1. Normal sinus rhythm.
1.1. Rate 60-100 bpm
1.1.1. P-wave upright.
1.1.1.1. QRS complex narrow
1.2. Treatment- Monitor, position of comfort,O2 considered,Transport considered.
1.2.1. http://www.bem.fi/book/19/fi/1902a.gif
2. Atrial fibrillation.
2.1. Rate 100-175 bpm
2.1.1. P-wave indiscernible
2.1.1.1. QRS complex narrow
2.2. Treatment-Hi Flow O2, cardiac monitor,IV, Cartiziem 20mg, slow IVP, Consider 50 Joules, 100 joules.
2.2.1. Only treat new acute onset of A -FIB.
2.2.1.1. http://www.neheart.com/wp-content/uploads/2015/10/tachycardia.jpg
3. Atrial Flutter.
3.1. Rate 150 - 300
3.1.1. P - Wave indiscernible
3.1.1.1. QRS complex narrow
3.2. Treatment -Hi flow O2, Cardiac monitor, IV, Cartiziem 20mg, slow IVP, Consider 50 Joules, 100 Joules.
3.2.1. http://www.neheart.com/wp-content/uploads/2015/10/tachycardia.jpg
4. Atrial Fibrillation with RVR.
4.1. Rate > 100 BPM
4.1.1. P - Wave indiscernible
4.1.1.1. QRS complex narrow
4.2. Treatment Hi Flow O2 Cardiac monitor,IV Cartiziem 20mg,slow IVP, Considered 50 Joules,100 joules.
4.2.1. http://www.neheart.com/wp-content/uploads/2015/10/tachycardia.jpg
5. Supra ventricular Tachycardia
5.1. Rate150-180 BPM
5.1.1. Inverted P- Wave
5.1.1.1. QRS complex narrow
5.2. Treatment - Hi flow O2, Cardiac monitor, IV, Vagal Maneuver, Adenosine 6mg,12mg,12mg, slow IVP.
5.2.1. http://www.bem.fi/book/19/fi/1902a.gif
6. Ventricular Tachycardia/ pulse
6.1. Rate >130 BPM
6.1.1. P -Wave indiscernible
6.1.1.1. QRS complex wide
6.2. Treatment- CPR considered, Hi Flow O2, Synchronize cardiovert 100 joules, Amioderone 150mg, 1mg/kg Epi 1/10,000 every 3-5 min. CPR cont X2, 100 Joules, Amioderone 150 mg. Think H's and T's.
6.2.1. http://www.neheart.com/wp-content/uploads/2015/10/tachycardia.jpg
7. V-Tach or V-Fib w/o pulse
7.1. Rhythm disorganized
7.2. Treatment- CPR, Defibrillate 200 joules, Amiorderone, 300mg, 1mg/kg EPI 1/10,000 every 3-5 min.CPR cont X2, Defibrillate 200 joules, Amioderone 150 mg.
7.2.1. http://www.bem.fi/book/19/fi/1902a.gif
8. First Degree Heart Block
8.1. Rate 40-60
8.1.1. P-Wave upright
8.1.1.1. QRS complex normal
8.2. Asymptomatic
8.2.1. Treatment- Hi Flow O2,IV, Consider 0.5 mg Atropine, Consider Transcutaneous pacing.
8.2.1.1. http://www.emedgroup.com/images/ekgs.gif
9. Second Degree Heart Block
9.1. Rate 40-60
9.1.1. P-wave Pro longed
9.1.1.1. QRS complex normal
9.2. Treatment - Hi Flow O2,IV, Considered 0.5 mg Atropine, Consider Transcutaneous pacing.
9.2.1. http://www.emedgroup.com/images/ekgs.gif
10. Third Degree Heart Block
10.1. Rate 20-30
10.1.1. P-wave no correlation to QRS complex
10.1.1.1. QRS complex normal
10.2. Treatment Hi Flow O2, IV, Transcutaneous pace, set rate mili amp mechanical capture,check pulse dopamine drip.
10.2.1. http://www.emedgroup.com/images/ekgs.gif
11. Asystole
11.1. Rate - none
11.2. Treatment- CPR, EPI 1mg/kg 1/10,000 IVP
11.2.1. http://www.neheart.com/wp-content/uploads/2015/10/tachycardia.jpg