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Rhythm Strips. Jessica Wagner UMSON. EKG Grid. Ventricular Rate. 1 st method: Count the number of QRS complexes over the 6 second and then multiply by 10. - PowerPoint PPT Presentation


Ventricular Fibrillation

Rhythm StripsJessica WagnerUMSON

EKG Grid

Normal P Wave: .06-0.11 seconds or 1.5 to 2.75 small boxesNormal PR Interval: 0.12 to 0.20 seconds (3 to 5 small boxes) in adults, longer in elderly people. This interval shortens with increased heart rate.Normal QRS Interval: 0.06 to 0.12 seconds (1.5 to 3 boxes). Measure the QRS interval from the end of the PR interval to the end of the S wave.Normal QT interval: is 0.36 to 0.44 seconds (9-11 boxes). It is measured from the beginning of the QRS complex to the end of the T wave. The QT interval will vary with patient gender, age and heart rate. Another guideline is that normal QT Intervals is less than half of the R-R Interval for heart rates below 100 bpm.5Ventricular Rate

1st method: Count the number of QRS complexes over the 6 second and then multiply by 10The 2nd method uses the small boxes. Count the number of small boxes for a typical R-R interval. Divide this number into 1500 to determine heart rate.

In the second image, the number of small boxes for the R-R interval is 22.5. The heart rate is 1500/21.5, which is 69.8.

Ventricular FibrillationFibrillation is an uncontrolled twitching or quivering of muscle fibers (fibrils). When it occurs in the lower chambers of the heart, it is called ventricular fibrillationDuring VF, blood is notpumped from the heart Sudden cardiac death resultsNO pulsehttp://health.nytimes.com/health/guides/disease/ventricular-fibrillation/overview.htmlCauses of VFConditions that can lead to VF include:Ischemia of the heart muscleElectrocution accidents or injury to the heartHeart attack (#1 cause!)Heart disease that is present at birth (congenital)Heart muscle disease, including cardiomyopathiesHeart surgeryNarrowed coronary arteriesSudden cardiac death (commotio cordis), typically occurring in athletes after an injury over the surface of the heart

Risk FactorsSmokingDiabetesHypertensionSymptomsA person who has a VF episode can suddenly collapse or become unconscious, because the brain and muscles have stopped receiving blood from the heart.The following symptoms may occur within minutes to 1 hour before the collapse:Chest painDizzinessNauseaRapid heartbeatShortness of breathDiagnosing V FibNEVER from a 12-lead EKG b/c it will look the same as asytoleCardiac monitor will show a very disorganized heart rhythmGo in the room and check on your patient (pulses?)There is nothing to measure because your patient is dead you better be doing CPRTreatmentVF is a medical EMERGENCY! TX STAT or deathIf person has VF episode at home: 911Place persons head and neck in line with the rest of their body to make breathing easierStart CPR by doing chest compressionsContinue until person is alert or help arrivesTreatment(#1) VF is treated by delivering a quick electric shock through the chest using a device called an external defibrillatorThe electric shock can immediately restore the heartbeat to a normal rhythm, and should be done as quickly as possibleMany public places now have these machines (AED)TreatmentAn implantable cardioverter defibrillator (ICD) is a device that can be implanted in the chest wall of people who are at risk for this serious rhythm disorderThe ICD can help prevent sudden cardiac death by quickly sending an electrical shock when ventricular fibrillation occurs Medicines may be given to control the heartbeat and heart function after 3 defibrillation attempts (i.e. amiodarone, vasopressin, epinepherine)Antiarrhythmics agents: raise fibrillation and defibrillation thresholdAnticholinergic agents: reduce vagal activity improves conductionVasopressor agents: augment blood flow