acls rhythms cheat sheet
TRANSCRIPT
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ACLS Rhythms Cheat Sheet
Amanda Hooper2008-2009
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Normal Sinus Rhythm
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Arrest Rhythms
AsystolePEA
Vfib/pulseless Vtach
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Agonal Rhythm/Asystole
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Pulseless Electrical Activity (PEA)
Note that PEA can look like any rhythm (any organized electrical activity), but if no pulse it is PEA
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Course Ventricular Fibrillation
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Fine Ventricular Fibrillation
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Non-Arrest Rhythms
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• One very important thing that seems like it should be easy but I always have to remember how to do: determine the rate…
• Find a QRS complex that is closest to a dark vertical line. Then count the number of “big boxes” until the next QRS complex. For each “big box” you pass, select the next number off the mnemonic "300-150-100-75-60-50" to estimate the rate.
• Alternatively, you can count the number of big boxes between two QRS complexes and divide 300 by that number.
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Sinus Tachycardia
Note the rate is > 100 bpm
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Atrial Fibrillation
Note it is “irregularly irregular” and there are no definite p waves
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Atrial flutter
Note the “saw-tooth” pattern
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Reentry Supraventricular Tachycardia
This is a regular, narrow complex tachycardia without P waves, usually with a sudden
onset and cessation
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Monomorphic Ventricular Tachycardia
With ventricular rhythms, QRS is usually wide. V tach is more organized electrical activity than v fib, but v tach
often deteriorates into v fib so both are very bad!
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Polymorphic Ventricular Tachycardia
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Torsades de Pointes
A special type of polymorphic Vtach-Note the “spindling” in the QRS complexes
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Sinus Bradycardia
Note the rate <60 bpm. Could be physiologic or symptomatic depending on the patient.
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1st Degree AV Block
Note the increased PR interval
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2nd Degree AV Block: Mobitz type I (Wenckebach)
Note the progressive lengthening of the PR interval until one P wave (arrow) is not followed by a QRS
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2nd Degree Block: Mobitz type II
Note the regular PR interval until beats are dropped.
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3rd Degree AV Block
Note the regular P waves and regular ventricular “escape beats” but no relationship between the P waves and
escape beats.