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Questions and Answers
Which of the following is a characteristic of a narrow QRS complex with a uniform shape?
Which of the following is a characteristic of a narrow QRS complex with a uniform shape?
- Wide complex
- Variable morphology
- Irregular spacing
- Regular spacing (correct)
What is the recommended action for a patient who is awake and has a severe but stable condition?
What is the recommended action for a patient who is awake and has a severe but stable condition?
- Don't shock (correct)
- Immediate cardioversion
- Stack medications
- Induce a pulseless state
What is a key characteristic of an unstable rhythm?
What is a key characteristic of an unstable rhythm?
- Pulseless (correct)
- Regular QRS intervals
- Stable blood pressure
- Narrow QRS complex
When is cardioversion typically considered?
When is cardioversion typically considered?
What intervention should be avoided in a patient who is awake, but in severe condition?
What intervention should be avoided in a patient who is awake, but in severe condition?
In what situation is synchronized cardioversion typically used?
In what situation is synchronized cardioversion typically used?
What is a characteristic of a narrow QRS complex?
What is a characteristic of a narrow QRS complex?
Which intervention is not typically done on a patient who is awake?
Which intervention is not typically done on a patient who is awake?
What should you avoid in a pulseless patient?
What should you avoid in a pulseless patient?
What is a characteristic of a regular rhythm?
What is a characteristic of a regular rhythm?
What should you avoid in a patient who is awake, but in severe condition?
What should you avoid in a patient who is awake, but in severe condition?
When is cardioversion typically used?
When is cardioversion typically used?
What can we say about QRS complex/Interval?
What can we say about QRS complex/Interval?
What can we say about Regular spacing?
What can we say about Regular spacing?
Flashcards
Cardioversion
Cardioversion
A procedure used to treat a rapid heart rate or irregular heart rhythm by delivering an electrical shock to the heart.
Pulseless shock
Pulseless shock
An electrical shock that is delivered to the heart when there is no pulse.
Severe, Awake
Severe, Awake
Refers to a state where a patient is awake, conscious, but experiencing severe symptoms that require immediate medical intervention.
Ventricular Tachycardia
Ventricular Tachycardia
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Narrow QRS Complexes
Narrow QRS Complexes
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Vtach
Vtach
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Synchronized Cardioversion
Synchronized Cardioversion
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Pulseless VTach
Pulseless VTach
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Unstable VTach
Unstable VTach
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Regular rhythm QRS complex
Regular rhythm QRS complex
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Study Notes
Ventricular Tachycardia (VTach)
- VTach can be addressed with cardioversion or defibrillation
- Cardioversion is suitable if the patient unstable
- Defibrillation is used in cases of VTach that are more severe
- If a patient with VTach is awake, they should not be shocked
- Pulseless VTach should be shocked
- Unstable VTach, needs to be shocked
- The physician is always there
QRS Complex/Interval
- Narrow complexes with uniform shape and regular spacing are characteristic
- The duration is less than 0.12 seconds
P Wave
- Upright and rounded morphology is considered "Married" to the QRS complex
PR Interval
- Duration ranges from 0.12 to 0.20 seconds and remains constant from beat to beat
Heart Rate (HR)
- Normal range is 60 to 100 beats per minute
- Heart rate can be calculated by counting the number of complexes on a 6-second strip and multiplying by 10
- It can be calculated by counting the number of small blocks between QRS complexes and dividing by 1500
Electrode Placement
- Appropriate placement of electrodes/leads is needed to obtain Leads I, II, III, and MCL 1
Bipolar Leads
- Bipolar leads are standard limb leads that using a difference in electrical potential between two selected electrodes
- Lead I involves the right arm (negative) and left arm (positive)
- Lead II uses the right arm (negative) and left leg (positive)
- Lead III incorporates the left arm (negative) and left leg (positive)
- Limb leads are represented by ROMAN numerals, while precordial leads are represented by ARABIC numerals
Precordial Leads
- Six unipolar leads view the heart from the horizontal plane and are all positive
Precordial Lead Locations
- V1: Located to the right of the sternum
- V2: Located to the left of the sternum
- V3: Positioned between V2 and V4
- V4: Located at the 5th intercostal space, mid-clavicle
- V5: Located at the anterior axillary line
- V6: Located past V5
Continuous Monitoring Leads
- Lead II: Places the positive electrode on the left abdomen, negative electrode on the right shoulder, and the ground electrode on the left shoulder
- MCL₁: Places the positive electrode in the 4th ICS RSB, negative electrode on the left shoulder, and the ground electrode on the right shoulder
- MCL₁ is a modified chest lead 1, similar to V1
Electrocardiographic Truths
- Positive QRS complex: Signifies an impulse traveling towards the positive electrode
- Negative QRS complex" Signifies an impulse traveling away from the positive electrode
- Isoelectric QRS complex signifies an impulse traveling perpendicular to the positive electrode (no electrical activity)
- A flat line signifies there is no electrical impulse at all
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Description
This lesson covers the characteristics of narrow QRS complexes, appropriate actions for patients in various conditions, and characteristics of unstable rhythms. It also addresses when cardioversion is considered and interventions to avoid in certain patients.
