[Music] hi my name is Michelle cuns I'm hoping you saw my other videos on har plocks 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 to RS and the P tops 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 teoc cardia it's a faster Rhythm Q s's are narrow but it's difficult to differentiate between the P's and and the te's but it usually is a regular rhythm sinus teoc cardia sinus braic cardia 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 sign is braic cardia ay a deadly Rhythm we will check in more than one lead to see maybe it is V FIB but asy there is no rhythm start CPR atrial flutter it is one irritable folky firing rapidly in the atrium causing the saw too or picket fence pattern in the basement line the r RS are here are narrow and are usually regular atrial flutter atrial fibrillation multiple irritable folky firing rapidly in the atrium quing that very chaotic Baseline the AR RS are never regular and there are no discernable p waves atrial fibrillation here is sinus rhythm with pac's it's an ectopic firing in the atrium causes an irregular Rhythm to occur but no symptoms usually pac's here's a sinus rhythm with PVCs an ectopic originating in The ventricle they could be unifocal PVCs or if they look different they could be called multifocal PVCs here has a sinus rhythm with two PVCs in a row called a couplet here's sinus rhythm with a run of vtac but the patient goes back to a normal sinus rhythm here the patient is converting to a ventricular Tech of card I'm going to check a pulse if there is a pulse I'm going to use medications and synchronized cardiio version here's a patient in vtac that converts to a pulses Rhythm called viib if this picture was larger I might even call this picture Tad deant it is a form of vtac actually and I would check a p pulse but this picture here is a good example of ventricular fibrillation a pulseless rhythm here's a rhythm called first deegree heart BL block it is not slow at this time but sometimes heart blocks are slow but if you notice the PR interval is greater than 020 seconds in this Rhythm I see groupings of qrs's and dropped beats the PR interval also gets longer longer longer and then there's a p-wave with a dropped QRS longer longer longer drop what's my name wingy boach in this patient this Rhythm appears regular but I see more P's than Q's so I know it's a heart block and every time there's a QRS the P interval is constant so every time there's a QRS I say it's married to a p and every time it's married to a p I'm thinking of two people getting married second degree type two is the married har Block in this Rhythm I do notice wide qrs's I notice the heart rate is also slow below 60 I see more p's and q's I know it's a heart block and there is no consistent relationship between the P's and the 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 C or SES are wide originating in The ventricle this is often called an idov ventricular Rhythm patient may be stable this also could look like a rhythm after a patient has coated there may or may not even be a pulse here's a slow Rhythm it's a regular rhythm but I notice 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 the 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 paste Rhythm this is a ventricular Pac maker 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 Pac maker 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 [Music] [Applause] you