Tuesday, February 10, 2015

Practice EKG Strips 406

Identify the following rhythms.

1.







a. Sinus arrhythmia
b. Sinus arrest
c. 2nd degree heart block type I
d. Sinus rhythm with dropped PACs

2.











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

3.











a. Successful defibrillation of atrial fibrillation
b. Unsuccessful cardioversion of atrial fibrillation
c. Successful cardioversion of atrial fibrillation
d. Unsuccessful capture and pacing of atrial fibrillation with slow ventricular response

4.













a. Epinephrine 1 mg IV q3 - 5 minutes
b. Magnesium 1 - 2 grams IV infused over 15 - 30 minutes
c. Calcium chloride 10% IV push
d. Amiodarone 150 mg IV infused over 30 minutes

5.











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

Answers
1.c. 2nd degree heart block type I. The rhythm is irregular with a rate of about 50 bpm. The P waves have a positive axis. The PR interval gets progressively longer in the first three complexes and this is followed by a nonconducted P wave after the 3rd complex. The cycle repeats itself in the next three complexes. PR: .12/.20/.24 sec. QRS: .08 sec, QT: .40 sec.

2.  b. Polymorphic VT. The electrical axis on the QRS complex remains positive. In TdP the electrical axis will show cyclic changes in the electrical axis of the QRS complexes.

3.  c. Successful cardioversion of atrial fibrillation. On one of yesterdays EKG strips we almost killed our patient with an inappropriate defibrillation. Today we saved the patient. I like happy endings

4. b. Magnesium 1 - 2 grams IV infused over 15 - 30 minutes. Compare this strip to the polymorphic VT strip that was also posted today and you can see that in this strip there is a cyclic change in the electrical axis

5. a. Demand atrial pacing.

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