THE ECG IS ONLY ONE PART

OF PATIENT ASSESSMENT
ONLY measures the ELECTRICITY present in the patients heart
Tells you NOTHING about cardiac output
ONLY works if the leads are all properly attached to the patient, the
cable is plugged into the monitor, and the monitor is turned on!!
Patient Assessment
A - Airway
Is the airway OPEN and MAINTAINABLE
B - Breathing
Respiratory rate and quality
C - Circulation
Pulse rate and quality
Level of Consciousness
Signs of Perfusion
Cardiac Output - blood pressure
D - Defibrillation
Is the patient in a rhythm requiring defibrillation
Myocardial Cell Type
Working Cells
Electrical System Cells
Formation of electrical impulse
Conduction of electrical impulse
Mechanism of Impulse Formation
Automaticity (normal)
Reentry (tachydisrhythmias)
Causes of Arrhythmias
Disturbances in Automaticity
Disturbances in Conductivity
Combination of Both
Normal Sinus Rhythm
Rate: 60 to 100/min
Rhythm: Regular
QRS: < .12 sec
Atrial Activity: upright Ps
P to QRS: 1 to 1
Premature Complexes
Complexes that come earlier than anticipated
Atrial, junctional, ventricular
PAC: upright P wave
PJC: NO upright P,
narrow QRS
PVC: wide QRS
R on T Phenomenon
Treat ASAP
do NOT wait to see if supplemental oxygen has any
effect
R on T Phenomenon
Also know as ??
Ventricular Tachycardia
(sustained)
With a pulse and stable
With a pulse and unstable
Pulseless
Ventricular Fibrillation
A - Airway
B - Breathing
C - Circulation
D - Defibrillation
Asystole
Treat appropriately
Epinephrine q 3 to 5 minutes
Atropine q 3 to 5 minutes
Pacing is rarely effective unless initiated immediately in
a primary asystolic arrest