Arrest Rhythms Asystole PEA Vfib/pulseless Vtach
Pulseless Electrical Activity (PEA) Note that PEA can look like any rhythm (any organized electrical activity), but if no pulse it is PEA
Course Ventricular Fibrillation
Fine Ventricular Fibrillation
One very important thing that seems like it should be easy but I always have to remember how to do: determine the rate… Find a QRS complex that is closest to a dark vertical line. Then count the number of “big boxes” until the next QRS complex. For each “big box” you pass, select the next number off the mnemonic " " to estimate the rate. Alternatively, you can count the number of big boxes between two QRS complexes and divide 300 by that number.
Sinus Tachycardia Note the rate is > 100 bpm
Atrial Fibrillation Note it is “irregularly irregular” and there are no definite p waves
Atrial flutter Note the “saw-tooth” pattern
Reentry Supraventricular Tachycardia This is a regular, narrow complex tachycardia without P waves, usually with a sudden onset and cessation
Monomorphic Ventricular Tachycardia With ventricular rhythms, QRS is usually wide. V tach is more organized electrical activity than v fib, but v tach often deteriorates into v fib so both are very bad!
Polymorphic Ventricular Tachycardia
Torsades de Pointes A special type of polymorphic Vtach- Note the “spindling” in the QRS complexes
Sinus Bradycardia Note the rate <60 bpm. Could be physiologic or symptomatic depending on the patient.
1 st Degree AV Block Note the increased PR interval
2 nd Degree AV Block: Mobitz type I (Wenckebach) Note the progressive lengthening of the PR interval until one P wave (arrow) is not followed by a QRS
2 nd Degree Block: Mobitz type II Note the regular PR interval until beats are dropped.
3rd Degree AV Block Note the regular P waves and regular ventricular “escape beats” but no relationship between the P waves and escape beats.