EKG Rhythm Strips 34
Identify the following rhythms.
1.
2.
3.
4.
5.
Answers
1.
The rhythm is irregular due to the multiple ectopic beats. The ventricular rate is 96/min. The P waves are positive and are associated with a QRS complex. There are ectopic beats every other beat. The character of these ectopic beats is different and there are some P waves present before some of the beats, the 3rd and 4th ectopic beats. These two ectopic beats may represent aberrantly conducted PACs. PR: .12 sec, QRS: .08 sec, QT: .32 sec.
2.
The rhythm begins with fine ventricular fibrillation and deteriorates into aystole. The treatment of asystole begins with high quality CPR: adequate depth of compression, at least 100/min, minimizing interruptions, and avoiding hyperventilation. Attention should be given to treating reversible causes: hypoxia, hypovolemia, hydrogen ions (acidiosis), tamponade, tension pneumothorax, and thrombosis (cornonary and pulmonary).
3.
The rhythm is regular with a rate of 150//min. There are small P waves before each QRS complex. No ectopic beats are noted. The QRS complex is wide. PR: .10 sec, QRS: .14 sec, QT: ---
4
The rhythm is irregular with a rate of 50/min. The P waves are absent. A single PVC is noted at the beginning of the rhythm strip. PR: ---, QRS: .10 sec, QT: .40 sec.
5.
The rhythm is regular with wide, bizarre-looking QRS complexes. No atrial activity is noted. This rhythm is one of many PEA rhythms. There will be a rhythm on the monitor but the patient will be pulseless. In this case, immediate CPR is indicated. Epinephrine may be given to maintain the heart rate and blood pressure. The rescuer should give immediate attention to addressing any reversible causes that may have contributed to this rhythm.
Reviewed 3/1/16
1.
Answers
1.
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| NSR with ventricular bigemeny |
The rhythm is irregular due to the multiple ectopic beats. The ventricular rate is 96/min. The P waves are positive and are associated with a QRS complex. There are ectopic beats every other beat. The character of these ectopic beats is different and there are some P waves present before some of the beats, the 3rd and 4th ectopic beats. These two ectopic beats may represent aberrantly conducted PACs. PR: .12 sec, QRS: .08 sec, QT: .32 sec.
2.
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| Ventricular fibrillation changing to asystole |
The rhythm begins with fine ventricular fibrillation and deteriorates into aystole. The treatment of asystole begins with high quality CPR: adequate depth of compression, at least 100/min, minimizing interruptions, and avoiding hyperventilation. Attention should be given to treating reversible causes: hypoxia, hypovolemia, hydrogen ions (acidiosis), tamponade, tension pneumothorax, and thrombosis (cornonary and pulmonary).
3.
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| Sinus tachycardia with a wide QRS complex. |
The rhythm is regular with a rate of 150//min. There are small P waves before each QRS complex. No ectopic beats are noted. The QRS complex is wide. PR: .10 sec, QRS: .14 sec, QT: ---
4
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| Junctional rhythm with occasional PVC |
The rhythm is irregular with a rate of 50/min. The P waves are absent. A single PVC is noted at the beginning of the rhythm strip. PR: ---, QRS: .10 sec, QT: .40 sec.
5.
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| Agonal rhythm |
The rhythm is regular with wide, bizarre-looking QRS complexes. No atrial activity is noted. This rhythm is one of many PEA rhythms. There will be a rhythm on the monitor but the patient will be pulseless. In this case, immediate CPR is indicated. Epinephrine may be given to maintain the heart rate and blood pressure. The rescuer should give immediate attention to addressing any reversible causes that may have contributed to this rhythm.
Reviewed 3/1/16
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