EKG Training: Watching and Interpreting the Defibrillator Monitor

hi my name is Michelle Coons I'm hoping you saw my other videos on harp locks and how to look at a basic EKG picture today I'm going to show you EKG strips and give you a basic overview of each one thank you normal sinus rhythm the heart rate is between 60 and 100 PR interval measures normal the QRS is usually narrow the R - RS and the PDP's all measure regular so normal sinus rhythm or regular sinus rhythm is this picture when the heart rate is below 150 but yet above 100 it is sinus tachycardia it's a faster rhythm cure SS are narrow but it's difficult to differentiate between the peas and the T's but it usually is a regular rhythm sinus tachycardia sinus bradycardia notice the heart rate is below 60 patient may be symptomatic however it is a regular rhythm the PR interval measures normal it's just the heart rate is slow sinus bradycardia asystole a deadly rhythm we will check in more than one lead to see maybe it is v-fib but asystole there's no rhythm start CPR atrial flutter it is one irritable foci firing rapidly in the atrium causing the sawtooth or picket-fence pad and in the baseline the art of ours are here are narrow and are usually regular atrial flutter atrial fibrillation multiple herbal foci firing rapidly in the atrium causing that very chaotic baseline the art ours are never regular and there are no discernible p-waves atrial fibrillation here is sinus rhythm with PA C's it's an ectopic firing in the atrium causes an irregular rhythm to occur but no symptoms usually PA sees here is a sinus rhythm with PVCs an ectopic originating and the ventricle they could be unified evcs or if they look different they could be called multifocal PVCs he has a sinus rhythm with two PVCs in a row called a couplet here's sinus rhythm with a run of v-tach but the patient goes back to a normal sinus rhythm here the patient is converting to a ventricular tachycardia I'm going to check a pulse if there is a pulse I'm going to use medications and synchronized cardioversion here's a patient in v-tach that converts double pulses rhythm called v-fib if this picture was larger I might even call this picture toursad the plant it is a form of v-tach actually and I would check a pulse but this picture here is a good example of ventricular fibrillation a pulseless rhythm he has a rhythm called first degree heart block it is not slow at this time but sometimes heart blocks are slow but if you notice the PR interval is greater than 0.2 zero seconds in this rhythm I see groupings of qrs's and dropped beats the PR interval also gets longer longer longer and then as a p-wave with a drop QRS long along a longer drop what's my name winky back in this patient this rhythm appears regular but I see more peas than cues so I know it's a hard block and every time there's a QRS the peer interval is constant so every time there's a cure as I say it's married to a pea and every time it's married to a pea I'm thinking of two people getting married second degree type 2 is the married heart lock in this rhythm I do notice wide QRS is I notice the heart rate is also slow below 60 I see more P's and Q's I know it's a hard block and there is no consistent relationship between the P's and Q's so this is a third-degree heart block complete heart block also called AV dissociation this picture is a slow rhythm looks like the qrs's are wide originating in the ventricle this is often called an idioventricular rhythm patient may be stable this also could look like a rhythm after a patient has coded there may or may not even be a pulse here's a slow rhythm it's a regular rhythm but I noticed that the p-waves are inverted right before the QRS that's a junctional rhythm sometimes you don't see the P waves because they're hidden in a QRS or sometimes they're after the QRS either way you see it the P waves will be upside down because of retrograde or upside-down conduction that's a junctional rhythm I see a spike and an immediate capture this is a pace paced rhythm this is a ventricular pacemaker in this chaotic picture I see a spike in a p-wave a spike and a QRS so I have multiple spikes and captures this is an AV sequential or dual chamber pacemaker this is an implanted pacemaker this is what you might see on a cardiac monitor when they're doing CPR compressions on a patient's chest if they're doing deep effective high-quality CPR you will see this picture on your monitor this is not a good picture this is an end-of-life picture they call this an agonal rhythm thank you you

Channel: michelekunz

Views: 1,338,141

Keywords: ekg, ecg, monitor, nursing, \nursing education\, \michele kunz\, \michelle kunz\, \lifepak 20\, defibrillator, aed, \patient care\, \acls certification\, nursing school, ekg interpretation, ecg interpretation, cardiac conduction, arrhythmia, bundle branch block, arrhythmia interpretation

Id: 9ZTfR4AHq-c

Length: 9min 57sec (597 seconds)

Published: Wed Jul 29 2009