ECG
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ACLS (Advanced Cardiovascular Life Support) is a systematic training program for healthcare providers managing cardiovascular emergencies. It aims to support and restore effective oxygenation, ventilation, and circulation to achieve intact neurological function. The protocols cover initial response, treatment algorithms, cardiac arrest management using defibrillation and drugs, and identifying reversible causes of cardiac arrest like hypoxia, acidosis, and coronary thrombosis. Key skills include interpreting ECG rhythms like normal sinus rhythm, ventricular fibrillation, asystole, and pulseless electrical activity.
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CARDIAC ARRYTHMIAS AND ITS NURSING MANAGEMENTSarah Ajose The passage of ions across the myocytes cell membranes is regulated through specific ionic channels that cause cyclic depolarization and repolarization , called as action potential.
Voltage dependent fast sodium channels open, causing rapid depolarization mediated by sodium influx
When sodium channel influx, allowing calcium to enter through slow calcium channels and potassium to leave through potassium channels, a repolarization
Resting sinus heart rate 60 to 100 minute
Bradycardia- slower heart rate (in young people, athletes, and during sleep)
Tachycardia- faster heart rate (exercise , illness, emotions)
Slower heart rate while morning awakening
Increase in rate during inspiration and decrease in rate during expiration (respiratory sinus arrythmia)
Cardiac arrhythmia is the improper beating of the heart, whether irregular, too fast or too slow. Cardiac arrhythmia occurs when electrical impulses in the heart do not work properly.
VENTRICULAR ARRYTHMIAS- lower chambers of the heart (ventricles)
SUPRAVENTRICULAR ARRYTHMIAS- upper chambers of the heart(area above ventricles- atria)
HR- <60 beats/ minute
Because of SA node not sending signals to ventricles
Caused by CNS does not send signal due to
Aging
Congenital defects
Antiarrythmic and antihypertensive medicines
HR-> 100 beats/ minute
Fast heart rate begins in ventricles- VT
Begins in atria- SVT
SA no longer control the ventricles
Heart beat quickens
Feeling of “skipping beats”
Shortness of breath
Dizziness
Fainting
syncope
Uncontrolled irregular beat
Instead of one misplaced beat from the ventricles, the patient may have several impulses that begin at the same time from different locations—all telling the heart to beat.
HR-> 300 beats/ min
Very little blood pumped from heart to brain- fainting
Shock delivered for the return of normal rhythm
Ventricles contracts too soon
Also called as PVB (premature ventricular beat )
Generally not needed treatment
Caffeine
Tea
Soda
Chocolate
Cough and cold medicines
Supraventricular arrhythmias begin in the areas above the heart’s lower chambers, such as the upper chambers (the atria) or the atrial conduction pathways.
tobacco
alcohol
caffeine
cough and cold medicines
Supraventricular tachycardia (SVT) is a rapid, regular heart rate where the heart beats anywhere from 150-250 times per minute in the atria. Another name for SVT is paroxysmal supraventricular tachycardia (PSVT). The word “paroxysmal” means occasionally or from time to time.
Supraventricular tachycardia or PSVT happens when electrical signals in the heart’s upper chambers fire abnormally, which interferes with electrical signals coming from the SA node (the heart’s natural pacemaker). The beats in the atria then speed up the heart rate.
It is also more likely to occur in women, anxious young people, and people who are extremely tired (fatigued). People who drink a lot of coffee or alcohol or who are heavy smokers also have a greater risk.
Atrial fibrillation is a fast, irregular rhythm where s
ECG analysis on normal sinus rhythm and atrial arrhythmias.pptx
ECG analysis on normal sinus rhythm and atrial arrhythmias.pptxcvkrishnapriya575 ECG play a vital role in healthcare industry. Analyzing a ECG is an hectic procedure hence this slide provide simple view about an ECG analysis on normal sinus rhythm and atrial arrhythmiasThe importance of ECG in the healthcare industry cannot be overstated. It is a crucial diagnostic tool that helps doctors and other medical professionals to accurately assess a patient's cardiac health. However, analyzing an ECG can be a complicated and time-consuming process, which is why this slide has been created to provide a simplified overview of ECG analysis for normal sinus rhythm and atrial arrhythmias. With this information, healthcare providers can quickly and easily interpret ECG results and make informed decisions about patient care.The importance of ECG in the healthcare industry cannot be overstated. It is a crucial diagnostic tool that helps doctors and other medical professionals to accurately assess a patient's cardiac health. However, analyzing an ECG can be a complicated and time-consuming process, which is why this slide has been created to provide a simplified overview of ECG analysis for normal sinus rhythm and atrial arrhythmias. With this information, healthcare providers can quickly and easily interpret ECG results and make informed decisions about patient care.
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Arrythmia ratheesh
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Cardiac Arrhythmias - Robert K. Altman, MD, FACC Director, Clinical Cardiac E...
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Analyzing cardiac rhythm shifts. Nursing Medsurg
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Samir rafla ecg arrhythmia for medical students- added amr kamal
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Cardiac arrhythmia.
Cardiac arrhythmia.BPT4thyearJamiaMilli This document provides information about cardiac arrhythmias. It defines arrhythmias as any abnormal heart rate or rhythm and normal sinus rhythm as 60-100 bpm originating from the sinus node. Arrhythmias are classified as sinus, atrial, or ventricular based on origin. Common types include sinus tachycardia/bradycardia, atrial fibrillation, ventricular tachycardia, and heart blocks. Symptoms vary depending on type but can include palpitations, dizziness, and fainting. Diagnosis involves ECG, echocardiogram, and Holter monitoring. Treatment depends on type and may include medications, ablation, pacemakers, or defibrillators.
