Monday, January 23, 2017

Basic EKG Rhythm Test 43



01. Identify the following rhythm.














a. Complete heart block
b. Sinus bradycardia
c. Second degree heart block type II
d. Idioventricular rhythm

02. Identify the following rhythm.













a. Sinus arrhythmia
b. 2nd degree heart block type II
c. Junctional rhythm
d. Sinus bradycardia with sinus arrest

03. Identify the following rhythm.












a. Second degree heart block type I
b. Sinus rhythm with a dropped PAC
c. Sinus bradycardia
d. Sinus arrest

04. Identify the following rhythm.














a. Agonal rhythm
b. Junctional rhythm
c. Torsades de pointes
d. Complete heart block

05. Identify the following rhythm.












a. Sinus bradycardia with a wide QRS complex
b. Idioventricular rhythm
c. Junctional rhythm
d. Agonal rhythm

06. Identify the following rhythm.














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

07. Identify the following rhythm.














a. Third degree heart block
b. Idioventricular rhythm
c. Junctional rhythm
d. Sinus bradycardia

08. Identify the following rhythm.












a. Sinus bradycardia
b. Normal sinus rhythm
c. Sinus arrhythmia
d. Junctional rhythm

09. Identify the following rhythm.













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

10. Identify the following rhythm.













a. Atrial flutter
b. Atrial tachycardia
c. Sinus arrhythmia
d. Atrial fibrillation

11 Identify the following rhythm.













a. Ventricular paced with bigeminal PVCs
b. Sinus rhythm with bigeminal PVCs
c. Sinus rhythm with a triplet of PVCs
d. Trigeminal PVCs

12. Identify the following rhythm.












a. Sinus tachycardia
b. Sinus arrhythmia
c. Sinus rhythm
d. First degree block

13. Identify the following rhythm.












a. Ventricular tachycardia
b. Ventricular standstill
c. Torsades de pointes
d. Ventricular fibrillation

14. Identify the following rhythm.












a. Normal sinus rhythm
b. Sinus arrhythmia
c. First degree block
d. 2nd degree block type II

15. Identify the following rhythm.












a. Sinus arrhythmia
b. Atrial fibrillation
c. Supraventricular tachycardia
d. Multifocal atrial tachycardia

16. Identify the following rhythm.












a. Atrial paced
b. AV paced
c. Biventricular paced
d. Failure to capture

17. Identify the following rhythm.











a. Ventricular paced with failure to capture
b. Ventricular paced with failure to pace
c. Ventricular paced with failure to sense
d. Demand ventricular pacing

18. Identify the following rhythm.












a. Sinus bradycardia with bigeminal PVCs
b. Sinus bradycardia with unifocal PVCs
c. Sinus bradycardia with a couplet of PVCs
d. Sinus bradycardia with multifocal PVCs

19. Identify the following rhythm.












a. Third degree heart block
b. First degree block
c. Second degree heart block type I
d. Second degree heart block type II

20. Identify the following rhythm.











a. Sinus arrhythmia
b. Sinus rhythm with PACs
c. Sinus arrest
d. Normal sinus rhythm

21. Identify the following rhythm.












a. Sinus rhythm with trigeminal PVCs
b. Sinus arrhythmia with unifocal PVCs
c. Sinus rhythm with sinus arrest
d. Sinus rhythm with a triplet of PVCs

22. Identify the following rhythm.











a. Biventricular paced
b. Atrial paced
c. Ventricular paced with failure to sense
d. AV paced

23. Identify the following rhythm.












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

24. Identify the following rhythm.













a. Sinus bradycardia
b. First degree block
c. Third degree block
d. Sinus arrest

25. Identify the following rhythm.











a. Atrial paced with failure to capture
b. Demand atrial pacing
c. Atrial paced with failure to sense
d. Atrial paced with failure to pace

26. Identify the following rhythm.













a. P wave asystole
b. Agonal rhythm
c. Junctional rhythm
d. Asystole

27. Identify the following rhythm.












a. Sinus bradycardia with a PAC
b. Sinus bradycardia with a PJC
c. Sinus bradycardia with a PVC
d. Sinus bradycardia with sinus arrhythmia

