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Old 03-21-2010, 12:58 PM   #1
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EKG Rhythm Flowchart?

Hey everyone!

Long time no see! I'm working on studying for my EKG Rhythms test on Friday, and I'm having a lot of trouble remembering all the traits of the rhythms.

For the exam, I'll need to be able to go forwards (see this strip, name the rhythm) and backwards (here's the name of the rhythm, tell me the characteristics you would see in a typical arrhythmia of this type).

I can probably just brute force memorize the backwards, but for the forwards, I was thinking of making a flow chart to be more efficient than running through a million rhythms.

Before I go reinventing the wheel though, does anyone know of a good flowchart (either available online for free or that I can pick up in a bookstore)? I'm willing to pay for it, but I have an A in my physics/cardiology class right now (98% actually woohoo!) and I'd like to keep it that way!

Thanks in advance for any help you can offer!


Let's Roll!
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Old 03-21-2010, 01:03 PM   #2
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In reality it's just rote memorisation and understanding.

I can get a two second look at a strip and go "yeah ok looks normal, move on" or "hmm that looks strange, lets have a nosey".

We are taught:

- P waves; present, absent, inverted etc?
- PR interval; long or short?
- QRS; narrow? wide? absent? pathologic Q waves? etc
- ST segment; normal? depressed? inverted?
- Rate 1500 or 300 method; regular or irregular?
- Identify the rhythm

Things like PVCs can be picked up pretty easy, as can an irregular rhythm but I have to go looking for this PAC or PJC. You can then look at R-R interval and things like that for blocks.

For a 12 lead you also look at reciprocal leads.

It's much harder to go backwards than forwards I find, which for me works out OK, I just repeat the same mistakes over and over!
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Old 03-21-2010, 11:51 PM   #3
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There is a good 'flow chart' in Dale Dubins EKG book, might want to give that a looksie.
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Old 03-22-2010, 09:41 AM   #4
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Similar to MrBrown, we were taught:

(assuming you are talking about the basic rhythms of the 3 lead)

P waves- there? not there? weird looking?
PRI- long? variable? short? not able to determine?
QRS- Wide or narrow?
Rate- Fast? Slow? Normal?
Regularity- Regularly regular, eg. NSR, SVT? regularly irregular eg. Mobitz II, P_C's? irregularly irregular (A-fib)?

Practice practice practice and NEVER EVER EVER memorize how a rhythm "looks", you'll get bit in the @$$ if you do. Take the time to analyze each part of each rhythm and make a determination from that.
"Now we gotta make the best of it, improvise, adapt to the environment, Darwin, stuff happens, I Ching, whatever man we gotta roll with it"
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