Arrhythmias Medical Student Teaching Tuesday 24 th January 2012 Dr Karen Jones, SpR Emergency Medicine.

Slides:

Advertisements

Similar presentations

ECG TRAINING MODULE 4 BY BRAD CHAPMAN RCT.

Advertisements

By Dr.Ahmed Mostafa Assist. Prof. of anesthesia & I.C.U.

Basic Overview ECG Rhythm Interpretation

Rhythm Review March 2010 CE Condell EMS System Prepared by: Steve Holtz, FF,PM Libertyville Fire Department Reviewed/revised by: Sharon Hopkins, RN, BSN,

ACLS Rhythms Cheat Sheet

European Resuscitation Council

EKG Monitoring.

Recognizing heartrhythm disturbances in PSG

Basic Dysrhythmia Kamlya balgoon 2009.

ECGs and Acute Cardiac Events Workshop

Cardiac Arrhythmia. Cardiac Arrhythmia Definition: The pumping action of the heart is coordinated by an electrical system within the heart tissue.

Electrocardiography Arrhythmias Review

Arrhythmias: The Good, the Bad and the Ugly

Cardiovascular Monitoring Cardiac Dysrhythmia

Arrhythmias Danny Haywood FY1.

Fast & Easy ECGs, 2nd E – A Self-Paced Learning Program

Bradycardia & Tachycardia

Arrhythmias Principles of long and short term management of arrythmias.

Arrhythmia recognition and treatment

Sinus, Atrial, Junctional / Nodal, Ventricular, Blocks, others.

Cardiovascular System Block Cardiac Arrhythmias (Physiology)

Cardiology II Arrhythmias. Objectives O Describe the normal conduction in the heart O Describe pathophysiology of bradycardias O Describe pathophysiology.

Arrythmia Interpretation (cont’d) Rates of automaticity – Too fast (tachycardia) – Too slow (bradycardia) – Too irritable (Premature) – Absent (block)

Basic Dysrhythmia &Recording ECG

Natalia Fernandez, PT, MS, MSc, CCS University of Michigan Health Care System Department of Physical Medicine and Rehabilitation.

Basic ECG Strips Sampler of 46 ECG Strips of Cardiac Rhythms.

Chapter 17 Interpreting the Electrocardiogram

Elsevier items and derived items © 2006 by Elsevier Inc. Chapter 37 Interventions for Clients with Dysrhythmias.

Bradycardia Risk of asystole? History of asystole Mobitz II AV block Any pause  3 s Complete heart block, wide QRS Adverse signs? Clinical evidence of.

Supraventricular Arrhythmias Claire B. Hunter, M.D.

Basic Arrhythmias © 2011 American Heart Association. Do not edit.

EKG Interpretation Just the beginning

By Dr. Zahoor CARDIAC ARRHYTHMIA.

Fast & Easy ECGs – A Self-Paced Learning Program

By: Martin Grant Student no  Cardioversion is defined as a “synchronised direct current (DC) discharge, and … does not apply to ventricular.

Clk. Alexander L. Gonzales II December 14, SINUS RHYTHM  >60bpm and

ADVANCED CONCEPTS IN EMERGENCY CARE (EMS 483)

Adel Hasanin, MRCP (UK), MS (Cardiology)

By Dr. Zahoor Atrial Fibrillation There are no P-waves, QRS complexes appear irregularly irregular. 4.

Normal EKG – P wave: Atrial depolarization – PR interval: < 0.20 sec – QRS complex: ventricular depolarization – QRS interval < 0.10 sec SA 0.10 – 0.12.

Kamlya balgoon 2009 AV Blocks  AV block occur when the conduction of impulse through AV node decrease or stop  Prolonged P-R interval or more P waves.

ARRHYTHMIA. Disturbance of cardiac rythumn Anatomy of the conducting system.

Tachyarrhythmia, Cardioversion and Drugs. Learning outcomes At the end of this workshop you should: Be able to recognise types of tachyarrythmia, defined.

SCN EKG Review and Strip

Cardiac monitoring Egan’s Ch. 17, CARC Ch. 11.

2  Unstable :  Altered mental status  Ischemic chest discomfort  Acute heart failure  Hypotension  Other signs of shock  Symptomatic:  Palpitations.

Aims The ECG complex Step by step interpretation Rhythm disturbances Axis QRS abnormalities Acute and chronic ischaemia Miscellaneous ECG abnormalities.

A nursing student’s guide

Dr. Mona Soliman, MBBS, MSc, PhD Associate Professor Department of Physiology Chair of Cardiovascular Block College of Medicine King Saud University.