28. Identify the following rhythm.













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

29. Identify the following rhythm.












a. Sinus bradycardia with sinus arrest
b. Sinus bradycardia with sinus arrhythmia
c. Third degree heart block
d. Sinus bradycardia with a dropped PAC

30. Identify the following rhythm.













a. Ventricular fibrillation
b. Torsades de pointes
c. Ventricular tachycardia
d. Atrial fibrillation


Answers
01. c. Second degree heart block type II
02. c. Junctional rhythm
03. b. Sinus rhythm with a dropped PAC
04. a. Agonal rhythm
05. b. Idioventricular rhythm
06. d. Biventricular paced
07. a. Third degree heart block
08. c. Sinus arrhythmia
09. a. Ventricular paced
10. a. Atrial flutter
11. b. Sinus rhythm with bigeminal PVCs
12. c. Sinus rhythm
13. d. Ventricular fibrillation
14. c. First degree block
15. b. Atrial fibrillation
16. a. Atrial paced
17. b. Ventricular paced with failure to pace
18. b. Sinus bradycardia with unifocal PVCs
19. c. Second degree heart block type I
20. b. Sinus rhythm with PACs
21. a. Sinus rhythm with trigeminal PVCs
22. d. AV paced
23. b. Sinus bradycardia
24. c. Third degree block
25. b. Demand atrial pacing
26. a. P wave asystole
27. a. Sinus bradycardia with a PAC
28. c. Ventricular tachycardia
29. a. Sinus bradycardia with sinus arrest

30. b. Torsades de pointes



Friday, January 20, 2017

Transcutaneous Pacing

 Patient admitted with elevated BP and shortness of breath.  Hx of diabetes, renal failure, dialysis, PVD, MI

Initial rhythm






VS: 97.4 38-26.  204/89. Monitor, oxygen, IV started.  0.5 mg of atropine given.  No change in rhythm.




Initiate transcutaneous pacing.  Rate 60 ppm




Increased milliamps to 50.  No mechanical capture

Increased milliamps to 60. No mechanical capture

MD into evaluate patient.  Pacing paused to evaluate.  Rhythm 1st degree block.










Demand pacing.  Underlying rhythm 1st degree block with periods of arrest.





She had good capture at 70 mAs.  She had a lot of musculoskeletal contractions. It was difficult to even feel a femoral pulse.  A doppler was used and it found her heart rate to be in the 40s.  At this point, we increased the mAs up to 90.  The doppler rate was now 60 ppm


80 mAs.










90 mAs.  Doppler rate 60 ppm.   SpO2 rate correlates too.



100% paced with good mechanical capture by doppler. Patient sent to cath lab for transvenous pacemaker insertion.








Monday, January 16, 2017

Basic EKG Rhythm Test 42

01. Identify the following rhythm.












a. Ventricular paced
b. AV paced with biventricular pacing
c. Atrial paced
d. Failure to sense

02. Identify the following rhythm.











a. Sinus arrhythmia
b. Sinus rhythm with an exit block
c. Sinus rhythm with a PJC
d. Sinus rhythm with a PAC

03. Identify the following rhythm.











a. Sinus rhythm with an exit block
b. Atrial fibrillation
c. Complete heart block
d. Sinus arrhythmia

04. Identify the following rhythm.












a. Multifocal atrial tachycardia
b. Sinus tachycardia
c. Ventricular tachycardia
d. Supraventricular tachycardia

05. Identify the following rhythm.










a. Idioventricular rhythm
b. Complete heart block
c. Junctional rhythm
d. Wenckebach

06. Identify the following rhythm.










a. Normal sinus rhythm
b. Sinus arrest
c. First degree block
d. 2nd degree heart block type II

07. Identify the following rhythm.












a. Sinus arrhythmia
b. Sinus rhythm with wandering baseline
c. Supraventricular tachycardia
d.  Agonal rhythm

08. Identify the following rhythm.











a. Atrial fibrillation
b. Complete heart block
c. Junctional rhythm
d. Sinus bradycardia

