Saturday, June 29, 2013

Basic EKG Rhythm Test 09

Identify the following rhythms

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Answers

01.    Atrial fibrillation
02.    Sinus tachycardia
03.    Ventricular paced
04.    Accelerated junctional rhythm
05.    Sinus bradycardia with bigeminal PVCs
06.    Junctional rhythm
07.    Multifocal atrial tachycardia
08.    1st degree AV block with PJCs
09.    2nd degree AV block type I
10.    Normal sinus rhythm
11.    Agonal rhythm
12.    Atrial paced
13.    Supraventricular tachycardia
14.    Ventricular tachycardia
15.    Idioventricular rhythm
16.    Complete heart block
17.    Junctional tachycardia
18.    Normal sinus rhythm with PACs
19.    Dual paced
20.    Sinus tachycardia with a sinus pause
21.    Sinus arrhythmia
22.    1st degree AV block
23.    2nd degree AV block type II
24.    Atrial flutter
25.    Ventricular fibrillation

Friday, June 28, 2013

Practice EKG Rhythm Strips 155

Identify the following rhythms.

1.













2.



3.



4.


5.















Answers

1.













There is AV dissociation.  The atrial rate is regular with a rate of 107/min and a ventricular rate of 32/min.  The P waves are positive and uniform but have no relationship to a QRS complex.  No ectopic beats are present.  PR:  ---,  QRS:  .16 sec,  QT:  .66 sec.

2.


The rhythm is irregular.  The rate is 70/min.  The P waves are splint but are associated with a QRS complex.  The 3rd complex occurs early and has a change in the P wave morphology.   This is especially evident in the lower V1 lead.  This is followed by a junctional escape beat, 4th complex,  then a sinus beat.   The 6th complex is another PAC.   This is followed by another sinus looking beat.  PR:  .20 sec,  QRS:  .10 sec,  QT:  .40 sec.

3.
Junctional rhythm
The rhythm is regular with a rate of 50/min.  Retrograde P waves precede the QRS complex.  No ectopic beats are present.  PR:  .12 sec,  QRS;  .06 sec,  QT:  .32 sec.

4.
1st degree block with a PVC
 The rhythm is regular.   The rate is 83.   There are upright P waves before each QRS complex.  The PR interval is prolonged at .24 sec.   The QRS complex is wide .12 sec.   The QT interval is .40 sec.

5.
Sinus arrhythmia








The rhythm is irregular.   The rate is 60.   There are upright P waves before each QRS complex.  No ectopic beats are present.  The PR:  .16 sec,   QRS: .08 sec,  QT: .40 sec.






Thursday, June 27, 2013

Practice EKG Rhythm Strips 154

Identify the following rhythms.

1.


2.



3.



4.



5.













Answers

1.

Spraventricular tacycardia

The rhythm is regular.   The rate is 166/min.  No readily identifiable P waves are present.  No ectopic beats are present.  The QRS is narrow, 0.08 sec.  The QT interval is 0.28 sec.

2.
Sinus tachycardia with 1st degree block and a PVC













The rhythm is irregular due to the PVC.  The rate is 110/min.  The P waves are upright and precede QRS complex.  The PR interval is prolonged.  A single PVC is present and it coupled with a P wave.  PR:  .24 sec,  QRS:  .08 sec,  QT:  .36 sec.


3.
1st degree block changing to 2nd degree type II
The rhythm starts out as a 1st degree block with a PR interval of .32 and then transitions into a type I block and then a type II block.

4.
Polymorphic ventricular tachycardia changing to sinus bradycardia













The strip begins with polymorphic ventricular tachycardia which abruptly changes to a sinus bradycardia.  The first P wave is negative and appears junctional.   The following complexes are sinus in origin.  The QT interval is prolonged which may help to explain why the patient was having these runs polymorphic ventricular tachycardia.  PR:  .12 sec,  QRS:  .08 sec,  QT: .56 sec.


5.
Ventricular paced













The rhythm is regular with a rate of 93/min.  The P waves are upright and are associated with the QRS complexes.  No ectopic beats are present.  A ventricular pacer spike occurs before each QRS complex.  PR:  .16 sec,  QRS:  .16 sec,  QT:  .42 sec.

Wednesday, June 26, 2013

Practice EKG Rhythm Strips 153

Identify the following rhythms.

1.


2.


3.


4.


5.














Answers


1.
Agonal rhythm
Agonal rhythm is a slow idioventricular rhythm with a rate of less than 20.   A terminal rhythm that often precedes asystole and death.


2.
Demand pacing with unifocal PVCs
The rhythm is irregular due to the ectopic beats.   The rate is  60/min.   The are some native P waves as well as some that are pacemaker generated.  On the first complex the P wave is generated by the patient.  The PR interval is prolonged and measures .26 sec.  On the subsequent complexes a P wave is not sensed by the pacemaker so the atrial pacemaker generates an impulse within it's set parameters.  The ventricle is completely paced.  Two unifocal PVCs are present.  PR:  .24 sec, QRS:  .16 sec,  QT:  .48 sec.


3.
Sinus pause

The rhythm is irregular because of the pause.  The rate is 60/min.  The P waves are upright and precede the QRS complex but the PR interval is prolonged.  A sinus pause occurs after the 5th complex.  PR:  .28 sec,  QRS:  .10 sec  QT:  .42 sec.

4.
Sinus bradycardia
The rhythm is regular.   The rate is 57.   One upright P wave for every QRS complex. No ectopic beats are present.  PR: 16 sec.   QRS:  .08 sec,  QT:  .38 sec.


5.
Sinus tachycardia with a PVC

















The rate is irregular due to the PVC.   The rate is 110/min.  The P waves are positive, uniform, and precede each QRS complex.  A single PVC occurs toward the end of the strip.  PR:  .12 sec,  QRS:  .08 sec,  QT:  .32 sec.