T5 Dysrhythmias

• How long should a QRS interval be?

  Less than 0.12.
• What is the range for PR interval?

  0.12 - 0.20
• What is the intrinsic rate for the SA node and atria?

  60 - 100 times/min.
• What is the intrinsic rate for the AV node and bundle of His?

  40 - 60 times/min.
• What is the intrinsic rate of the bundle branches and Purkinje fibers?

  20 - 40 times/min.
• What drugs can be given if atropine does not treat bradycardia?

  Epinephrine or Dopamine.
• Why is epinephrine or dopamine used if atropine does not treat bradycardia?

  They can be infused while atropine has a limited use daily.
• What can be done for sinus tachycardia that isn't medicinal?

  Vagal maneuvers.
• What medications can be given for sinus tachycardia?

  Beta blockers, adenosine, or calcium channel blockers.
• What is adenosine used for?

  Slow down tachycardia.
• What may someone feel with premature atrial contractions?

  Palpitations or heart "skips a beat".
• What happens on an EKG for a supraventricular tachycardia?

  PAC triggers a run of repeated premature beats.
• What are manifestations of SVT or PSVT?

  Heart rate is 151 - 220 beats/min, hypotension, palpitations, dyspnea, angina.
• What treatment can be done for SVT and PSVT without cardioversion and medications?

  Vagal stimulation.
• What medications can be given for SVT and PSVT?

  Adenosine, beta-blockers, calcium channel blockers.
• What procedure can be done for PSVT and SVT?

  Synchronized cardioversion.
• For defibrillation, is the synchronizer on or off?

  Off.
• For cardioversion is the synchronizer on or off?

  On.
• What atrial rate can be reached with atrial flutter?

  200 - 350 beats/min.
• What has an increased risk of occurring with atrial flutter?

  Stroke.
• What is the most common dysrhythmia?

  Atrial fibrillation.
• What drug is most commonly used to control atrial fibrillation?

  Amiodarone.
• What procedure can be done to treat atrial fibrillation?

  Radiofrequency ablation - Maze procedure with cryoablation.
• What treatments are done for 1st degree AV block?

  None.
• How can you identify 3rd degree AV heart block?

  Lack of association of P waves with QRS complexes.
• What drugs can be given for 3rd degree AV block while awaiting pacing?

  Dopamine and Epinephrine.
• What is the 1st drug of choice for PSVT?

  Adenosine.
• What would patients need if they have 3rd degree AV block?

  Pacemakers - TCP, TVP, Permanent.
• How do I identify a PVC?

  QRS complex that is wide and distorted in shape that lasts more than 0.12 seconds.
• How do I identify a PAC?

  Heart beats that fire too early causing irregularity. P waves looking different from regular P waves in rhythm.
• What does it mean if there are 3 or more PVCs in a row?

  A burst or short run of Ventricular Tachycardia.
• What does a ventricular bigeminy look like?

  Sinus beat followed by a ventricular beat.
• What does a trigeminy look like?

  Sinus, sinus, then ventricular beat.
• What medications can be given for PVCs?

  Beta blockers, lidocaine, amiodarone.
• Can ventricular tachycardia be pulse or pulseless?

  Both.
• What does Ventricular Tachycardia look like?

  Identical mountains with no P waves in a repeated pattern.
• What is another name of polymorphic ventricular tachycardia?

  Torsades de pointes.
• How do you treat Torsades de pointes?

  Magnesium.
• How is pulseless ventricular tachycardia treated?

  CPR and rapid defibrillation.
• How is ventricular tachycardia treated if the patient has a pulse?

  Antiarrhythmics or cardioversion.