CCI Rhythm Strips

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Author:
BrettIRB
ID:
66033
Filename:
CCI Rhythm Strips
Updated:
2011-02-13 12:45:12
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CCI
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Description:
Rhythm Interpetation
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  1. 5 IDENTIFYING COMPONENTS OF ECG STRIPS
    Rhythm: Regular or Irregular

    • P to P Interval: Beginning of P wave to beginning of next P wave
    • QRS Complex to QRS Complex: From R wave to next R wave
    • Rate: normal range 60 – 100 beat per min.

    • Regular: R wave to R wave (1500/# of small boxes)
    • Irregular: Count # of complete complexes within 6 second (x 10)
    • P waves: Are they upright and uniform? (description)

    • Are each followed by a QRS complex? (present)
    • PR Interval (PRI): normal range 0.12 to 0.20

    • Beginning of P wave to Beginning of QRS (# of Sm. Bx. x 0.04)
    • QRS Complex: normal range 0.06 to 0.10

    Beginning of Q wave to the J point (# of Sm. Bx. x 0.04)
  2. Sinus Rhythms
    (upright, uniform P wave / PRI & QRS are in normal range)
  3. Atrial Dysrhythmias
    (P wave changes in shape, size)
  4. Atrial–Junction Rhythms
    (P waves are inverted, absent, or after QRS/ PRI < 0.12)
  5. Heart Block Rhythms
    • 1st Degree : PRI > 0.20
    • 2nd Degree Type II : A. rate normal; V rate slower due to blocked QRS
  6. Bundle Branch Block:
    QRS will be 0.12 or greater
  7. Normal Sinus Rhythm:
    all 5 steps are within normal limits
  8. Sinus Bradycardia
    Rate is < 60
  9. Sinus Tachycardia:
    Rate is 100 - 150
  10. Sinus Dysrhythmia (Sinus Arrhythmia)
    P to P & R to R intervals will widen and narrow following the breathing pattern (variance > 0.08 or 2 small boxes=irregular rhythm)
  11. Sinus Arrest:
    Complete cardiac complexes precede and follow the arrest period. Length of Pause=from R before pause to R after pause (calc: # of Sm. Bx x 0.04)
  12. Premature Atrial Complexes (PAC):
    A beat that comes early with a positive deflected P wave.
  13. Wandering Atrial Pacemaker (WAP):
    Changing P wave configuration with at least 3 variations. Rate is 60 - 100
  14. Atrial Flutter (A Flutter):
    sawtooth” pattern between QRS complexes. Atrial rate is 250-350 (calc: vent. rate x F waves between QRS) (no P (or T) waves, only F waves).
  15. Atrial Fibrillation (A fib):
    Chaotic disorder between QRS complexes. Atrial rate 375-700 (no P waves, only f waves).
  16. Supraventricular Tachycardia (SVT):
    Rate of 150 – 250
  17. Wolff-Parkinson-White (WPW) Syndrome:
    • QRS is > 0.10
    • (QRS start on the down slop of P wave making a Delta wave)
  18. Junctional Escape Rhythm:
    Rate 40 - 60 (P waves are inverted, absent, or after QRS/ PRI < 0.12)
  19. Accelerated Junctional Rhythms:
    Rate 60 – 100 (P waves are inverted, absent, or after QRS/ PRI < 0.12)
  20. Junctional Tachycardia:
    Rate 100 – 180 (P waves are inverted, absent, or after QRS/ PRI < 0.12)
  21. Premature Junctional Complex (PJC):
    A beat that comes early with an inverted (if seen) or buried P wave.
  22. AV Block with Varied PRI
    • 2nd Degree Type I (Wenckebach): A rate normal; V rate slower with prolonging PRI until QRS drops then cycle begins again. (recurrent prolonging pattern)
    • 3rd Degree (Complete Heart Block or CHB): P-P and R-R are firing @ different rate (A rate 60 – 100, V rate 20 – 40)
  23. Ventricles Rhythm
    (No P wave, QRS wide (>0.12) and bizarre)
  24. Premature Ventricular Complexes (PVC):
    An early QRS complex with no P wave.
  25. Idioventricular Rhythm:
    Ventricular rate 20-40 (No P wave, QRS wide (>0.12) and bizarre)
  26. Accelerated Idioventricular Rhythm:
    Ventricular rate 40-100 (No P wave, QRS wide (>0.12) and bizarre)
  27. Ventricular Tachycardia (V Tach):
    “Sharkteeth” appearance, V rate > 100 (No P wave, QRS wide (>0.12) and bizarre)
  28. Torsades De Pointes (Multifocal V Tach) (“twisting of the points”):
    QRS morphology varies in width & shape (No P wave, QRS wide (>0.12) and bizarre)
  29. Agonal Rhythm:
    V rate < 20 (No P wave, QRS wide (>0.12) and bizarre)
  30. Ventricular Fibrillation (V Fib):
    Chaotic in appearance (No P wave, QRS wide (>0.12) and bizarre)
  31. Asystole:
    No noticeable deflection in waveform. (flatline) (No P wave, QRS wide (>0.12) and bizarre)
  32. Pulseless Electrical Activity (PEA):
    absence of a palpable pulse with organized electrical activity

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