EKG Concepts CC

Pacemaker of the heart that beats to a rate of 60-100

SA Node

Where the impulse is delayed for optimal filling of the atria at a rate of 40-60

AV node

Name order of impulses of the heart

SA Node

AV Node

Bundle of His

Bundle Branches

Perkinje Fibers

Normal PR interval

0.12-0.20

Normal QRS interval

less than 0.12

Normal QT interval

less than 0.5 sec

What does the P wave signify

atrial depolarization

What signifies atrial repolarization

Hidden in QRS

What indicates how long impulse from SA Node to AV Node

PR interval

What does the QRS signify

Ventricular depolarization

What does the T signify

Ventricular repolarization

What signifies the about of time it takes for ventricles to depolarize and repolarize

QRS

Prolonging the QRS can cause what?

Torsades

What QTc means Torsades

over 0.5sec or 500msec

When shocking, you want to cardiovert synchronized to QRS to not shock the ___ wave

T wave (will kill them)

The ability to of heart cells to generate electrical impulses

automacity

The ability for heart muscle to respond to impulses with pumping action

Contractility

Where is the White lead located

2nd intercostal space, right MCL

Where is the Black lead located

2nd intercostal space, left MCL

Where is the brown lead located

4th intercostal space, left MCL

Where is the green lead located

right side below lowest rib

Where is the red lead located

left side below lowest rib

Only times a heart monitor can be removed

order from physician or discharge order

How often to change electrodes

Daily

Most common cause of elevated ST

Myocardial infarction

What should you obtain to confirm a QTc measurement over 0.60 sec or greater than 500msec

a 12 lead EKG

Heart alarm parameters can only be changes with ________ with the physician

collaboration

Treatment for sinus tach

underlying cause

betablockers/calcium channel

Treatment for bradycardia

Atropine (1 mg), temporary pacer

Dose for atropine

1 mg

Treatment for sinus arrhythmia

Nothing unless symptomatic (bradycardia protocol)

PAC where the QRS is normal

Normal PAC

PAC where the QRS is wide

Aberrant PAC

PAC where the QRS is missing

Nonconducted PAC

HR for SVT

greater than 150

Treatment for SVT

Vagal stimulation

Adenosine

Synchronized cardioversion

A Fib and Flutter treatment

Betablockers/Calcium channel blockers

Amiodarone

Cardioversion

Key sign of wandering pacemaker

3 P wave configurations

A fib or A flutter are at risk of what

CLOTS

Rate of a Junctional Rhythm

40-60bpm

Rate of a accelerated junctional

60-100bpm

Rate of Junctional tachycardia

greater than 100

Key Sign of bundle branch block

Wide QRS

Treatment of consious ventricular tachycardia

Amiodarone 150mg IV bolus over 10 min

Treatment of unconscious ventricular tachycardia

CPR, defib, epi 1 mg, amiodarone 300mg bolus, then 150mg bolus

What causes torsades

low Mg levels

Treatment Ventricular Fibrillation

CPR, defib, epi 1 mg, amiodarone 300mg then 150mg bolus

PEA can trick you into thinking there is a ____

pulse

PEA treatment

treat like asystole

Can you defibrillate asystole?

NOOOOO

1st degree block means

long PR interval

Mobitz II and 3rd degree are different in that Mobitz II has

equal PR intervals

Treatment of complete heart block 3rd degree

Pacer

Is Wenckebach heart block reversible?

yes

Is Mobitz II reversible

No

When a pacer is sends an impulse and successfully triggers the heart muscle

Capture

When there are pacer spikes without a QRS complex

Failure to capture

What do you want to do if pacer is having trouble capturing?

increase the mA volts

Can you put a defib electrode pad on a pacer?

NOOOO

How far must the defib pad be from a pacer?

2 inches

While pacing your patient experiences V tach/ V fib. What do you do?

Stay and assess