EKG Rhythm Strips 35
Identify the following rhythms
1.
2.
3.
4.
5.
Answers
1.
The rhythm begins with complete heart block and changes to P wave asystole. After the 2nd QRS complex there is a complete loss of ventricular activity and only P waves are seen. With the loss of ventricular activity all cardiac output is loss. Although there is a rhythm on the monitor, the patient is now pulseless so immediate CPR is indicated. Epinephrine and vasopressin may given but attention must be given to treating the underlying cause of this rhythm change.
2.
The rhythm is regular with a heart rate of 60/min. Some sinus P waves are seen as well as some atrial paced P waves, the 1st and 7th P waves. The PR interval is prolonged on the sinus P waves. The QRS complexes are preceded by a ventricular pacer spike. PR: .44 sec, QRS: .16 sec, QT: .48 sec.
3.
The rhythm is regular with a ventricular rate of 71/min. There are flutter waves between the QRS complexes. No ectopic beats are seen. PR: ---, QRS: .08 sec, QT: .24 sec.
4.
The rhythm is regular with a rate of 45/min. The P waves are absent. No ectopic beats are noted. The QRS complex is narrow. PR: ---, QRS: .08 sec, QT: .44 sec.
5.
The rhythm begins with a coarse ventricular fibrillation and transitions into asystole. The treatment of choice for ventricular fibrillation is immediate defibrillation, however, with the change in the rhythm to aystole defibrillation is no longer an option. Treatment of asystole includes high quality CPR, vasoconstrictors: epinephrine or vasopressin, and investigation of reversible causes: hypoxia, hypovolemina, acidosis, hypothermia, hyper/hypokalemia, tension pneumothorax, overdoses/poisioning, cardiac tamponade, coronary thrombosis, or pulmonary embolism.
Reviewed 3/2/16
1.
Answers
1.
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| 3rd degree heart block changing to ventricular standstill |
The rhythm begins with complete heart block and changes to P wave asystole. After the 2nd QRS complex there is a complete loss of ventricular activity and only P waves are seen. With the loss of ventricular activity all cardiac output is loss. Although there is a rhythm on the monitor, the patient is now pulseless so immediate CPR is indicated. Epinephrine and vasopressin may given but attention must be given to treating the underlying cause of this rhythm change.
2.
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| Ventricular paced with demand atrial pacing |
The rhythm is regular with a heart rate of 60/min. Some sinus P waves are seen as well as some atrial paced P waves, the 1st and 7th P waves. The PR interval is prolonged on the sinus P waves. The QRS complexes are preceded by a ventricular pacer spike. PR: .44 sec, QRS: .16 sec, QT: .48 sec.
3.
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| Atrial flutter |
The rhythm is regular with a ventricular rate of 71/min. There are flutter waves between the QRS complexes. No ectopic beats are seen. PR: ---, QRS: .08 sec, QT: .24 sec.
4.
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| Junctional rhythm |
The rhythm is regular with a rate of 45/min. The P waves are absent. No ectopic beats are noted. The QRS complex is narrow. PR: ---, QRS: .08 sec, QT: .44 sec.
5.
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| Ventricular fibrillation changing to asystole |
The rhythm begins with a coarse ventricular fibrillation and transitions into asystole. The treatment of choice for ventricular fibrillation is immediate defibrillation, however, with the change in the rhythm to aystole defibrillation is no longer an option. Treatment of asystole includes high quality CPR, vasoconstrictors: epinephrine or vasopressin, and investigation of reversible causes: hypoxia, hypovolemina, acidosis, hypothermia, hyper/hypokalemia, tension pneumothorax, overdoses/poisioning, cardiac tamponade, coronary thrombosis, or pulmonary embolism.
Reviewed 3/2/16
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