EKG Basic Rythem Interpretation

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Chapter 8

Sinus Bradycardia occurs when the HR is

Less than 60

Sinus Tachycardia occurs when the HR is

100 - 180

Normal Sinus Rhythm (NSR) rate is

60 - 100

Sinus Arrythmia is NSR that occurs when

The HR varies with RESPIRATION

Sinus Tachycardia is Normal NSR that occurs when

The patient is ANXIOUS, IN PAIN OR HAS A FEVER

Sinus Bradycardia is Normal NSR that occurs in

ATHLETES OR WHEN THE PATIENT IS ASLEEP

In NSR the PR interval usually measures

.12 to .20 seconds or 3 to 5 small squares

In NSR the QRS interval usually measures

.4 to .10 seconds or about 1 to 2.5 small squares

In NSR every P wave is followed by a

QRS

Twelve small squares equals

.48 seconds

Five large squares equals

25 seconds

To determine the HR, measure the

R to R interval and DIVIDE the number of squares by 1500

If there are 20 small squares between QRS complexes, the HR is

75 bpm (1500/20)

If there are 30 small squares between QRS complexes, the HR is

50 bpm (1500/30)

Ten small squares equal

2 large squares

Large Squares equal one minute

300

If there are four large squares between QRS complexes, the HR is

75 bpm (300/4)

If there are two large squares between QRS complexes, the HR is

150 bpm (300/2)

If there are five large squares between QRS complexes, the HR is

60 bpm (300/5)

The hash marks above the grid at the top of the EKG paper occur every

3 seconds

PR Interval current goes through the

Atrium

QRS interval current goes through the

Ventricals

Time is represented by

Horizontal lines

Voltage is represented by

Vertical axis

The taller the waveform, the

MORE voltage is represents

How many seconds are needed to get a good interpretation

6 seconds or 2 hash marks

How many LARGE Boxes equal ONE minute

300

How many SMALL boxes equal ONE minute

1500

Flat Line

Asystole - Baseline or isoelectric line

Steps in determining the Systematic Rhythm Analysis

1. Determine HR; 2. Determine Regular intervals; 3. Measure duration of P wave and the QRS complex

Determine Heart Rate by

Counting R waves during a 6 second period and then multiply by 10 to get bpm

A more accurate way to determine the HR

Count LARGE squares between each beat and then memorize what HR is associated with each interval.

Mathematical Method to determine the HR

Count number of SMALL squares between two beats, or QRS complexes then divide that number by 1500 to get the bpm

Determine if Rhythm is Regular or Irregular by

Use a blank piece of paper and mark the R to R intervals for the first 3 R waves. Move the paper down one cycle. If the marks fall on R waves, the rhythm is regular

Marching Out

Using a piece of paper to determine regular heart rhythm

Calipers

A metal tool used to assist in the accurate measurement of waveforms. Can be locked.

ST Elevation (STEM)

Myocardial Infarction (heart attack)

ST Depression (STDIP)

Ischemia

Heart Block

A disturbance in the conduction system of the heart. May have several large positive or negative spikes that make up one QRS complex

Sinus Bradycardia

A heart rhythm that originates in the SA Node. The rhythm is regular and all waveforms have normal shape and duration, BUT the heart rate is LESS THAN 60 bpm

Sinus Tachycardia

A heart rhythm that original in the SA node. The rhythm is regular and all waveforms have normal shape and duration, BUT the heart rate is MORE THAN 100 bpm

Sinus Arrhythmia

Variation of NSR in which the rhythm is initiated from the sinus node and meets all criteria for NSR EXCEPT that it is IRREGULAR. The rhythm varies with RESPIRATION, speeding up with INSPIRATION and SLOWING WITH EXPIRATION.

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