Rabu, 01 Februari 2012

MADE EASY 5 MINUTE - ECG INTERPRETATION MODULE II

A heart rhythm that originates in the sinoatrial node and is normally conducted is called a Normal Sinus Rhythm. The characteristics of a normal sinus rhythm are a regular rate between 60-100 beats per minute, a narrow complex, preceded by a P-wave where all the complexes look the same.


ANALYZE A RHYTHM 
Rhythm Analysis: 
Step 1: Calculate rate
Step 2: Determine regularity
Step 3: Assess the P wave
Step 4: Determine PR interval
Step 5: Determine QRS duration

STEP 1: CALCULATE RATE 
Option 1
Count the # of R waves in a 6 second rhythm strip, then multiply by 10
Remember: All rhythm strips in the modules are 6 second in length.
Interpretation?" 9x10 = 90 bpm
Option 2
Find a R wave that lands on a blod line.
Count the # of large boxes to the next R wave. If the second R wave is 1 large box away the rate is 300, 2 boxes -150, 3 boxes -100, 4 boxes - 75, etc 

STEP 2: DETERMINE REGULARITY
Look at the R-R distances (using a caliper or marking on a pen or paper)
Regular (are they equidistant apart)?, Occasionally irregular?, Regularly irregular? Irregularly irregular?
Interpretation? Regular

STEP 3: ASSESS THE P WAVES
Are there P waves?
Do the P waves all look alike?
Do the P waves occur at a regular rate?
Is there one P wave before each QRS?
Interpretation? Normal P waves with 1 P wave for every QRS

STEP 4: DETERMINE PR INTERVAL
NORMAL  0.12 - 0.20 SECONDS.(3-5 BOXES)
Interpretation? 0.12 Seconds

STEP 5: QRS DURATION
Normal: 0.04- 0.12 seconds. (1-3 boxes)
Interpretation? 0.08 Seconds

RHYTHM SUMMARY

RATE : 90-95 bpm
REGULARITY : regular
P WAVES : normal
PR interval : 0.12 s
QRS duration : 0.08 s
Interpretation? NORMAL SINUS RHYTHM

Prepared and Presented by
Akshaya Srikanth, Dr.S.Chandra Babu*
Pharm.D Internee, *Asst.Prof of Medicine
RIMS, Kadapa, India

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