Chapter 3 Analyzing EKG Rhythm Strips

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

To analyze EKG rhythm strip:

 Use organized format to collect available clues  Compare information collected to rules for each arrhythmia Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

Calculating Heart Rate – Regular Rhythms

 Count number of large squares between two R waves and divide into 300, or  Count number of small squares between two R waves and divide into 1500 Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

Calculating Heart Rate – Using Heart Rate Meter

 Place arrow above one R wave; read rate at next R wave Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

Calculating Heart Rate

Number of large squares between two R waves 1 2 3 4 5 6 Subsequent rate per minute 300 150 100 75 60 50 Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

Calculating Heart Rate – Regular or Irregular Rhythms

 Count number of R waves in a 6 second strip and multiply by 10 Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

Rhythm Strip Analysis Format

 Regularity (Rhythm)  Rate  P Waves  PR Intervals  QRS Complexes Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

Regularity (Rhythm)

 Is it regular?

 Is it irregular?

 Are there any patterns to the irregularity?

 Are there any ectopic beats; if so, are they early or late?

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

P Waves

  Are P waves regular?

Is there one P wave for every QRS?

  Is P wave in front of QRS or behind it?

  Is P wave normal and upright in Lead II?

 Are there more P waves than QRS complexes?

Do all P waves look alike?

Are irregular P waves associated with ectopic beats?

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

PR Interval

 Are all PRIs constant?

 Is PRI measurement within normal range?

 If PRI varies, is there a pattern to changing measurements?

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

QRS Complex

   Are all QRS complexes of equal duration?

 What is the measurement of QRS complex?

 Is QRS measurement within normal limits?

Do all QRS complexes look alike?

Are unusual QRS complexes associated with ectopic beats?

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

Chapter 3 Practice Strips

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.1

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.2

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.3

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.4

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.5

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.6

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.7

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.8

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.9

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.10

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.11

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.12

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.13

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.14

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3.15

Gail Walraven,

Basic Arrhythmias

, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