Medic 11 Rhythm Cards

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medic11
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41665
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Medic 11 Rhythm Cards
Updated:
2010-10-12 13:58:39
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Heart rhythms
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heart rhythm 5 rules
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  1. Sinus Bradycardia
    • Rate-- < 60
    • Rhytnm-- regular
    • P waves-- upright & normal in morphology
    • PR-- normal (0.12-0.20 sec & constant)
    • QRS-- Normal (0.04-0.12 sec)
  2. Sinus Tachycardia
    • Rate-- >100
    • Rhythm-- regular
    • P Waves-- upright & normal in morphology
    • PR-- Normal (0.12-0.20 sec & constant)
    • QRS--Normal (0.04-0.12 sec)
  3. Sinus Dysrhythmia
    • Rate-- 60-100 varies w/resp
    • Rhythm-- irregular
    • P waves-- upright & normal in morphology
    • PR-- Normal (0.12-0.20 sec & constant)
    • QRS-- Normal (0.04-0.12 sec)
  4. Sinus Arrest
    • Rate-- Normal to slow depending frequency & duration of arrest
    • Rhythm-- irregular
    • P waves-- upright & normal morphology
    • PR-- Normal (0.12-0.20 sec & constant)
    • QRS-- Normal (0.04-0.12 sec)
  5. Sinus Block
    • Rate-- Normal to slow depending on frequency & duration of arrest
    • Rhythm-- regular
    • P waves--Upright & normal Morphology
    • PR-- Normal (0.12-0.20 sec & constant)
    • QRS-- Normal (0.04-0.12 sec)
  6. Sinus Pause
    • Rate-- Normal to slow depending on duration & frequency of arrest
    • Rhythm-- Irregular
    • P Waves-- Upright & normal in morphology
    • PR-- Normal (0.12-0.20 sec & constant)
    • QRS-- Normal (0.04-0.12 sec)
  7. Sick Sinus Syndrome
    • Rate-- Extremely variable
    • Rhythm-- irregular
    • P Waves-- Upright & normal morphology
    • PR-- Normal (0.12-0.20 sec & constant)
    • QRS-- Normal (0.04-0.12 sec)
  8. Wandering Atrial Pacemaker
    • Rate-- Usually normal
    • Rhythm-- Slightly Irregular
    • P waves-- Morphology changes beat to beat; Waves may disappear completely
    • PR-- Varies fr. <0.12 sec to normal to >0.20
    • QRS-- Normal (0.04-0.12 sec)
  9. PACs
    • Rate-- Dependent upon underlying rhythm
    • Rhythm-- Dependent upon underlying rhythm; usually reg except for PAC
    • P Waves-- P wave of PAC differs fr P wave of underlying rhythm. It occurs earlier than the next expected P wave & may be hidden in the preceding T wave
    • PR-- Usually normal but may vary w/location of ectopic focus. Nearer SA node 0.12 sec or greater. Nearer AV node 0.12 sec or less
    • QRS-- Usually normal; may be >0.12 if PAC abnormally conducted thru partially refrac ventricles. In some cases the ventricles are refractory & won't depolarize in response to the PAC making QRS absent
  10. Paroxysmal Supraventricular Tachycardia
    • Rate-- 150-250/min
    • Rhythm-- Characteristically regular, except @ onset & termination
    • P Waves-- Atrial Ps differ slightly fr atrial Ps. P often buried in preceding T. P may be impossible to see.
    • PR-- Usually normal but can vary w/location of ectopic pacemaker (nr SA will be close to 0.12 sec, nr AV 0.12 or less)
    • QRS-- Normal (0.04-0.12 sec)
  11. Supraventricular Tachycardia
    • Rate-- 150-250 bpm
    • Rhythm-Characteristically normal except @ onset & termination
    • P Waves-- May be impossible to see due to rate
    • PR-- Usually normal but can vary w/location of ectopic pacemaker (nr SA close to 0.12, nr AV 0.12 or less)
    • QRS-- Normal (0.04-0.12 sec)
  12. Atrial Flutter
    • Rate-- Atrial rate 250-350 bpm. Vent rate varies w/ratio of AV conduction
    • Rhythm-- Atrial is reg. Vent rhythm usually reg but can be irregular if block is variable
    • P Wave-- Flutter (F) waves (resemble saw tooth) are present. Pattern difficult to ID in 2:1 flutter however if vent rate is 150ish suspect 2:1
    • PR-- Usually constant but may vary
    • QRS-- Normal (0.04-0.12 sec)
  13. Atrial Fibrillation
    • Rate-- Atrial rate is 350-750; Vent rate varies greatly depending on conduction thru AV node
    • Rhythm-- Irregularly irregular
    • P Wave-- None discernible; Fibrillation (f) waves are present, indicating chaotic atrial activity
    • PR-- none
    • QRS-- Normal
  14. PJCs (not an actual rhythm)
    • Rate-- Depends on underlying rhythm
    • Rhythm-- Underlying rhythm usually reg except for PJCs
    • P Waves-- Inverted, May appear b/f or aft QRS. May be masked by QRS or absent completely
    • PR-- If P b/f QRS <0.12. If P aft technically RP interval
    • QRS-- Usually narrow but may > 0.12 sec if PJC is conducted thru partial refractory vents
  15. Junctional Escape Rhythm
    • Rate--40-60 bpm
    • Rhythm-- Ventricular rhythm is reg
    • P Wave-- May or may not be present; may precede, be buried in or follow QRS; abnormal appearing
    • PR-- Usually abnormally short
    • QRS-- Usually narrow
  16. Accelerated Junctional Rhythm
    • Rate-- 60-100 bpm
    • Rhythm-- Ventricular Rhythm is reg
    • P Wave-- May or may not be present; may precede, be buried in or follow QRS; abnormal appearing
    • PR-- Usually abnormally short
    • QRS-- Usually narrow
  17. Junctional Tachycardia
    • Rate-- >100 bpm
    • Rhythm-- Vent rhythm is reg
    • P Wave-- May or may not be present; may precede, be buried in or follow QRS; abnormal appearing
    • PR-- Usually abnormally short
    • QRS-- Usually narrow
  18. PVCs ( Not an actual rhythm)
    • Rate--Depends on underlying rhythm & rate of PVCs
    • Rhythm-- Interrupts regularity of underlying rhythm; occasionally irregular
    • P Wave-- None; however a normal sinus P wave sometimes appears b/f a PVC
    • PR-- none
    • QRS-- Greater than 0.12 sec & bizarre in morphology
  19. Idioventricular Rhythms
    • Rate-- Usually 20-40 bpm
    • Rhythm-- Regular rhythm
    • P Wave-- No P waves
    • PR-- No PR b/c no P wave
    • QRS-- Wide & bizarre
  20. Accelerated Idioventricular
    • Rate-- > 40 but < 100
    • Rhythm-- Regular rhythm
    • P Wave-- No P waves
    • PR-- No PR b/c no P waves
    • QRS-- wide & bizarre

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