# EKG Basic Rythem Interpretation

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Chapter 8

Less than 60

100 - 180

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

QRS

.48 seconds

25 seconds

### To determine the HR, measure the

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

75 bpm (1500/20)

50 bpm (1500/30)

2 large squares

300

75 bpm (300/4)

150 bpm (300/2)

60 bpm (300/5)

3 seconds

Atrium

Ventricals

Horizontal lines

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

300

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)

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

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.

Example: