Saturday, September 29, 2012

Code Blue


Again the vision of the white gate returns.  And this time with his hand Maximus pushes open the gate.  In the distance can be seen tall green cedars that line the road leading home.  And beyond the his home can be seen an open field of golden wheat being gently blown by the wind.  As he slowly crosses this sea of wheat, he can see two figures standing in the far off distance and the sound of boyish laughter can be heard.  As the wind blows across this field of wheat it looks like great waves rolling across the face of the sea.   With each wave, his steps become lighter and the cares that once held him are slowly washed away. As he wades through the field of golden wheat his wife and son look up and see him.  Upon recognizing him, his son smiles and runs toward him …now he is home; now he is finally free.

“Gladiator” and all related marks and media are
TM & c2000 DreamWorks LLC & Universal Studios. 


Refractory Ventricular Fibrillation




Amiodarone 300mg IV push

CPR Rhythm






5th Shock at 360 J











Refractory Ventricular Fibrillation










Epinephrine 1mg IV push

CPR rhythm








Sodium Bicarbonate 50mEq IV push

CPR Rhythm









Rhythm Check Reveals Refractory Ventricular Fibrillation














Refractory Ventricular Fibrillation










The family decided to stop any further resuscitative attempts and the code was ended.




Friday, September 28, 2012

Code Blue


From the movie Gladiator

As Maximus stands unsteadily to his feet, the vision comes to him once again, this time more clearly than before.  His wife and son are there.  As he loses consciousness, he falls to the ground.  From out of the stadium comes Lucilla.  She runs into the arena and drops to his side and calls his name.

Maximus’ eyes open and looks up at her and in a whispered voice asks, “Lucius is safe?”

Lucilla gives him a reassuring nod.  At peace now, his eyes close and the light slowly fades.  Lucillia, sensing that death is near, urges him to “Go to them.”  With his face calm and at rest, the gladiator takes his last breath. 



Ventricular tachycardia


1st shock at 200 J


Refractory ventricular tachycardia

Epinephrine 1mg IV push given

CPR Rhythm






2nd Shock at 300 J


Ventricular Fibrillation


Vasopression 40 units given

CPR Rhythm











3rd shock at 360 J







Refractory Ventricular Fibrillation















Epinephrine 1mg IV given

CPR Rhythm












4th Shock at 360 J





Thursday, September 27, 2012

EKG Rhythm Strip Quiz 60

Identify the following rhythm strips.

1.





a.  1st degree block
b.  Sinus bradycardia 
c.  Sinus arrhythmia 
d.  2nd degree heart block type II 


2.







a.  Agonal rhythm
b.  Ventricular standstill
c.  3rd degree heart block 
d.  Junctional rhythm


3.





a.  AV paced
b.  Ventricular paced
c.  Atrial pacing
d.  Biventricular pacing 


4.




a.  Demand atrial paced
b.  Demand ventricular paced
c.  Demand AV pacing
d.  Demand biventricular pacing 


5.





a.  Sinus bradycardia
b.  Idioventricular rhythm
c.  Agonal rhythm
d.  Atrial fibrillation with slow ventricular response


6.




a. Sinus tachycardia
b. Atrial flutter with rapid ventricular response
c. Supraventricular tachycardia
d. Junctional tachycardia 


7.






a.  Multifocal atrial tachycardia
b.  Ventricular fibrillation
c.  Atrial fibrillation
d.  Ventricular tachycardia


8.





a.  Normal sinus rhythm
b.  Sinus arrhythmia
c.  Atrial fibrillation
d.  Wandering atrial pacemaker 


9.






a.  Normal sinus rhythm with 1st degree block
b.  Sinus bradycardia
c.  Atrial flutter
d.  2nd degree heart block type II


10.





a.  Normal sinus rhythm with 1st degree block
b.  Sinus bradycardia
c.  2nd degree heart block type II
d.  Atrial flutter with variable rate


11.





a.  Atrial fibrillation with slow ventricular response  
b.  3rd degree heart block
c.  Agonal rhythm
d.  Junctional rhythm


