P bgwave

P bgwave:
v




PR bginterval: v




QRS bgcomplex: v




(ST bgsegment) v




T bgwave:
v




QT bginterval: bg- bg bgcorrect bganswer- bg• bgP bgwave bg- bgatrial bgdepolarization bgand
v v v v v v v v v v v v




bgcontraction
v




• bgPR bginterval bg- bgtime bgof bgtravel bgfrom bgthe bgSA bgnode bgto bgAV bgnode bg(.12-.2)
v v v v v v v v v v v v v v




• bgQRS bg- bgventricular bgdepolarization bgand bgcontraction bg(.08-.12)
v v v v v v v




- bgNote: bgAtrial bgrepolarization bgoccurs bgduring bgthis bgtime, bgbut bgcannot bgbe bgseen
v v v v v v v v v v v




bgon bgEKG
v v




• bgT bgwave bg- bgventricular bgrepolarization
v v v v v




• bgQT bginterval bg- bgstart bgof bgventricular bgcontraction bgto bgend bgof bgrelaxation
v v v v v v v v v v v




Systematic bgApproach bgto bganalyzing bgEKG bg(7 bgsteps) bg- bg bgcorrect bganswer- bg1.
v v v v v v v v v v v




bgDetermine bgatrial bg& bgventricular bgrate bgand bgrhythm.
v v v v v v v




2. bgIdentify bgP bgwaves bgand bgshape, bgand bgif bgthere bgare bgP bgwaves bgfor bgevery
v v v v v v v v v v v v v




bgQRS.
v




3. bgDetermine bgPR bginterval bg(0.12-.2), bgand bgif bgconsistent, bgirregular bgbut bgwith
v v v v v v v v v v




bgpattern bgto bgirregularity, bgor bgjust bgirregular.
v v v v v v




4. bgDetermine bgQRS bgduration, bgconsistency, bgand bgshape. bg(<0.12)
v v v v v v v




5. bgIdentify bgT bgwave bgand bgshape.
v v v v v




6. bgIdentify bgST bgsegment, bgand bgany bgelevation/depression.
v v v v v v




7. bgIdentify bgany bgectopic bgbeats bgoccurring bgoutside bgunderlying bgrhythm.
v v v v v v v v




Determining bgHR bgfrom bgEKG bgstrip bg- bg bgcorrect bganswer- bgTypical bgheart bgrhythm v v v v v v v v v v v




bgstrips bgwill bgcontain bg6 bgseconds bg(30 bgbig bgboxes)
v v v v v v v v




• bgRates bgin bga bg6 bgsecond bgstrip bgcan bgbe bgobtained bgby
v v v v v v v v v v




- bgVentricular bgrate bg= bgQRS bg(QRS bgto bgQRS-the bggaps) bgx bg10
v v v v v v v v v v




- bgAtrial bgrate bg= bgP bgwaves bgx bg10
v v v v v v v




OR bgVentricular bgrate bg= bg1500 bg/ bg# bgof bgsmall bgboxes bgbetween bg2 bgQRS; bgAtrial
v v v v v v v v v v v v v




bgrate bg= bg1500 bg/ bg# bgof bgsmall bgboxes bgbetween bg2 bgP bgwaves
v v v v v v v v v v v v




• bg1 bgsmall bgbox bg= bg.04sec, bg5 bgboxes/large bgbox bg= bg0.2sec; bg5 bglarge bgboxes bg=
v v v v v v v v v v v v v v




bg1 bgsecond, bg15 bglarge bg= bg3sec
v v v v v v




To bgimprove bglead bgconduction... bg(4) bg- bg bgcorrect bganswer- bg- bgClean bgand bgdry
v v v v v v v v v v v v




bgskin bgwith bgsoap bgand bgwater
v v v v v




- bgRemove bgexcess bghair
v v v




- bgGentle bgabrasion bgof bgskin bgwith bgclean bggauze bgto bgexpose bgepidermis bg(dry
v v v v v v v v v v v




bggauze, bgnot bgalcohol bgwhich bgacts bgas bgbarrier, bgskin bgis bga bgnatural bgconductor)
v v v v v v v v v v v v




- bgHave bgpatient bgremain bgstill bgand bgsupine
v v v v v v




Normal bgSinus bgRhythm bg- bg bgcorrect bganswer- bg• bgVentricular bgand bgatrial bgrate: bg60
v v v v v v v v v v v v




bgto bg100 bgbpm
v v v




• bgVentricular bgand bgatrial bgrhythm: bgRegular
v v v v v

, • bgQRS bgshape bgand bgduration: bgUsually bgnormal, bgbut bgmay bgbe bgregularly
v v v v v v v v v v




bgabnormal
v




• bgP bgwave: bgNormal bgand bgconsistent bgshape; bgalways bgin bgfront bgof bgthe bgQRS
v v v v v v v v v v v v




