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
Sinus Bradycardia
Rate: 40 to 60/min
Rhythm: Regular
QRS: < .12 sec
Atrial Activity: upright Ps
P to QRS: 1 to 1
First Degree AV Block
Rate: within sinus range
Rhythm: Regular
QRS: < .12 sec
Atrial Activity: PR interval > .20 seconds
P to QRS: 1 to 1
Second Degree AV Block, Type I
AKA: Mobitz I, Wenckebach
Progressive prolongation of the PR interval until a beat
is dropped
May look like clusters of complexes
Second Degree AV Block, Type II
AKA: Mobitz II
Intermittently conducted impulses
PR interval constant WHEN CONDUCTED
Third Degree AV Block
Two separate electrical hearts, dual pacemakers
SA node
Nodal or ventricular pacemaker
P to P interval constant, R to R constant
Mobitz II vs. Third Degree
Pacemaker Generated Rhythm
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