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ACLS Study Guide for Precourse Self-Assessment
ACLSStudyGuideforPrecourseSelf-Assessment 20 rhythm strips on Precourse Self-Assessment with the following matching choices: Agonal rhythm/Asystole Atrial Fibrillation Atrial Flutter Ventricular Fibrillation Monomorphic Ventricular Tachycardia Normal Sinus Rhythm Polymorphic Ventricular Tachycardia RHYTHM & ETIOLOGY Normal Sinus Rhythm • Normal, None Sinus Tachycardia • • • • • • • • • • • Exercise Anxiety Caffeine Nicotine Fever Shock CHF Hypotension Pain Hypoxemia Anterior MI Pulseless Electrical Activity Supraventricular Tachycardia Second-Degree Atrioventricular Block (Mobitz I, Wenckebach) Second-Degree Atrioventricular Block (Mobitz II) Sinus Bradycardia Sinus Tachycardia Third-Degree Atrioventricular Block CRITERIA OVERVIEW RHY – Regular R – 60-100 P – Upright PRI – 0.12-0.20 QRS – 0.04-0.10 UNIQUE CRITERIA None, normal rhythm RHY – Regular R – 100-160 P – Upright PRI – 0.12-0.20 QRS – 0.04-0.10 Rate 100-160 SAMPLE STRIPS EXPRESSTRAININGSOLUTIONS–444CAMINODELRIOSSTE108–SANDIEGO,CA92108–(888)815-0313–EXPRESSTRAINING.COM AdditionalmaterialcreatedtoenhanceandsupplementthelearningexperienceandisnotAHAapproved CardiacDysrhythmiaOverviewiscourtesyofKeyMedicalResources,Inc.TerryRudd CardiacDysrhythmiaOverviewtoHelpwithACLSPrecourseSelf-AssessmentMay2016,Page1[TCL] ACLSStudyGuideforPrecourseSelf-Assessment RHYTHM & ETIOLOGY CRITERIA OVERVIEW Sinus Bradycardia RHY – Regular R – Below 60 • Damage SA P – Upright • Normal sleep PRI – 0.12-0.20 athletes QRS – 0.04-0.10 • • • • • • SAMPLE STRIPS Vagal Glaucoma Hypothermia Inferior MI Drugs – MS, digoxin, Inderal IICP PVC/PVD Premature Ventricular Contraction/Depolarization • Hypoxia • Hypotension • Anemia • Ischemic heart disease • • Electrolytes • M.I. • Myocarditis, pericarditis • CHF • Stress, fatigue, smoking, • Overeating, caffeine • Hypoglycemia • Sepsis • Cyclic antidepressants •Supraventricular Acidosis Tachycardia • UNIQUE CRITERIA Rate below 60 Not visible sudden start or stop AN ECTOPIC BEAT RHY – Irregular R – 60-100 P – Upright PRI – 0.12-0.20 QRS – 0.04-0.10 SR, early beat has Vent beat (wide & bizarre) RHY – Regular Rate above R – 160 - 250 160-250 P – Upright PRI – 0.12-0.20 QRS – 0.04 – 0.10 EXPRESSTRAININGSOLUTIONS–444CAMINODELRIOSSTE108–SANDIEGO,CA92108–(888)815-0313–EXPRESSTRAINING.COM AdditionalmaterialcreatedtoenhanceandsupplementthelearningexperienceandisnotAHAapproved CardiacDysrhythmiaOverviewiscourtesyofKeyMedicalResources,Inc.TerryRudd CardiacDysrhythmiaOverviewtoHelpwithACLSPrecourseSelf-AssessmentMay2016,Page2[TCL] ACLSStudyGuideforPrecourseSelf-Assessment RHYTHM & ETIOLOGY CRITERIA UNIQUE OVERVIEW CRITERIA RHY – Regular or Regular or Irregular Irregular R – Atrial 250-400 No Ps Vent: 70 - 150 (called Fs) P – None, Fs PRI – None Saw tooth QRS – 0.04-0.10 Atrial Flutter • • • • • • • • Ischemic heart disease MI Digoxin toxicity Mitral, Tricuspid valve disease Stress PE Hyperthyroid Often temp Atrial Fibrillation • • • • • Ischemic heart disease Digoxin toxicity CHF MI Mitral or Tricuspid valve disease PEA Pulseless Electrical Activity • SAMPLE STRIPS RHY – Irregular Irregular, no R – Atrial 350-600 No Ps (called Vent. – Fs) Below 100 controlled Above 100 uncontrolled P – None Fs PRI – None QRS – 0.04-0.10 Looks like any rhythm that should have a pulse but does not RHY – Irregular PRI – Vary P – Extra Ps QRS – 0.04-0.10 2nd Degree AV Block Type I Mobitz I Wenckebach Irregular EXTRA Ps PRI longer & longer Dropped QRS EXPRESSTRAININGSOLUTIONS–444CAMINODELRIOSSTE108–SANDIEGO,CA92108–(888)815-0313–EXPRESSTRAINING.COM AdditionalmaterialcreatedtoenhanceandsupplementthelearningexperienceandisnotAHAapproved CardiacDysrhythmiaOverviewiscourtesyofKeyMedicalResources,Inc.TerryRudd CardiacDysrhythmiaOverviewtoHelpwithACLSPrecourseSelf-AssessmentMay2016,Page3[TCL] ACLSStudyGuideforPrecourseSelf-Assessment RHYTHM & ETIOLOGY 2nd Degree AV Block Type II Mobitz