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Rhythm Strips Jessica Wagner UMSON

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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

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Rhythm StripsJessica Wagner

UMSON

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EKG Grid

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Ventricular Rate

1st method: Count the number of QRS complexes over the 6 second and then multiply by 10

The 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.

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Ventricular Fibrillation

• Fibrillation is an uncontrolled twitching or

quivering of muscle fibers (fibrils). When it

occurs in the lower chambers of the heart, it

is called ventricular fibrillation

• During VF, blood is not pumped from the

heart Sudden cardiac death results

• NO pulse

http://health.nytimes.com/health/guides/disease/ventricular-fibrillation/overview.html

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Causes of VF• Conditions that can lead to VF include:

– Ischemia of the heart muscle

– Electrocution accidents or injury to the heart

– Heart attack (#1 cause!)

– Heart disease that is present at birth (congenital)

– Heart muscle disease, including cardiomyopathies

– Heart surgery

– Narrowed coronary arteries

– Sudden cardiac death (commotio cordis), typically occurring

in athletes after an injury over the surface of the heart

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Risk Factors

• Smoking

• Diabetes

• Hypertension

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Symptoms• A 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 pain

– Dizziness

– Nausea

– Rapid heartbeat

– Shortness of breath

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Diagnosing V Fib

• NEVER from a 12-lead EKG b/c it will look the

same as asytole

• Cardiac monitor will show a very disorganized

heart rhythm

• Go in the room and check on your patient

(pulses?)

• “There is nothing to measure because your

patient is dead… you better be doing CPR”

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Treatment• VF is a medical EMERGENCY! TX STAT

or death

• If person has VF episode at home: 911

– Place person’s head and neck in line with

the rest of their body to make breathing

easier

– Start CPR by doing chest compressions

• Continue until person is alert or help arrives

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Treatment

• (#1) VF is treated by delivering a quick electric

shock through the chest using a device called an

external defibrillator

• The electric shock can immediately restore the

heartbeat to a normal rhythm, and should be

done as quickly as possible

• Many public places now have these machines

(AED)

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Treatment• An 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 disorder

• The 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 threshold

– Anticholinergic agents: reduce vagal activity improves conduction

– Vasopressor agents: augment blood flow

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