CLASS 1 TICKET TELE ACTIVITY

​ Review the exhibit​. Identify the rhythm. ​ ​ ​ (a)  

• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• SINUS TACHYCARDIA
• SINUS BRADYCARDIA
• ATRIONODAL REENTRANT TACHYCARDIA (SVT)
• ATRIAL FIBRILLATION
• MONOMORPHIC VENTRICULAR TACHYCARDIA
• ASYSTOLE
• VENTRICULAR FIBRILLATION
• POLYMORPHIC VENTRICULAR TACHYCARDIA

Answer explanation

There is a p wave, and the rate is 60-100, so the rhythm is sinus

​ Review the exhibit​. Identify the rhythm. ​ ​ (a)  

• SINUS RHYTHM WITH PVCS
• SINUS TACHYCARDIA
• SINUS BRADYCARDIA
• ATRIONODAL REENTRANT TACHYCARDIA (SVT)
• ATRIAL FIBRILLATION
• MONOMORPHIC VENTRICULAR TACHYCARDIA
• ASYSTOLE
• VENTRICULAR FIBRILLATION
• SINUS RHYTHM
• POLYMORPHIC VENTRICULAR TACHYCARDIA

Answer explanation

There is a P wave, and the rate is 60-100 which makes this a sinus rhythm. However, notice the wide complex beats that have QRS durations 0.12 seconds or longer. If this were to continue every 3rd beat, it would be called trigeminy. Every 2nd beat is bigeminy. 2 in a row is coupled. 3 or more in a row is a run of ventricular tachycardia.

​ Review the exhibit​. Identify the rhythm. ​ ​ (a)  

• SINUS BRADYCARDIA
• SINUS TACHYCARDIA
• ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA
• ATRIAL FIBRILLATION
• MONOMORPHIC VENTRICULAR TACHYCARDIA
• ASYSTOLE
• VENTRICULAR FIBRILLATION
• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• POLYMORPHIC VENTRICULAR TACHYCARDIA

Answer explanation

There is a p wave so it is sinus in origin. The rate is less than 60, so it is bradycardia. Just an FYI (you do NOT have to diagnose heart block for this course), if the R is far from P it would be a 1st degree. If the PR interval gets longer, longer, longer and then drop then it's a Wenkebach (Mobitz type 1). If some P's don't bet through then it's a Mobitz 2. If P's and Q's don't agree it's a 3rd degree.

​ Review the exhibit​. Identify the rhythm. ​ ​ ​ ​ (a)  

• ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA
• SINUS TACHYCARDIA
• ATRIAL FIBRILLATION
• MONMORPHIC VENTRICULAR TACHYCARDIA
• ASYSTOLE
• VENTRICULAR FIBRILLATION
• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• SINUS BRADYCARDIA
• POLYMORPHIC VENTRICULAR TACHYCARDIA

Answer explanation

If you can't with 100% certainty identify P waves, then chose NO for step 2. This narrows it down to 3 options. Since it's narrow complex, it can't be ventricular in nature. If it were irregular, it could be atrial fibrillation RVR. But since it's regular, it is atrioventricular nodal reentrant tachycardia (AVNRT), aka SVT (supraventricular tachycardia)

​ Review the exhibit​. Identify the rhythm. ​ ​ ​ (a)  

• ATRIAL FIBRILLATION
• SINUS TACHYCARDIA
• MONOMORPHIC VENTRICULAR TACHYCARDIA
• ASYSTOLE
• VENTRICULAR FIBRILLATION
• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• SINUS BRADYCARDIA
• ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA
• POLYMORPHIC VENTRICULAR TACHYCARDIA

Answer explanation

If you can't with 100% certainty identify P waves, then chose NO for step 2. This narrows it down to 3 options. Since it's narrow complex, it can't be ventricular in nature. If it were regular and above 120, it would be atrioventricular nodal reentrant tachycardia (AVNRT), aka SVT (supraventricular tachycardia). Because it is irregular, it is atrial fibrillation

​ Review the exhibit​. Identify the rhythm. ​ ​ ​​ ​ (a)  

• ASYSTOLE
• SINUS TACHYCARDIA
• VENTRICULAR FIBRILLATION
• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• SINUS BRADYCARDIA
• ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA
• ATRIAL FIBRILLATION
• MONOMORPHIC VENTRICULAR TACHYCARDIA
• POLYMORPHIC VENTRICULAR TACHYCARDIA

Answer explanation

There is no electrical activity or complexes. Check 2 leads just in case a fine ventricular fibrillation could be seen. An ultrasound (FAST exam) will also confirm lack of cardiac activity). Some refer to this rhythm a flatline (see the movie Flatliners)

​ Review the exhibit​. Identify the rhythm. ​ ​ ​​ ​ ​ ​ (a)  

• SINUS TACHYCARDIA
• VENTRICULAR FIBRILLATION
• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• SINUS BRADYCARDIA
• ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA
• ATRIAL FIBRILLATION
• MONOMORPHIC VENTRICULAR TACHYCARDIA
• ASYSTOLE
• POLYMORPHIC VENTRICULAR TACHYCARDIA

Answer explanation

There is a P wave so it is sinus in nature. It is faster than 100, so it is tachycardia

​ Review the exhibit​. Identify the rhythm. ​ ​ ​​ ​ ​​ ​ (a)  

• VENTRICULAR FIBRILLATION
• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA
• ATRIAL FIBRILLATION
• MONOVENTRICULAR TACHYCARDIA
• ASYSTOLE
• SINUS TACHYCARDIA
• SINUS BRADYCARDIA
• POLYMORPHIC VENTRICULAR TACHYCARDIA

Answer explanation

There is electrical activity, but disorganized. This is a coarse ventricular fibrillation

​ Review the exhibit​. Identify the rhythm. ​ ​ ​​ ​ ​​ ​ (a)   ,

• MONOMORPHIC VENTRICULAR TACHYCARDIA
• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA
• ATRIAL FIBRILLATION
• ASYSTOLE
• SINUS TACHYCARDIA
• SINUS BRADYCARDIA
• VENTRICULAR FIBRILLATION

Answer explanation

This has a wide complex and consistent/regular QRS shape and rate which makes it monomorphic ventricular tachycardia.

​ Review the exhibit​. Identify the rhythm. ​ ​ ​​ ​ ​​ ​ (a)   ,

• POLYMORPHIC VENTRICULAR TACHYCARDIA
• SINUS RHYTHM
• SINUS RHYTHM WITH PVCS
• ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA
• ATRIAL FIBRILLATION
• ASYSTOLE
• SINUS TACHYCARDIA
• SINUS BRADYCARDIA
• VENTRICULAR FIBRILLATION

Answer explanation

This has a wide complex and inconsistent/irregular QRS shape and rate which makes it polymorphic ventricular tachycardia, aka Torsades de Pointes.