Thursday, March 19, 2015

Practice EKG Strips 433

Identify the following rhythms.

1.











a. Sinus bradycardia
b. Sinus rhythm
c. Junctional rhythm
d. Idioventricular rhythm

2. In a cardiac arrest, what is the correct dosage for the second dose of Amiodarone used to treat refractory VT?











a. Amiodarone 100 mg
b. Amiodarone 150 mg
c. Amiodarone 200 mg
d. Amiodarone 300 mg

3.











a. Atrial fibrillation
b. Atrial tachycardia
c. Atrial flutter
d. Atrial paced


4.













a. Sinus rhythm with demand AV pacing
b. Atrial fibrillation with demand AV pacing
c. Complete heart block with demand AV pacing
d. Junctional rhythm with demand AV pacing


5.












a. Atrial fibrillation with slow ventricular response
b. Sinus bradycardia
c. Junctional rhythm
d. Complete heart block

Answers
1. a. Sinus bradycardia. The rhythm looks regular. The rate is around 55/min. There are P waves before each QRS complex. The P waves are uniform. The QRS complexes are narrow. No ectopic beats are seen. PR: .20 sec, QRS: .08 sec, QT: .40 sec.

2. b. Amiodarone 150 mg.  IV amiodarone affects sodium, potassium, and calcium channels and has α- and β-adrenergic blocking properties. It is the first antiarrhythmic that is considered for treatment of VF or pulseless VT unresponsive to shock delivery, CPR, and vasopressors.  An initial dose of 300 mg IV/IO can be followed by a second dose of 150 mg IV/IO.

3. c. Atrial flutter. The rhythm is regular. The rate is 75/min. There are 3:1 flutter waves present.

4. a. Sinus rhythm with demand AV pacing. The rhythm is 100% ventricular paced. The 5th and 6th complexes have a native P wave present. The QRS complexes look like some kind of fusion beats between an intrinsic QRS complex and a paced QRS complex.

5. c. Junctional rhythm. No P waves are seen. The rate is around 46/min. There is an rSR complex in the V1 lead. So, normally you would probably want to call this an accelerated idioventricular rhythm but in this case the patient has a known RBBB which is the cause of the wide QRS complex.

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