By Lippincott Williams & Wilkins
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Development acceptance is a vital studying instrument within the interpretation of ECGs. regrettably, until eventually confronted with a sufferer with an arrhythmia or structural center ailment, pediatric practitioners regularly obtain constrained publicity to ECGs. the power to obviously distinguish an irregular ECG development from an ordinary variation in an emergency scenario is a necessary ability, yet one who many pediatricians think ill-prepared to make use of hopefully.
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The most common cause of a pause is a blocked PAC. Precipitous PACs PACs may precipitate a more serious arrhythmia, such as atrial flutter or atrial fibrillation, in patients with heart disease. indd 54 10/7/2011 4:18:09 PM RECOGNIZING OTHER ARRHYTHMIAS 55 occur with an acute MI, they may signal heart failure or an electrolyte imbalance. What the ECG tells you When PACs occur with acute MI, they may signal heart failure or an electrolyte imbalance. • Rhythm: Atrial and ventricular rhythms are irregular as a result of the PACs but the underlying rhythm may be regular.
Indd 27 10/7/2011 4:17:53 PM 28 RECOGNIZING CARDIAC ARRHYTHMIAS Step 8: Evaluate other components Finally, observe other components on the ECG strip, including ectopic or aberrantly conducted beats and other abnormalities. Check the ST segment for any abnormalities, such as elevation above or depression below the isoelectric line, and look for a U wave. Note your findings. I’m so proud of myself! My normal sinus rhythm is a model of classic cardiac conduction. Recognizing normal sinus rhythm Before you can recognize an arrhythmia, you must be able to recognize a normal sinus rhythm (NSR).
Rate: Atrial and ventricular rates are less than 60 beats/minute. • P wave: Normal size and configuration; P wave precedes each QRS complex. • PR interval: Within normal limits and constant. • QRS complex: Normal duration and configuration. • T wave: Normal size and configuration. • QT interval: Within normal limits but may be prolonged. indd 53 10/7/2011 4:18:08 PM 54 RECOGNIZING CARDIAC ARRHYTHMIAS • Increased vagal tone that accompanies straining at stool, vomiting, intubation, mechanical ventilation, sick sinus syndrome, hypothyroidism, or hard physical exertion • Possible result of inferior MI involving the right coronary artery, which supplies blood to the SA node • Treatment with beta-adrenergic blockers, sympatholytic drugs, digoxin, or morphine What to look for Bradycardia may produce no symptoms in athletes.
ACLS Review Made Incredibly Easy by Lippincott Williams & Wilkins