How to Interpret Rhythm Strips - PDF

How to Interpret a Rhythm Strip © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Tools used to Analyze Rhythms ECG Paper Calipers R...

How to Interpret a Rhythm Strip © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Tools used to Analyze Rhythms ECG Paper Calipers Rate Chart (Helpful but not needed) © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e By Karen M. Ellis TCMC: P Reynolds Pearson Prentice Hall Upper Saddle River, NJ 07458  ECG Paper mm 1 box = 2 boxes = 3 boxes = 4 boxes 5 boxes = 0.04 0.08 0.12 = 0.16 0.20 © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e 🡪TIME🡪 Pearson Prentice Hall TCMC-P Reynolds By Karen M. Ellis Upper Saddle River, NJ 07458  The Five General Steps to Rhythm Interpretation Obtain 6 sec strip & Determine: If there are QRS complexes (do they look the same?). Shape consistent & within normal limits? Regular or irregular rhythm? Calculate the heart rate. If there are P waves (1 p wave with every QRS). Is there 1P : 1QRS ? The PR and QRS intervals (measure these) indicates sinus or AV node. © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Heart Rate Calculation Heart rate: Number of QRS complexes per minute. Same as ventricular rate. Atrial rate is number of P waves per minute. count QRS complexes = heart rate © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Methods For Calculating Heart Rate 6-second strip method: Use for calculation irregular rhythms Least accurate. Count number of QRS complexes on 6-second strip and multiply by 10. Standard paper will mark 3 sec intervals at top of strip © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Five Step Practice-Irregular Rate = 3 x 10=30 Irregular rhythm 6x10 (30 beats / min) Count how many QRS’s multiply by 10. © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Methods For Calculating Heart Rate (cont’d) Little block method: Count number of little blocks between QRS complexes and divide into 1500. Use for regular rhythm © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Little Block Method RS-.0 6 Figure 5-2: Little Block Method of Calculating Heart Rate © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Regular Rhythm (cont’d) If there is no more than 2-3 blocks different then it would be considered ‘regular’ for this pt. Split blocks by ½ if the reading falls between blocks. Figure 5-3: Regular Rhythm © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Regular but Interrupted by Premature Beats R-R intervals are regular until a beat pops in prematurely. © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Calculating Heart Rate: Regular but Interrupted by Premature Beats Ignore the premature beat. Using the little block method, calculate heart rate on an uninterrupted part of the strip. © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Calculating Heart Rate: Regular but Interrupted by Premature Beats (cont’d) 3 groups of 5 blocks = 15/1500 R-R interval: regular except for 1 early beat. 15 blocks (1500/15)= 100 bpm Figure 5-7: Regular Rhythm Interrupted by a Premature Beat © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Calculating Heart Rate: Regular but Interrupted by Pauses (cont’d) 20.5 19 19 19 18 R-R interval: regular except for pause. R-R 18-20.5 blocks. 1500/19 = 79bpm Figure 5-8: Regular Rhythm Interrupted by a Pause © 2007 Pearson Education, Inc. EKG Plain and Simple, 2e Pearson Prentice Hall By Karen M. Ellis Upper Saddle River, NJ 07458  Measuring the Waves (ch 2) MEMORIZE THESE NUMBERS PR =0.16 (normal is.12-.20 sec or 3-5 small blocks) QRS =0.08 (normal is