Main characteristic of ventricular rhythms

Wide QRS

Rate of asystole

0

Rate of agonal rhythm

0-10

Rate of idioventricular rhythm

10-40

Rate of accelerated idioventricular rhythm

40-100

Rate of ventricular tachycardia

>100

main characteristic of ventricular fibrillation

bizarre waveforms

Ectopics are..

not part of the underlying rhythm

characteristics of atrial ectopics (2 points)

Same shaped P wave as underlying atrial rhythm. Usually a narrow QRS

characteristics of junctional ectopics (3 points)

inverted P waves, may not be visible. Short PRI when present, Usually a narrow QRS

Characteristics of ventricular ectopics (3 points)

No P waves. T waves are in opposite direction. Wide bizarre QRS

main characteristic of first degree heart block

PRIs >5mm

Main characteristic of second degree heart block type 1

PRIs get longer until one p wave does not produce a QRS complex and the cycle repeats.

Main characteristic of second degree heart block type 2

PRI is the same across entire strip but PRI could be more or less than 3mm

main characteristics of both types of second degree heart block

some P waves do not have QRS complexes following them

Main characteristic of third degree heart block

atria and ventriclels not working together at all

how to tell which pace maker is controlling ventricles in 3rd degree heart block

check innate rate and QRS width