12.





a.  2nd degree AV block type II
b.  Atrial flutter with controlled rate
c.  Atrial fibrillation with rapid ventricular response
d.  Wandering atrial pacemaker 


13.





a.  AV paced
b.  Ventricular paced
c.  Atrial pacing
d.  Biventricular pacing 


14.






a.  Junctional rhythm
b.  Sinus bradycardia
c.  Idioventricular rhythm
d.  Atrial fibrillation with slow ventricular response


15.







a. Sinus tachycardia
b. Junctional tachycardia
c. Atrial flutter with rapid ventricular response  
d. Supraventricular tachycardia


16.






a.  Polymorphic ventricular fibrillation
b.  Idioventricular rhythm
c.  Ventricular fibrillation
d.  Torsades de pointe 


17.






a.  Ventricular tachycardia
b.  Idioventricular rhythm
c.  Ventricular fibrillation
d.  Atrial fibrillation 


18.
a.  Sinus arrrhythmia
b.  2nd degree heart block type II
c.  Compete heart block
d.  Sinus rhythm with sinus pauses

19.


a.  Bradycardia with sinus arrhythmia
b.  Idioventricular rhythm
c.  Complete heart block
d.  Accelerated junctional rhythm


20.
a.  2nd degree AV block type II
b.  Sinus arrhythmia
c.  Atrial flutter
d.  Wandering atrial pacemaker 


21.
a.  Atrial paced
b.  Ventricular paced
c.  AV pacing
d.  Biventricular pacing 


22.
a.  3rd degree heart block
b. Accelerated idioventricular rhythm
c.  Agonal rhythm
d.  Junctional rhythm

23.
a.  Multifocal atrial tachycardia
b.  Wandering atrial pacemaker
c.  Atrial fibrillation
d.  Atrial tachycardia

24.
a.  Torsades de pointe
b.  Accelerated Idioventricular rhythm
c.  Ventricular tachycardia
d.  Supraventricular tachycardia 

25.





a. Normal sinus rhythm with 1st degree block
b. Ventricular paced
c. Accelerated junctional rhythm
d. Accelerated idioventricular rhythm



Answers

1.     a.  1st degree block
2.     a.  Agonal rhythm
3.     c.  Atrial pacing
4.     d.  Demand biventricular pacing
5.     d.  Atrial fibrillation with slow ventricular response
6.     c. Supraventricular tachycardia
7.     b.  Ventricular fibrillation
8.     d.  Wandering atrial pacemaker
9.     d.  2nd degree heart block type II
10.   c.  2nd degree heart block type II
11.   b.  3rd degree heart block
12.   c.  Atrial fibrillation with rapid ventricular response
13.   a.  AV paced
14.   c.  Idioventricular rhythm
15.   b. Junctional tachycardia
16.   d. Torsades de pointe
17.   a.  Ventricular tachycardia
18.   b.  2nd degree heart block type II
19.   d.  Accelerated junctional rhythm
20.   c.  Atrial flutter
21.   d.  Biventricular pacing
22.   d.  Junctional rhythm
23.   a.  Multifocal atrial tachycardia
24.   c.  Ventricular tachycardia
25.   b. Ventricular paced


Reviewed 6/4/13, 3/6/16

Wednesday, September 26, 2012

EKG Rhythm Strip Quiz 59

Identify the following rhythms.

1.





a. 1st degree AV block
b. Junctional rhythm
c. Normal sinus rhythm
d. Sinus tachycardia

2.





a.  Idioventricular rhythm
b.  Mobitz II
c.  Complete heart block
d.  Sinus bradycardia

3.





a.  3rd degree AV block
b.  Agonal rhythm
c.  Junctional rhythm
d.  Accelerated idioventricular rhythm

4.



a.  Sinus tachycardia
b.  Ventricular tachycardia
c.  Atrial fibrillation with controlled ventricular response
d.  Atrial tachycardia

5.