1 Case 9 Stable Tachycardias © 2001 American Heart Association.

February EMS Training: AV Blocks & Pacing Used with permission of Silver Cross EMS System.

ARRHYTHMIA Objectives At the end of this session students should be able to:  Distinguish the normal from abnormal rhythms.  Understand the pathophysiologic.

Introduction to Cardiac Arrythmias Arrythmia is a generalized term used to denote disturbances in the heart's rhythm. Normal sinus rhythm is characterized.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 33 Disorders of Cardiac Conduction and Rhythm.

ARRHYTHMIAS Jamil Mayet. Arrhythmias - learning objectives –Mechanisms of action of antiarrhythmic drugs –Diagnosis To differentiate the different types.

Arrhythmias and EKGs.

Arrhythmias ED SHO TEACHING C Brown, August 2015.

Tachykardie / bradykardie

ECG RHYTHM ABNORMALITIES

Rhythm recognition Workshop

CODE BLUE MANAGEMENT Quick ECG Interpretation

Resident Survival Skills

What is this: laryngeal mask air way

Basic Telemetry Course

ECG Advanced Basics for Interns - Arrhythmias

ARRHYTHMIA DR MANSOUR ALQURASHI

ECG Strips of Cardiac Rhythms EYAS ALMOUSA,MD,FACC

Basic Rhythm Recognition

Basic Rhythm Recognition

Presentation transcript:

Arrhythmias Medical Student Teaching Tuesday 24 th January 2012 Dr Karen Jones, SpR Emergency Medicine

Aims:  Recognition of common arrhythmias  Identification of adverse features that indicate the risk of imminent deterioration  Understanding the treatment options

What are arrhythmias and why are they important?  Rhythms that are not produced by the SA node and transmitted through the electrical system of the heart in the normal way  Some abnormal rhythms may lead to cardiac arrest or deterioration if untreated  If you can identify an arrhythmia and institute the correct treatment you may be able to prevent deterioration

The Cardiac Conduction System

I think the patient has an arrhythmia, what should I do?

 Start with ABC!  Check for a pulse  Give oxygen!  Get the patient on a cardiac monitor  Insert an iv cannula  Assess for adverse features  Get a 12 lead ECG

Adverse features  Shock  Syncope  Heart failure  Chest pain  Extreme heart rate  > 150  < 40

What treatment options are there?  Do nothing  Simple clinical interventions  Drugs  Electricity

Assessing a rhythm 1.Is there any electrical activity? 2.What is the rate – fast, normal or slow? 3.Is the rhythm regular or irregular? 4.Is the QRS complex narrow or wide? 5.Are there P waves? 6.Are the P waves related to the QRS complexes?

What is the rhythm?

Asystole

What is the rhythm?

Ventricular Fibrillation

Treatment?

What is the rhythm?

Ventricular Tachycardia (VT)

Treatment?

It depends…CHECK THE PATIENT!  No pulse = ELECTRICITY (Defibrillate)  Adverse signs = ELECTRICITY (Cardioversion)  No adverse signs = DRUGS (Amiodarone)

What is the rhythm?

Torsades de Pointes

Treatment?

What is the rhythm?

Sinus Tachycardia

Treatment?

CHECK THE PATIENT!  Check for a pulse and ABC  Treat the underlying cause  Pyrexia  Hypoxia  Hypovolaemia  Pain  Agitation  Toxins

What is the rhythm?

AV nodal re-entry tachycardia (Supraventricular tachycardia SVT)

Treatment?

It depends…CHECK THE PATIENT!  No pulse = CPR  Adverse signs = Electricity (Cardioversion)  No adverse signs = Vagal Manoeuvres Drugs (Adenosine)

What is the rhythm?

Atrial Fibrillation

Treatment?

It depends…CHECK THE PATIENT!  No pulse = CPR  Adverse signs =ELECTRICITY (Cardioversion)  No adverse signs = DRUGS

What is the rhythm?

Atrial Flutter

Treatment?

What is the rhythm?

Sinus Bradycardia

What is the rhythm?

First Degree AV Block

What is the rhythm?

Second Degree AV Block Mobitz Type I (Wenckebach)

What is the rhythm?

Second Degree AV Block Mobitz Type II

What is the rhythm?

Third Degree AV Block (Complete Heart Block)

Treatment?

It depends…CHECK THE PATIENT!  Adverse signs = DRUGS (Atropine) Temporary pacing Permanent pacing  No adverse signs =MONITOR

TAKE HOME MESSAGES!  Always start with ABC  Check for adverse signs  Get a 12 lead ECG and use the 6 step approach  Treatment depends on the clinical state of the patient CHECK THE PATIENT!