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Various Ventricular Fibrillations 1. Ventricular Fibrillation 2. Ventricular Fibrillation 3.   Ventricular Fibrillation 4.    Ventricular Fibrillation 5. Ventricular fibrillation 6. Ventricular fibrillation 7. Ventricular fibrillation 8. Ventricular fibrillation 9. Ventricular fibrillation 10. Ventricular fibrillation

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 2nd degree heart block type I The rhythm is irregular with a rate of 60/min.   The P waves are uniform and upright.   There is some splitting of the P wave which is often seen with biatrial enlargement.   There is progressive elongation of the PR interval over successive beats.   There is a dropped P wave after the 2nd QRS complex.   The QRS complexes are narrow.   PR:  .20/.24/..26/.30 sec.   QRS:  .08 sec,  QT:  .44 sec.   Interpretation:  2nd degree heart block type I 2. Accelerated junctional changing to sinus rhythm The rhythm is slightly irregular.   The heart rate is 83/min.   The P waves are negative or possibly biphasic in complexes 1 through 5 and then are positive in the remaining complexes.   The QRS complexes are narrow.  PR:  .10 sec,  QRS: ...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Atrial fibrillation with rapid ventricular response The rhythm is irregular with a rate of 110/min.   There are not any P waves associated with the QRS complexes, just fibrillatory or even some flutter waves.  No ectopy is identified.  PR:  ---,  QRS:  .08 sec,  QT:  .32 sec. 2. Supraventricular tachycardia The rate is regular.   The rate is 150/min.  No P waves are seen.  No ectopic beats are present.  PR:  ---,  QRS:  .06 sec,  QT:  .32 sec. 3. Sinus tachycardia The rhythm is regular and the rate is 107/min.   There are upright P waves that are tall and wide suggesting biatrial enlargement.  No ectopic complexes are present.  PR:  .20 sec,  QRS:  .08 sec,  QT:  .36 sec. 4. Ventricular fibrillati...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Normal sinus rhythm with bigeminal PVCs The rhythm is irregular due to the PVCs.   The rate is 60/min.   P waves are present, upright, and associated with a QRS complex.  There are unifocal PVCs occurring every other beat.  The PVCs are followed by a compensatory pause. A fusion beat, the last complex, is formed as a PVC occurs as a sinus impulse is initiated.  PR:  .16 sec.  QRS:  .10 sec.  QT:  .44 sec. 2. Trigeminal fusion complexes The rhythm is irregular due to the PVCs.   The rate is 80/min.   The P waves are upright and precede the QRS complexes.  The PR interval is prolonged.  There are unifocal PVCs that occur every third beat.  These PVCs are preceded by a P wave.  The P-P interval is very consistent across the str...

Oh Danny boy, the pipes, the pipes are calling From glen to glen, and down the mountain side The summer's gone, and all the flowers are dying 'Tis you, 'tis you must go and I must bide. Danny Boy A 94 year old admitted with chest pain. 0206:  Called to room because patient was feeling nauseated.  Patient found to be diaphoretic,  nauseated, and anxious.   Holding chest.   Became unresponsive and pulseless.   Code Blue called. 0210:  CPR initiated.   Placed on monitor.   Normal saline started. 0211:  Defibrillated at 200 joules.   Post-shock rhythm ventricular tachycardia.   CPR resumed 0213:   Epinephrine 1mg IV given.   CPR in progress.   Positive pressure ventilations adequate. 0215:  Defribrillated 300 joules.    CPR resumed.    Ventilations becoming more difficult.  Abdomen distended.  Attempted NG insertion ...