II CRITERIA OVERVIEW RHY – Regular or Irregular PRI – Constant P – Extra Ps QRS – Normal or wide 3rd Degree AV Block Complete Heart Block RHY – Regular PRI – vary P – Extra Ps QRS – Usually wide Regular RHY – Regular R – Above 100 P – None PRI – None QRS – Wide, bizarre R over 100 RHY – Chaotic R – None P – None PRI – None QRS – None, fibrillatory line Chaotic wavy line • Same as 1st degree Ventricular Tachycardia Monomorphic • • All complexes are the same shape and look the same Wide complex tachycardia Ventricular Fibrillation • • • • Following V Tach Acute MI Electrolyte Imbalance UNIQUE CRITERIA Regular or Irregular SAMPLE STRIPS EXTRA Ps EXTRA Ps PRI varies greatly All Vent beats No pulse EXPRESSTRAININGSOLUTIONS–444CAMINODELRIOSSTE108–SANDIEGO,CA92108–(888)815-0313–EXPRESSTRAINING.COM AdditionalmaterialcreatedtoenhanceandsupplementthelearningexperienceandisnotAHAapproved CardiacDysrhythmiaOverviewiscourtesyofKeyMedicalResources,Inc.TerryRudd CardiacDysrhythmiaOverviewtoHelpwithACLSPrecourseSelf-AssessmentMay2016,Page4[TCL] ACLSStudyGuideforPrecourseSelf-Assessment RHYTHM & ETIOLOGY Torsades de Pointes Polymorphic Ventricular Tachycardia Best treated with magnesium Agonal • • Dying heart Drugs used in cardiac arrest provide some electrical waves Asystole • • Primary event in cardiac arrest Untreated V-tach or V-fib CRITERIA OVERVIEW RHY – Chaotic waves R – None P – None PRI –None QRS – Points twist UNIQUE CRITERIA Chaotic wavy line RHY – Regular R – Slow P – None PRI – None QRS – Very, very wide Slow wide bizarre stretched out waves RHY – None unless only Ps R – No Vent rate P – May be present PRI – None QRS – None Straight line or only Ps SAMPLE STRIPS No pulse Points twist No Pulse No Pulse Calculating Heart Rate - note strips on pretest are longer than 6 seconds. Table for Small Box Method To calculate the heart rate, count the number of 0.04 squares (or small boxes) between two QRS complexes (1500 divided by X = HR) Small Boxes from R to R 5 = 300 6 = 250 7 = 214 8 = 188 9 = 168 10 = 150 11 = 136 12 = 125 13 = 115 14 = 107 15 = 100 16 = 94 17 = 88 18 = 83 19 = 79 20 = 75 21= 72 22 = 68 23 = 65 24 = 63 25 = 60 26 =58 27 = 56 28 = 54 29 = 52 30 = 50 31 = 48 32 = 47 33 = 45 34 = 44 35 = 43 36 = 42 37 = 41 38 =40 39 = 38 40 = 37 41 = 37 42 = 36 43 = 35 44 = 34 45 = 33 46 = 33 47 = 32 48 = 31 EXPRESSTRAININGSOLUTIONS–444CAMINODELRIOSSTE108–SANDIEGO,CA92108–(888)815-0313–EXPRESSTRAINING.COM AdditionalmaterialcreatedtoenhanceandsupplementthelearningexperienceandisnotAHAapproved CardiacDysrhythmiaOverviewiscourtesyofKeyMedicalResources,Inc.TerryRudd CardiacDysrhythmiaOverviewtoHelpwithACLSPrecourseSelf-AssessmentMay2016,Page5[TCL] ACLSStudyGuideforPrecourseSelf-Assessment Heart Blocks and Tricks for Analysis 2nd Degree AV block Type I Mobitz I Wenckebach Extra Ps Rhythm is always irregular from QRS to QRS PR intervals get longer and longer 2nd Degree AV block Type II Mobitz II Extra Ps PR intervals on conducted beats are the same - the only heart block with extra Ps that has this 3rd Degree Heart Block Complete Heart Block Extra Ps Rhythm is always regular from QRS to QRS PR Intervals different EXPRESSTRAININGSOLUTIONS–444CAMINODELRIOSSTE108–SANDIEGO,CA92108–(888)815-0313–EXPRESSTRAINING.COM AdditionalmaterialcreatedtoenhanceandsupplementthelearningexperienceandisnotAHAapproved CardiacDysrhythmiaOverviewiscourtesyofKeyMedicalResources,Inc.TerryRudd CardiacDysrhythmiaOverviewtoHelpwithACLSPrecourseSelf-AssessmentMay2016,Page6[TCL] ACLSStudyGuideforPrecourseSelf-Assessment http://www.univie.ac.at/cga/courses/BE513/EKG/qrs.gif http://pspl.technion.ac.il/projects/2004s22/ecg1.JPG EXPRESSTRAININGSOLUTIONS–444CAMINODELRIOSSTE108–SANDIEGO,CA92108–(888)815-0313–EXPRESSTRAINING.COM AdditionalmaterialcreatedtoenhanceandsupplementthelearningexperienceandisnotAHAapproved CardiacDysrhythmiaOverviewiscourtesyofKeyMedicalResources,Inc.TerryRudd CardiacDysrhythmiaOverviewtoHelpwithACLSPrecourseSelf-AssessmentMay2016,Page7[TCL]