Cardiac arrhythmia.
Cardiac arrhythmia.BPT4thyearJamiaMilli An arrhythmia is any abnormal heart rate or rhythm that arises from problems with the heart's electrical system. The document classifies and describes different types of arrhythmias including sinus node dysfunction, atrial arrhythmias like atrial fibrillation, and ventricular arrhythmias like ventricular tachycardia. Treatment depends on the specific arrhythmia but may include medications, catheter ablation, pacemakers, or defibrillators. Exercise is an important part of rehabilitation and can help reduce risk factors when done according to an individualized prescription.
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ECG
- 1. Advance Cardiovascular Life Support Chanak Trikhatri
- 2. History ACLS (Advacnce Cardiovascular Life support was started formally since 1999 the concept and practice was established by the American Heart Association.
- 3. Definition Advance Cardiovascular Life Support is systematic design course for health care worker and provider who either directly or participate in the management of cardiopulmonary and cardiovascular emergency.
- 4. Goal of ACLS The main goal of ACLS is to support and restore effective oxygenation, ventilation, circulation with return of intact neurological function
- 5. Systemic Approach • If patient is unconscious use the BLS protocol for initial assessment and treatment then use the ACLS protocols • If patient is conscious use ACLS protocols directly
- 6. Anatomy The heart structures that you must know in order to understand ECG: • Sino-atrial (SA) node (impulse generate 70/m and velocity of conduction 0.05 m/sec) • Atrium (singular is atrium) • Atrio-ventricular (AV) node (impulse generate 60/m and velocity of conduction 0.05 m/sec)
- 7. Anatomy Cont… • Ventricular conducting pathways (i.e. bundle of His, right and left bundle branches (impulse generate 36/m and velocity of conduction 1 m/sec)) • Ventricles • Purkinje fiber (impulse generate 40/m and velocity of conduction 4 m/sec)
- 9. Physiology A normal heart beat follows this sequence: 1. the SA node generates an electrical current 2. this current travels through the atrium 3. the current then enters the AV node, where is slows down for a little delay 4. the current enters the ventricular conduction pathways where it travels rapidly and the 5. ventricles contract 6. and then the ventricles relax
- 12. Reading of ECG 1. Rate 2. Rhythm 3. P wave 4. PR interval 5. QRS complex
- 14. Bradycardia Any rhythm disorder with a heart rate < 60/min. When bradycardia is the cause of the symptoms the rate is generally <50/min. Sinus bradycardia is caused by the SA node firing at a rate of less than 60 bpm. The remaining electrical activity downstream is normal. Rates less than 60 bpm are commonly found in healthy adults.
- 16. Ventricular Tachycardia ( VT) Any abnormal disorder with an abnormal fast heart beat at a rate of 100-250 beat per minute that are initiated in the ventricles and it does not show any response to pressure on carotid artery
- 18. Ventricular Fibrillation (VF) When part of the heart fibrillates, there is no coordinated contraction. However, there is a very high amount of uncoordinated electrical activity which results in quivering. It is this quivering that gives rise to the noisy ECG signal in ventricular fibrillation. There are no ventricular contractions and therefore no cardiac output, no pulse, and no blood pressure.
- 20. Asystole Asystole is the absence of any systolic function. Therefore, there are no atrial or ventricular contractions. It is a flat line. Asystole is the last stage of deterioration of the heart. In an “electrically failing” heart, not all steps will necessarily occur (i.e. could go from bradycardia straight to asystole)
- 21. Asystole
- 22. Pulseless Electrical Activity PEA encompasses a heterogeneous group of rhythms that are organized or semiorganized but lack a palpable pulse includes: Idioventricular rhythms, Ventricular escape rhythms, Postdefibrillation idioventricular rhythms, Sinus rhythm. Even sinus rhythm without a detectable pulse is called PEA.
- 25. Drug Therapy • Epinephrine / Adrenalin IV/IO dose: 1 mg every 3-5 minute • Vasopressin IV/IO dose: 40 units can replace the first or second dose of epinephrine • Amiodarone IV/IO dose: First dose 300mg bolus, second dose 150 mg
- 26. Shock Energy • Monophasic : 360 J • Biphasic: 120-200 J
- 27. Reversible Causes • Hypovolemia • Hypoxia • Hydrogen Ion acidosis • Hypo/hyperkalemia • Hypothermia • Tension pneumothorax • Tamponade cardiac • Toxins • Thrombosis pulmonary • Thrombosis coronary
- 28. Do Not Attempt to resuscitate • Rigor Mortis • Written Documents • Threat to safety of providers
- 29. Chest Pain Chest pain or Acute coronary syndrome due to poor supply of the oxygenated blood to the myocardal tissue which lead to poor perfusion then ischemia develop and cause severe chest pain.
- 30. Management of Chest Pain • Assess the symptoms suggestion ischemia or myocardial infraction. • Emergency assessment, care and hospital prepartion. • Monitor, support ABC be prepared to provide CPR and defibrillation • Administer (MONA) Morphin, Oxygen, Nitroglycerin, Aspirin if needed
- 31. Management of Chest Pain • Obtain 12 lead ECG • Oxygen saturation 94% start at 4 L/min titrate • Aspirin 160 to 325 mg if not given by emergency • Nitroglycerin sublingual or spray • Morphin IV if discomfort is not relieved by nitroglycerin
- 33. Summary Advance Cardiovascular Life Support is design protocol which help patient to support and recover from the cardiovascular and cardiopulmonary emergency and help to return to the intact neurological function with the help of health care provider who are skilled and expertise on ACLS practice.
- 34. Thank You