What am I?
My rhythm is irregular, my ventricular rate is 112bpm, my P waves are present and UUP, my PRI is 0.14s and my QRS are 0.10s. What am I
Sinus tachycardia with sinus arrhythmia
Your patient suddenly goes into AFIB. The rate is controlled and the patient feels fine, do you need to do anything? If so, what?
Check the previous ECG to see if it is new, if it is new the patient must be put on an anticoagulant so they need to see their family doctor ASAP.
If your patient is a right leg amputee, how do you modify the lead placements?
You would put both RL and LL on the left leg. Arms remain the same
What medication is primarily used in the bradycardia algorithm?
*BONUS 200 points* there are 2 other medications that can be used if that one is ineffective. What are they?
Atropine is primarily used.
Epinephrine and Dopamine are used if Atropine is not effective.
Which medication is the most important for patient with AFIB? Give me 1 example of this medication.
Blood thinner (anticoagulant). Examples: Apixaban (Eliquis), Warfarin, Rivaroxaban (Xarelto), Dabigatran
My rate is 55bpm, my QRS are 0.10s and my PRI continues to prolong until a QRS is dropped. What am I?
Second degree AVB type I.
Your patient gives consent to begin the test. As you start putting the electrodes on, they begin to get agitated and aggressive. What do you do?
Try to reassure your patient this is a harmless procedure.
Give your patient a couple minutes to collect themselves.
Do not do the test.
You walk in and your patient is 6 months old. What additional leads do you need and why?
V3R, V4R and V7.
In children, RV is dominant so we need right sided leads.
What is the first line of treatment for someone experiencing SVT?
Vagal maneuvers
If AVR is positive, what 2 things could be happening?
Lead reversal or dextrocardia.
My rhythm is regular at a rate of 30 bpm, QRS is 0.15s, P waves are absent. What am I?
Idioventricular rhythm.
You walk in and your patient is in a wheelchair. What are your next steps to complete the ECG?
Assist the patient to the bed. If patient refuses, perform ECG as normal but *note* on the ECG that the ECG was done while sitting.
What do you do for a patient with dextrocardia?
Right sided ECG with limb leads reversed.
What 3 medications are used in cardiac arrest therapy?
Epinephrine, Lidocaine and Amiodarone.
Name 6 things that should be on a requisition.
Patient name, DOB, referring physician, family physician, physician signature, reason for referral, list of medications.
My rhythm is regular, QRS duration is 0.11s, P waves are inverted, PRI is 0.14s, rate is 60 bpm. What am I?
Junctional rhythm.
You finish your ECG and the interpretation is atrial fibrillation at a ventricular rate of 105 bpm. Your patient is unsure which medications they are taking. What do you do?
Ask the patient if they are aware they have AFIB. If patient is unsure, compare with a previous ECG to see if it is new or old. If it is new, report it to a physician and don't let the patient leave the hospital until seeing a doctor.
In an emergency situation where a right-sided ECG must be taken immediately, which lead is the MOST important?
V4R.
Name at least 2 reversible causes in the adult cardiac arrest algorithm.
Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo-/hyperkalemia, Hypothermia, Tension pneumothorax, Tamponade, Toxins, Thrombosis pulmonary, Thrombosis coronary
What are the 4 types of artifact?
Somatic tremors, static electricity, wandering baseline and AC interference.
My QRS complexes are 0.14s, my rate is 88bpm, my P waves are present and UUP and my PRI is 0.22s and my rhythm is overall irregular. What am I?
Normal sinus rhythm with a bundle branch block, first degree AVB and sinus arrhythmia.
You notice while your patient is hooked up to the machine they are having little runs of SVT. You take your ECG and it show's NSR. What do you do?
Take a rhythm strip to catch the start and end of a run to show the physician.
What are the anatomical positions for a posterior ECG?
V7: left posterior axillary
V8: tip of the left scapula
V9: left paraspinal region
What 3 anti-arrhythmic medications are used for stable, wide-QRS tachycardia?
Sotalol, Amiodarone and Procainamide.
(Adenosine used in regular SVT)
Explain the difference between 2nd degree type I and type II
Type I: prolonging PRI until drop in QRS
Type II: PRI constant with multiple P's to one QRS.