When you collect the 5 lines of data only plug in the abnormal finding(s)
into the chart below. Here are the normal findings
Rhythm - regular
Rate - atrial between 60 to 100 / ventricle rate 60 to 100.
P wave - uniform (same) and upright
PRI - equal to or between .12 to .20
QRS - less than .12
Example: If you collect the data you do not even need to view the strip to
know what it is. Pick out the abnormal finding in the following example.
Rhythm Regular
Rate atrial rate 56
ventricular rate 56 (the atrial and ventricular
rate should be 1 to 1 or the same)
P wave uniform and upright
PRI .16
QRS .10
The only abnormal finding was the rate is less than 60. So using the
chart below plug in the less than 60 and the answer has to be sinus brady.
It is that simple.
This chart contains general rules. There are exceptions that will be
discussed at the study session. If you do not attend the study session you
may find this chart confusing until explained to you. But at the end it is a
great learning tool.
The following chart is long hand. Click here for the
condensed chart. Using the charts try to
complete the following problems and we will review them at the study session.
Click here for problems
Rhythm |
What is abnormal? |
|
|
Sinus Rhythms |
P waves upright and uniform to pick these
rhythms |
Normal Sinus Rhythm |
ventricular rate between 60 to 100,
everything else normal |
Sinus Brady |
ventricular rate less than 60,
everything else normal |
Sinus Tach |
ventricular rate greater than 100 until you
cannot see the P waves, everything else normal |
Sinus Arrhythmia |
Slightly irregular |
|
|
Atrial Rhythms |
P waves are abnormal |
Wandering Pace Maker |
Slightly irregular and P waves change |
Atrial Flutter |
Atrial rate between 250 and 350.
P waves are sawtooth/picket fence |
Atrial Fib |
Irregular R to R,
Atrial rate greater than 350. P waves are wavy |
Atrial Tach (SVT) |
Cannot see P waves and
ventricular rate greater than 150. |
|
|
Junctional Rhythms |
P waves inverted (located
before, in or after the QRS) |
Escaped Junctional Rhythm |
P waves inverted or absent and ventricular
rate of 40 to 60 |
Accelerated Junctional |
P waves inverted or absent and ventricular
rate of 60 to 100 |
Junctional Tach |
P waves inverted or absent and ventricular
rate of 100 to 180 |
|
|
Ventricular Rhythms |
QRS measures at or greater than .12 |
Ventricular Tach |
Ventricular rate of 100 to 300 |
Ventricular Fib |
Ventricles are chaotic and fast |
Idioventricular |
No P waves and Ventricular rate of 20 to 40 |
Asystole |
No activity and leads are on pt. |
|
|
Heart Blocks |
Extra P waves |
1st degree |
1 P and 1 QRS but the PRI is constant and
greater than .20 |
2nd degree type 1 |
The PRI consequently gets progressively
longer until dropping a QRS. Saying "PRI
gets longer, longer, longer, drop one type 1. |
2nd degree type 2 |
Extras P waves but PRI is constant |
3rd degree |
PRI has no pattern |
|
|