09. Identify the following rhythm.












a. Sinus rhythm with bigeminy
b. Sinus rhythm with a couplet
c. Sinus rhythm with nonsustained VT
d. Sinus rhythm with unifocal PVCs

10. Identify the following rhythm.











a. Sinus arrhythmia
b. Atrial fibrillation
c. Junctional rhythm
d. Second degree heart block type I

11. Identify the following rhythm.











a. Junctional tachycardia
b. Atrial fibrillation with RVR
c. Sinus tachycardia
d.  Ventricular tachycardia

12. Identify the following rhythm.











a. Sinus arrhythmia
b. Normal sinus rhythm
c. First degree block
d. Mobitz II

13. Identify the following rhythm.










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

14. Identify the following rhythm.










a. Sinus rhythm with unifocal PVCs
b. Sinus rhythm with trigeminal PVCs
c. Sinus rhythm with multifocal PVCs
d. Sinus rhythm with demand ventricular pacing

15. Identify the following rhythm.










a. Idioventricular rhythm
b. Agonal rhythm
c. Ventricular paced with failure to capture
d.  Demand ventricular pacing

16. Identify the following rhythm.











a. Junctional rhythm
b. Atrial fibrillation
c. P wave asystole
d.  Mobitz II

17. Identify the following rhythm.











a. Ventricular paced with failure to capture
b. Ventricular paced with failure to pace
c.  Demand ventricular pacing
d.  Ventricular paced with failure to sense

18. Identify the following rhythm.










a. Ventricular fibrillation
b. Atrial fibrillation
c. Complete heart block
d. Sinus rhythm with exit block

19. Identify the following rhythm.












a. Atrial fibrillation
b. Ventricular fibrillation
c. Ventricular tachycardia
d. Ventricular standstill

20. Identify the following rhythm.











a. Sinus rhythm with a couplet of PVCs
b. Sinus rhythm with a triplet of PVCs
c. Sinus rhythm with multifocal PVCs
d.  Sinus rhythm with bigeminal PVCs

21. Identify the following rhythm.












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

22. Identify the following rhythm.











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

23. Identify the following rhythm.











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

24. Identify the following rhythm.












a. Torsades de pointes
b. Atrial fibrillation
c. Artifact
d.  Ventricular fibrillation

25. Identify the following rhythm.









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

26. Identify the following rhythm.








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

27. Identify the following rhythm.










a. 2nd degree heart block type II
b. Ventricular fibrillation
c. Atrial tachycardia
d.  Atrial flutter

28. Identify the following rhythm.








a. Normal sinus rhythm with exit block
b. Sinus arrhythmia
c. Sinus rhythm with multiple PVCs
d. Sinus rhythm with bigeminal PACs

29. Identify the following rhythm.









a. Sinus bradycardia
b. Normal sinus rhythm
c. Junctional rhythm
d. First degree block

30. Identify the following rhythm.










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


Answers
01. b. AV paced with biventricular pacing
02. c. Sinus rhythm with a PJC
03. a. Sinus rhythm with an exit block
04. d. Supraventricular tachycardia
05. b. Complete heart block
06. c. First degree block
07. b. Sinus rhythm with wandering baseline
08. c. Junctional rhythm
09. b. Sinus rhythm with a couplet
10. d.  Second degree heart block type I
11. c. Sinus tachycardia
12. a. Sinus arrhythmia
13. b. Atrial paced
14. a. Sinus rhythm with unifocal PVCs
15. c. Ventricular paced with failure to capture
16. d.  Mobitz II
17. c.  Demand ventricular pacing
18. b. Atrial fibrillation
19. b. Ventricular fibrillation
20. d.  Sinus rhythm with bigeminal PVCs
21. b. Ventricular paced
22. c. Sinus bradycardia
23. a. Ventricular tachycardia
24. c. Artifact
25. a. Atrial fibrillation
26. a. Biventricular paced
27. d.  Atrial flutter
28. d. Sinus rhythm with bigeminal PACs
29. b. Normal sinus rhythm
30. b. Agonal rhythm