Basic EKG Questions and Answers Graded A

Basic EKG Questions and Answers Graded A ABC's of Arrhythmias - Rhythm - Rate - "P" Wave - PR Interval - QRS Duration Measure the Intervals Normal PR Interval 0.12-o.20 s (3 - 5 small squares) Normal QRS Complex 0.06 - 0.10 s Normal P wave height and width Height - 2.5mm Width - 0.11 s Normal QT Interval 0.42 s Which arrhythmias have regular rhythms? - Sinus Rhythms - Junctional Rhythms - Ventricular Rhythms - Heart Blocks - Atrial Rhythms Which arrhythmias have Irregularly Irregular rhythms? - Atrial Fibrillation - Multifocal Atrial Rhythms - Atrial Flutter (Variable Ventricular Response) Which arrhythmias have Patterned Irregular Rhythms? - Second degree Heart Block Type one - Bigeminal Patterns - Trigeminal Patterns Which arrhythmias have Patterned Regular Rhythms? - Atrial Flutter with 2:1 Conduction - Sinus Arrhythmia How is the rate determined on an EKG? - Count Heavy Lines and divide into 300 - Count Light Lines and divide into 1500 - Count Complexes in 6 seconds and multiply by 10 - Mnemonic fashion (300, 150, 100, 75, 60, 50, 43, 37) Determining Rate 1 Determining Rate 2 Practice Rate Determination 1 Bradycardia HR 60 BPM Tachyardia HR 100 BPM Eucardia HR 60 - 100 BPM The P Wave What does the P wave in an EKG indicate? Represents Atrial depolarization and subsequent contraction. What morphology can a P wave have? - Notched - Peaked - Biphasic The PR Interval What is the PR Interval? The distance between the beginning of the P wave and the beginning of the QRS complex What can a long PR interval indicate? - First degree Heart Block - Ca++ or beta blocker intoxication - Sarcoid or connective tissue disease What can a short PR interval indicate? - LGL - Catacholamine intoxication - Thyroxotoxosis - Street drugs (cocaine or methamphetamine) The QRS Complex What is the QRS complex? Ventricular activation and depolarization time and subsequent ventricular contraction What can a prolonged QRS duration indicate? Prolonged ( 0.12 sec) - Bundle branch block - Ventricular rhythm - Pre-excitation syndromes - Non-specific Interventricular Conduction Defects - Iatrogenic Affects - Electrolyte Abnormalities What can a short QRS duration indicate? Short (0.06 sec) - Pacer spike - CPR artifact Different QRS Complexes Normal Sinus Rhythm Sinus Arrhythmia Sinus Bradycardia Sinus Tachycardia Sinus Pause/Arrest Premature Atrial Contraction Ectopic Atrial Tachycardia Wandering Atrial Pacemaker Atrial Flutter Atrial Fibrillation Premature Junctional Contraction Junctional Escape Beat Junctional Rhythm Accelerated Junctional Rhythm Premature Ventricular Beat Ventricular Escape Beat Idioventricular Rhythm Accelerated Idioventricular Rhythm Ventricular Tachycardia Torsade De Pointes Ventricular Flutter Ventricular Fibrillation Sinus Rhythm w 1st Degree Heart Block Sinus Rhythm with 2nd Degree Heart Block Type 1 (Wenckebach / Mobitz I) Sinus Rhythm with 2nd Degree Heart Block Type 2 (Mobitz II) Sinus Rhythm with Atrioventricular Dissociation (3rd Degree Heart Block)