P53 interpretation of ECG basic
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| ECG Rules and Characteristics (5 step)Rhythm Interpretation | Analyze Rate (How fast or slow) | Analyze Rhythm (Regular?) (occasional irreg)(reg irreg)(irreg irreg) | Analyze P wave (P present)(P regular to Ps)(One P for each QrS)(upright or inv)(look alike) | Analyze PRI (norm 0.12-0.20sec) | Analyze QRS (look alike)(Duration norm 0.04-0.12) | ||||||||||||
| Normal Sinus Rhythm (NSR) | 60-100bpm / Reg-Reg | Upright and similar | 0.12-0.20sec & consistent | 0.04-0.10sec | 1P:1qRs | ||||||||||||
| Sinus Tachycardia | >100bpm / Reg-Reg | Upright and similar | 0.12-0.20 sec & consistent | 0.04-0.10 sec | 1P:1qRs | ||||||||||||
| Sinus Bradycardia | <60bpm / Reg-Reg | Upright & similar | 0.12-0.20 sec & consistent | 0.04-0.10 sec | 1P:1qRs | ||||||||||||
| Premature Atrial Contraction(PAC) | usually <100bpm /dependant on underlying rhythm / Irregular | Early & upright/ different from Sinus | 0.12-0.20sec / different from Sinus | 0.04-0.10sec | 1P:1qRs | ||||||||||||
| Atrial Flutter | Atrial: 250-350 / Ventricle: 150 common/ A: Regular Vent: Reg or Irregular | Not identifiable / F waves uniform (sawtooth) | not measurable | 0.04-0.10sec | n/a due to no P defined | ||||||||||||
| Atrial Fibrillation | Atr: 400-700 /Vent: 160-180 /A: Irr V: Irr | not identifiable P / f waves may be seen | unable to measure | usually normal | n/a due to no P | ||||||||||||
| Paroxysmal Atrial Tachycardia(PAT) | usually 160-220bpm / Reg-Reg | differ in shape from Sinus/ difficult to identify due to rate | Normal when P identified / short if WPW | normal | 1P:1qRs onset sudden often inititated by PAC | ||||||||||||
| Premature Junctional Conatraction(PJC) | usually <100bpm (dependant on undr) /Irregular | Inverted before or after qRs or not visible | <0.12sec when inverted P is before qRs | 0.04-0.10 sec | 1P:1qRs if P visible | ||||||||||||
| Junctional Escape Rhythm | 40-60bpm or 61-100 (accelerated)/Regular | Inverted before or after qRs or not visible | <0.12sec when inverted before QRs | 0.04-0.10sec | 1P:1qRs if P visible | ||||||||||||
| Junctional Tachycardia | 101-200bpm/Regular | Inverted before or after qRs or not visible | <0.12sec when inverted before QRs | 0.04-0.10sec | 1P:1qRs if P visible | ||||||||||||
| Supraventricular Tachycardia (SVT)/ umbrella term used when unable to distinquish which rhythm present | >150bpm / absolutely regular | P wave not visible | not measurable | 0.04-0.10sec | |||||||||||||
| Premature Ventricular Complex (PVC) | dependant / A: Reg V: Irr | usually absent if present not associated with PVC | if present? | 0.12 or greater / bizarre and notched | n/a ST&T often opposite qRs/ every other bigeminy / multifocal if different shape/ RonT =PVC | ||||||||||||
| Ventricular Tachycardia (Vtach) | >100bpm usually not >220 / usually regular | no P or not associated | n/a | Wide and bizarre | three PVC in row or more at 100bpm is Vtach | ||||||||||||
| Ventricular Fibrillation (Vfib) | could be any | no regularity/chaotic undulating | no P | n/a | No qRs | ||||||||||||
| Idioventricular Rhythm | 20-40bpm / 40-100bpm(accelerated) / Regular | No P associated with qRs | n/a | >0.12sec notched /bizarre | ST/T oppposite direction of qRs | ||||||||||||
| Aystole | 0 / unless P present then could be reg or irregular | may be present | n/a | not there | not there | ||||||||||||
| 1st degree AV block | 1P:1qRs | indicated by prolonged PRI (>0.20sec but not >0.40sec) | |||||||||||||||
| 2nd degree AV block type 1 | Ap not equal V | More P waves than qRs | PRI progressively increases until P appears w/o qRs | cyclic pattern reoccurs non-conducted Pwave | |||||||||||||
| 2nd degree AV block type 2 | could be Reg or Irreg | More P waves than qRs | PRI consistent | qRs normal (if wide Bundled Branch block) | non-conducted P waves present | ||||||||||||
| 3rd degree AV block | More P waves than qRs | P not related to qRs (P too close or too far) | PRI varies greatly | qRs normal or wide | could have regular Vent |
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Created by:
rdslack
on 2011-02-18