Practice EKG Rhythm Strips 130
Identify the following rhythms.
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Answers
1.
The rhythm is irregular. The rate is 90. There are no P waves present, only flutter waves. There is a 4:1 and 5:1 conduction between the atrium and the ventricle. No ectopic beats are seen. PR: --- QRS: .08 sec, QT: .38 sec.
2.
The rhythm is irregular because of the ectopy. The underlying rhythm is sinus rhythm that is punctuated by couplets occurring every third beat. The calculated sinus rate is 78. There are upright P waves present. Unifocal couplets occur every 3rd beat. PR: .12 sec, QRS: .08 sec, QT: .40 sec.
3.
The rhythm starts out with a sinus beat and then changes to a polymorphic ventricular tachycardia. Polymorphic refers to the varying morphology of each QRS complex in the ventricular rhythm. The treatment of choice for polymorphic ventricular tachycardia is defibrillation. It is acceptable to cardiovert a monomorphic ventricular tachycardia but the American Heart Association recommends giving unsynchronized shocks to the polymorphic rhythm. The problem is that the defibrillator/monitor will have difficulty synchronizing with the polymorphic rhythm and will likely deliver an unsynchronized shock anyway.
4.
The rhythm is regular. The calculated rate (1500/number of small boxes between to R waves) is 57/min. Upright P waves are present. No ectopic beats are noted. PR: 16 sec, QRS: .08 sec, QT: .42 sec.
5.
The rhythm is regular. The rate is 83. Upright P waves precede each QRS complex. There is a ventricular pacer spike before each QRS complex. The 2nd complex may represent a fusion beat. Fusion beats occur when a sinus beat or ectopic beat is initiated at the same time the pacemaker initiates an impulse. PR: .12 sec. QRS .12 sec, QT: .32 sec.
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2.
3.
4.
5.
Answers
1.
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| Atrial flutter with variable response |
The rhythm is irregular. The rate is 90. There are no P waves present, only flutter waves. There is a 4:1 and 5:1 conduction between the atrium and the ventricle. No ectopic beats are seen. PR: --- QRS: .08 sec, QT: .38 sec.
2.
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| Trigeminal couplets |
The rhythm is irregular because of the ectopy. The underlying rhythm is sinus rhythm that is punctuated by couplets occurring every third beat. The calculated sinus rate is 78. There are upright P waves present. Unifocal couplets occur every 3rd beat. PR: .12 sec, QRS: .08 sec, QT: .40 sec.
3.
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| Polymorphic ventricular tachycardia |
The rhythm starts out with a sinus beat and then changes to a polymorphic ventricular tachycardia. Polymorphic refers to the varying morphology of each QRS complex in the ventricular rhythm. The treatment of choice for polymorphic ventricular tachycardia is defibrillation. It is acceptable to cardiovert a monomorphic ventricular tachycardia but the American Heart Association recommends giving unsynchronized shocks to the polymorphic rhythm. The problem is that the defibrillator/monitor will have difficulty synchronizing with the polymorphic rhythm and will likely deliver an unsynchronized shock anyway.
4.
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| Sinus bradycardia |
The rhythm is regular. The calculated rate (1500/number of small boxes between to R waves) is 57/min. Upright P waves are present. No ectopic beats are noted. PR: 16 sec, QRS: .08 sec, QT: .42 sec.
5.
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| Ventricular paced |
The rhythm is regular. The rate is 83. Upright P waves precede each QRS complex. There is a ventricular pacer spike before each QRS complex. The 2nd complex may represent a fusion beat. Fusion beats occur when a sinus beat or ectopic beat is initiated at the same time the pacemaker initiates an impulse. PR: .12 sec. QRS .12 sec, QT: .32 sec.
This blog is excellent I really appreciate that you make these post. I am currently in paramedic school and these rhythm strips are great study tools.
ReplyDeleteYou are welcome Rashad. Glad to be of service to you. Best wishes with your paramedic studies.
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