• bgPR bginterval: bgConsistent bginterval bgbetween bg0.12 bgand bg0.20 bgseconds
v v v v v v v v v




• bgP:QRS bgratio: bg1:1
v v v




Sinus bgBradycardia bg- bg bgcorrect bganswer- bg• bgAtrial/ventricular bgrate bgand bgrhythm:
v v v v v v v v v v




bg< bg60 bgand bgregular
v v v v




• bgP bgwave: bgNormal bgand bgconsistent bgshape; bgalways bgin bgfront bgof bgQRS
v v v v v v v v v v v




• bgPR bginterval: bgConsistently bgbetween bg0.12 bgand bg0.2 bgseconds
v v v v v v v v




• bgQRS bgshape bgand bgduration: bgUsually bgnormal, bgbut bgmay bgbe bgregularly
v v v v v v v v v v




bgabnormal
v




• bgConcern bg- bgdecreased bgcardiac bgoutput bgand bgtissue bgperfusion
v v v v v v v v




Etiology bgof bgSinus bgBrady bg(causes) bg- bg bgcorrect bganswer- bg• bgLower bgmetabolic
v v v v v v v v v v v




bgneeds bg- bgSleep, bgAthletes, bgHypothyroidism
v v v v v




• bgVagal bgstimulation bg(triggers bgparasympathetic) bg- bgVomiting, bgSuctioning, bgPain
v v v v v v v v




• bgMedications bg- bgCCB, bgBB, bgAmiodarone
v v v v v




• bgIdiopathic bgsinus bgnode bgdysfunction
v v v v




• bgIncreased bgintracranial bgpressure
v v v




• bgCoronary bgartery bgdisease
v v v




*Management bgwill bgdepend bgon bgcause bgand bgsymptoms v v v v v v




H's bgand bgT's bgfor bgabnormal bgheart bgrhythms bg(6/5) bg- bg bgcorrect bganswer- bg•
v v v v v v v v v v v v




bgHypovolemia bg- bgweight bgloss, bglow bgBP, bgincr. bgHR, bgconcentrated bgblood bg(high
v v v v v v v v v v v




bghematocrit), bgturgor/tenting
v v




• bgHypoxia bg- bgcyanosis bg(mouth, bgperiphery, bgO2 bgsat bgbelow bg95-100)
v v v v v v v v v




• bgHydrogen bgion bg(Acidosis) bg- bgmore bghydrogen bgions, bgABG bg(low bgpH, bgbicarb
v v v v v v v v v v v




bg≤22, bglow bgCO2 bg= bgcompensation, bgCO2 bgwill bgbe bghigh bgif bgthe bgcause bgbicarb
v v v v v v v v v v v v v




bgabove bg26)
v v




• bgHypo/hyperkalemia bg- bgweakness, bgchange bgin bgT bgwaves
v v v v v v v




• bgHypoglycemia bg- bgcold bgand bgclammy bggive bgcandy
v v v v v v v




• bgHypothermia
v




• bgToxins bg- bgmeds, bgcomorbidities, bgkidneys bg(main bgexcreters bg- bgwill bgsee bghigh
v v v v v v v v v v v




bgBUN, bgCr, bgdecr. bgurine bgand bgGFR)
v v v v v v




• bgTamponade, bgcardiac bg- bgfluid bgbuildup bgaround bgheart
v v v v v v v




• bgTension bgpneumothorax bg- bgcollapsed bglung bgr/t bgair; bgwill bgpresent bgwith bgabsent
v v v v v v v v v v v




bgbreath bgsounds bgon bgaffect bgside, bglow bgO2 bgsat, bgtracheal bgshift, bgSOB
v v v v v v v v v v v




• bgThrombosis bg- bgchest bgpain, bgneuro bgchanges, bgetc.
v v v v v v v




• bgTrauma
v




Sinus bgTachycardia bg- bg bgcorrect bganswer- bg• bgAtrial/ventricular bgrate bgand bgrhythm:
v v v v v v v v v v




bg> bg100, bgbut bg< bg120 bgand bgregular
v v v v v v v




• bgP bgwave: bgNormal bgand bgconsistent bgshape; bgalways bgin bgfront bgof bgQRS
v v v v v v v v v v v




• bgPR bginterval: bgConsistently bgbetween bg0.12 bgand bg0.2 bgseconds
v v v v v v v v