9-17 Sinus Rhythms

what is the only way to tell difference between sinus rhythms

rate and rhythmicity

what are the rates for the sinus rhythms

NSR 60-100

brady <60

sinus tach 100-170

• 150-170 is difficult to diagnose

sinus dysrhythmia 0-170 but irregular

sinus block

sinus node fires normally but the impulse in blocked from exiting the node. The gap is an exact (within 1mm) multiple (complete comensatory pause)

• remember to identidy underlying rhythm

sinus arrest

the SA node just doesnt fire and then begins again. Not an exact multiple. Incomplete non-compensatory pause

• remember to identidy underlying rhythm

causes for sinus tach

fear, pain, anxiety, hypovolemia, hypoglycemia, hypoxia- adults, stimulant use, exercise, fever

A SYMPTOM OF UNDERLYING CAUSE, DONT TREAT SINUS TACH, TREAT THE CAUSE

Sinus brady causes

acute MI (inferior and posterior), hypoxia- peds, hypothermia, side effect of certain meds. Normal for athletes, excessive vagal tone- suctioning, increased ICP

symptoms for insufficient cardiac output

for rhythms LESS than 50 or GREATER than 150:

CRASH

hypotension (SBP <90 or MAP <60)

Ischemic chest pain

S/S of shock (skin signs)

AMS- including syncope

Acute pulmonary edema