Waveforms and measurements
Atrial Depolarization
What is a P wave
This process of passing a current through a fibrillating heart to depolarize the cells and allow them to repolarize uniformly, thus restoring an organized cardiac rhythm.
What is Defibrillation?
These are the four main sources of drugs.
What is plants, animal, mineral, and synthetic (lab)
Your patient is complaining of tearing chest pain that radiates straight through to his back. His pulse is 96. He appears cool, clammy, and pale. The patient states that this conidition came on suddenly. He denies any other symptoms at this point. This patient is most likely suffering from: A.)...MI B.).... Pulled chest muscle C.) .....Pneumonia D.).... Aortic dissection
Aortic dissection. Classic sign is tearing pain radiating to the back
Ischemia causes this wave or segment to become depressed or inverted.
What is ST depression or an inverted T wave?
The junction between the end of the QRS and the beginning of the ST segment
What is the J-Point? Note: The J-point is found by looking for the point where the QRS stops and makes a sudden sharp change of direction.
Stroke Volume X Heart Rate
What is cardiac output?
In which of the following arrhythmias is lidocaine NOT indicated: A.) V-Tach B.) V-Fib C.) Wide complex tach of uncertain origin D.) Bigeminy at a rate of 80
Answer: Lidocaine is NOT indicated for a bigeminy at a rate of 80. NOTE: Lido could eliminate the PVCs, but then the end result would be a patient with a HR of 40 and more unstable rhythm. You need to first fix the rate before fixing the PVCs.
Your patient is complaining of shortness of beath. She has pink, frothy sputum. Her blood pressure is low. She is cool and clammy to the touch. You would suspect: A)....Right sided heart failure B.)....Left sided heart failure C.)....Pneumonia D.) .....MI
Left sided heart failure because it backed up into the lungs.
Injury, the second stage of development of an MI, causes this change to happen on the 12-Lead EKG
What is ST segment elevation?
This syndrome is characterized by a short PR interval, a long QRS duration, and the upstroke of the QRS often has a slur called the delta wave.
What is WPW? (Wolf Parkinson’s White)
Every third beat is a PVC
What is Trigeminy?
What class of anti-dysrhythmics is cardizem?
Class IV
Your 22 year old female patient is complaining of sudden chest pain, predominately on her left side. She states it is very sharp and worsens with inspiration. The only medication she takes is birth control pills, and she is a smoker. She has no other significant history. You would suspect. A.)....MI B.)....tension pneumothorax C.)....asthma D.)....Pulmonary Embolism
Pulmonary Embolism. The risk of PE goes up with the use of birth control and smoking
When there is elevation in II, III, aVF, there may be associated depression in any I, aVL, V leads and in the same regard, when there is elevation in any I, aVL, V leads, there may be associated depression in II, III, aVF, is known as this term.
What are Reciprocal changes? Remember, the INFERIOR is on the bottom and the rest of the leads are looking from atop, so they are literally mirror images of each other.
Most commonly apparent in hypothermia, this wave is noted by its slow, positive deflection at the end of the QRS complex.
What is the Osborn or J-wave?
Literally means “pain in the chest.”
What is angina pectoris?
What is your pediatric epi dose for cardiac arrest
0.01 mg of epi 1:10,000
Your patient is complaining of a headache and blurred vision. They also appear markedly flushed in appearance and have a bounding pulse. They have not been to their PCP in many years, are obese and are sedentary. You most likely suspect: A.)...Hemorrhagic stroke B.)...Primary hypertension C.)...Malignant brain tumor D.)...Parkinson's Disease
What is B.) Primary hypertension
Explain how to determine a pathological Q wave
0.04 seconds wide and is 25 % the height of the R wave
This wave can indicate an old MI
What is a Pathological Q-wave?
Excess fluid accumulates inside the pericardium.
What is Cardiac Tamponade?
Flumazenil is indicated for what?
Benzodiazepine overdose
Your 63-year-old patient is recovering after cardiac surgery and in the ICU. After the nurse does her morning checks, the patient complains of chest pain and shortness of breath. There is noted JVD and the patient's blood pressure is 96/79. What is most likely occurring in this patient?
Cardiac/Pericardial Tamponade
Explain the steps to determine LVH
1.) look in V1 and V2. Pick the deepest negative deflection. Count the small boxes of negative deflection in that lead. Remember that number. 2.) Compare V5 and V6. Determine which is the tallest. Count the small boxes of positive deflection. Remember that number. 3.) add the two numbers together, suspect if the sum equals 35 or more (7 big boxes)