a.  Accelerated idioventricular rhythm
b.  Demand AV paced
c.  Ventricular tachycardia
d.  Pacemaker failure to capture

6.




a.  Junctional tachycardia
b.  Accelerated junctional rhythm
c.  Supraventricular tachycardia
d.  Ventricular tachycardia

7.





a.   Junctional rhythm
b.   Idioventricular rhythm
c.   Complete heart block
d.  P wave asystole


8.




a.  Atrial fibrillation
b.  Ventricular paced
c.  Accelerated idioventricular rhythm
d.  Complete heart block

9.





a.   Wandering atrial pacemaker
b.   Ventricular tachycardia
c.   Accelerated idioventricular rhythm
d.   3rd degree AV block

10.




a.   Atrial fibrillation with slow ventricular response
b.   Complete heart block
c.   2nd degree AV block type I
d.   2nd degree AV block type II

11.







a.   1st degree AV block
b.   2nd degree AV block type I
c.   2nd degree AV block type II
d.   3rd degree AV block


12.




a.  Atrial paced
b.  AV paced
c.  Ventricular paced
d.  Biventricular paced

13.



a.  Atrial flutter
b.  Atrial fibrillation
c.  2nd degree AV block type II
d.  P wave asystole

14.




a.   Junctional tachycardia
b.   Atrial tachycardia
c.   Multifocal atrial tachycardia
d.   Sinus tachycardia

15.




a.   Junctional tachycardia
b.   Atrial tachycardia
c.   Ventricular tachycardia
d.   Supraventricular tachycardia


16.





a.  Atrial fibrillation
b.  Ventricular fibrillation
c.  Atrial flutter
d.  Ventricular flutter

17.






a.   Slow ventricular tachycardia
b.   Idioventricular rhythm
c.   Junctional rhythm
d.   Complete heart block

18.
a.   1st degree AV block
b.   2nd degree AV block type I
c.   2nd degree AV block type II
d.   3rd degree AV block


19.
a.   Normal sinus rhythm
b.  Accelerated junctional rhythm
c.  2nd degree AV block type I
d.  Atrial fibrillation

20.
a.  Atrial fibrillation
b.  1st degree AV block
c.  Atrial paced
d.  Junctional rhythm

21.
a.  Atrial paced
b.  AV paced
c.  Ventricular paced
d.  Biventricular paced

22.
a.  Sinus bradycardia
b.  Junctional rhythm
c.  Idioventricular rhythm
d.  Complete heart block

23.
a.   Junctional tachycardia
b.   Atrial tachycardia
c.   Multifocal atrial tachycardia
d.   Sinus tachycardia

24.
a.  Torsades de pointe
b.  Polmorphic ventricular fibrillation
c.  Ventricular tachycardia
d.  Atrial fibrillation with rapid ventricular response.

25.






a.  Accelerated idioventricular rhythm
b.  Polmorphic ventricular tachycardia
c.  Monomorphic ventricular tachycardia
d.  Atrial fibrillation with rapid ventricular response.




Answers

1.   a. 1st degree AV block
2.   c.  Complete heart block
3.   b.  Agonal rhythm
4.   d.  Atrial tachycardia
5.   b.  Demand AV paced
6.   a.  Junctional tachycardia
7.   d.  P wave asystole
8.   b.  Ventricular paced
9.   a.  Wandering atrial pacemaker
10. c.  2nd degree AV block type I
11. d.  3rd degree AV block
12. b.  AV paced
13. a.  Atrial flutter
14. a.  Junctional tachycardia
15. d.  Supraventricular tachycardia
16. b.  Ventricular fibrillation
17. b.   Idioventricular rhythm
18.  c.  2nd degree AV block type II
19.  b.  Accelerated junctional rhythm
20.  c.  Atrial paced
21.  d.  Biventricular paced
22.  b.  Junctional rhythm
23.  c.  Multifocal atrial tachycardia
24.  a.  Torsades de pointe
25.  c.  Monomorphic ventricular tachycardia


Reviewed 6/4/13, 3/6/16