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Cloned from: ECG Strips ACLS

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normal sinus rhythm, normal rate, no skips, extra beats,  etc
sinus arrythmia
sinus arrythmia, all complexes are normal, but rhythm is irregular, longest R-R exceeds shortest R-R. Impulses orginate at SA node at variing rate (reflects respiration).
sinus bradycardia, sinus rythm with rate < 60, TX: O2, ECG monitor, IV access, Atropine 0.5mg (may repeat to 3mg total), epi 2 to 10 ug/min or dopamine 2 to 10 ug/kg per min
sinus bradycardia, sinus rythm with rate < 60, TX: O2, ECG monitor, IV access, Atropine 0.5mg (may repeat to 3mg total), epi 2 to 10 ug/min or dopamine 2 to 10 ug/kg per min
sinus tachycardia, sinus rhythm with rate > 100, TX is O2 (first sign of hypoxemia is tachycardia)
sinus tachycardia tx oxygen
atrial flutter
atrial flutter
atrial fibrillation,
atrial fibrillation
junctional rhythm
junctional rhythm
junctional rhythm
PVC's, Premature Ventrical Contraction, TX O2, Lidocaine (same tx for multifocal PVC's)
Pulseless V-Tach TX- defibrilate
V-Tach with pulse present-lidocaine and cardiovert
V-fib, ventricular fibrillation, completely irregular ventricular rhythm, tx is defibrilation
Asystole-always confirm on 2 leads first, tx epinephrine, Atropine
Bundle branch block
1st degree AV block, PR interval > .20 seconds (caused by ischemia or digitalis), TX Atropine
AV Heart Block Second Degree Type 1
2nd degree AV block-irregular rhythm; normal P waves, but QRS complex is missing. TX Atropine, electrical pacemaker
3rd Degree AV Block-atrial rate > 60, ventrical rate < 40, missing PR interval, wide QRS, TX electrical pacemaker
myocardial infarction-significant elevation of S-T segment dictates injury TX O2
EKG Grid
Lead Placement
Pacemaker Rhythm
conduction of the P Wave
Conduction of the PR Interval
Conduction of the Q Wave
Conduction of the R Wave
Conduction of the S Wave
Conduction of the ST segment
Conduction of the T Wave
VFib/Pulseless VT Algorithm= Please Shock-Shock-Shock, Everybody Shock, And Let's Make patients Better
PSSSEVSALMB=P-Precordial Thump If pulse-less with no defibrillator, Shock, Shock, Shock, Epinephrine, Shock,Amiodarone,  Lidocaine, Magnesium, patients Bicarbonate
Wolff-Parkinson-White Syndrome, sudden unexplain tachycardia, short PR interval with wide QRS, TX control tachy
Primary ABCD's
Assess:tap and ask, ARE YOU OK?, send for or call 911 and AED. Airway: open with head-tilt/chin lift. Breathing:if none give 2 breaths (O2 if avail). Circulation: check carotid, if none give 30:2 compressions, 5 cycles. Defibrilation: AED follow prompts.
Secondary ABCD's
Airway (100% O2), Breathing: 8-10 breaths per min with 100 continuous compressions per minute. Circulation: obtain IV/IO access-drugs per algorithm. Diagnosis: 6H's 5T's, DX and treat.
What are the 6H's and 5T's?
Hypoxia, hypovolemia, hypothermia, hypoglycemia, hypo/hyperkalemia, hydrogen ion (acidosis), Tomponade, tention pneumo, Toxins, Thrombosis, Trauma
What pulseless rhythms are shockable?
VF, VT, Torsades de Pointes
What pulseless rhythms are not shockable?
PEA and Asystole
ETT Drugs
NAVEL:Narcan/naloxone, Atropine, Vasopressin, Epinephrine, Lidocaine
What is the PRIMARY focus in cardiac arrest?
Effective CPR and early defibrillation, drugs are secondary and should never disrupt CPR.
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