You can stare at rhythm strips all day, but you’ll never be consistent at correctly identifying the rhythm until you master the criteria of each rhythm. Before you start looking at strips take the time to learn what makes each rhythm unique.
It does take some practice but once you have the hang of it you’ll really increase you accuracy and speed in identifying various rhythms.
For those with experience: This isn’t a learn it once and forget it skill. This is something you should brush up on every once in a while.
Read on for more …
Things To Remember – Part 1
Although this is an EKG study guide it is not intended to be a complete stand alone work of reference. It is merely a study guide I used while attending a paramedic course of study at Vincennes University. I have many more study guides (study aids) to publish when I get some extra time. The information presented is in no particular order and should not be considered medical advice. It’s accuracy is not guaranteed as I’m tired and typing this late at night. Enjoy!
P Wave = Atrial Depolarization, Atria Contract
PR Segment = Delay at AV Node, Atria Relax, Atrial Repolarization
PR Interval = Total Atrial Activity
QRS Complex = Ventricular Depolarization, Ventricles Contract
ST Segment = Ventricles Begin To Relax, Ventricular Repolarization Begins
T Wave = Ventricular Repolarization and Relaxation Completed
ST Interval = Total Ventricular Relaxation
QT Interval = Total Ventricular Activity
- The PRI is measured from the beginning of the P wave to the beginning of the QRS
- The normal PRI is 0.12 – 0.20 seconds (3-5 small blocks)
- The QRS is measured from the beginning of the Q wave to the end of the S wave
- The QRS is normally less than 0.12 seconds
Autonomic Nervous System:
Affects the atria and the ventricles
Increases heart rate, conduction, irritability
Affects only the atria
Decreases heart rate, conduction, irritability
Electrical Conduction Through the Heart:
- SA Node
- Intra-atrial pathway
- Inter-nodal pathways
- AV Node
- Bundle of HIS
- Left Bundle Branch
- Right Bundle Branch
- Purkinje Fibers
SA Node – 60-100 bpm
AV Node – 40-60 bpm
Ventricular – 20-40 bpm
Indianapolis EMS is going to be sending a Social Worker out on 911 calls in an effort to reduce the number of “Frequent Flyers” that are abusing the system. One can read about it here. I am curious as to exactly what a Social Worker can do and whether or not a Social Worker would be appropriate in a 911 situation. Perhaps a Social Worker can explain programs that may exist that could offer assistance but will that really cut costs … or just shift them to someone else’s budget?
What are your thoughts?
This week, May 19th through 25th, marks EMS Week in the United States.
EMS Week celebrates and honors the hundreds of thousands of EMS practitioners serving our communities across the nation.
One Mission, One Team
I recently participated in a training/education session at a prominent hospital in Indianapolis. I participated in an eight hour session involving a 91 year old female cadaver. I was surprised, pleasantly, by the inclusion of other health care providers in the session. EMS professionals, a few nurses, and a couple of doctors participated and shared information among each other during the session. The staff leading the session were all paramedics with special training in the instruction and use of cadavers. I was informed that only seven or so people in Indiana have received this training.
One of the paramedics leading the session is also a funeral director.
The purpose of the session was to practice skills generally considered susceptible to skill decay with a primary focus on surgical and needle cricothyrotomy using traditional laryngoscopy and video laryngoscopy via a GlideScope. The bulk of the training session focused on the anatomy & physiology associated with the procedures. Alternate methods of determining landmarks were demonstrated and everyone in the session was evaluated and performed multiple identifications on our cadaver. Discussions included scenarios where improper landmark identification could become problematic.
We spent more than 75% of the allotted time on airway management. This included basic airway management using BVM, oral and nasal adjuncts, King Airway & CombiTubes, LMA insertion, and S.A.L.T device.
Tracheal intubations were practiced by all using both Macintosh and Miller blades as well as the video GlideScope. Everybody had the opportunity to perform as many intubations as they liked. Staff was very approachable and eager to offer tips and solutions to common problems associated with tracheal intubations in the field. Gum Bougie use was also demonstrated and utilized in our practice session as well as intubation without the device.
I was unaware of the S.A.L.T device as it isn’t used in my system. I found it particularly interesting since it may make tracheal intubations fast and easy. The general consensus was that if this device was all it is advertised to be it might very well be the best BLS oral adjunct option available. I wonder why it isn’t more prominent.
At the very least it should be an option in my opinion.
Read on …
Once again the United States has experienced a terrorist attack. This time the bombings occurred during the Boston Marathon. Multiple bombs detonated within seconds of each other near the finish line. A third bomb is reported to have also exploded nearby at the JFK Library.
Three other unexploded bombs have been reported found by Boston authorities. Two at another intersection near the marathon route and one outside of Boston proper.
As of the time of this article at least 2 people have been killed with up to 50 injuries (10 of which are reported to be amputations). I’m sure as the day goes on we will continue to receive updated reports of fatalities and injuries.
Good work by local EMS, Fire, and Police have helped transport and treat many others affected by these blasts. While I try not to be political with this blog I hope this tragic attack prompts those in charge of the purse strings to reevaluate cuts to EMS and other Public Safety organizations.
Images of the Boston Marathon Bombing April 15, 2013
I found a great article about Community Paramedicine at the Journal of Emergency Medical Services website. JEMS is one of my favorite places to visit for information concerning EMS. I have a feeling that as time goes by, and more and more of Obamacare is implemented, Community Paramedicine will become the centerpiece discussion for EMS professionals. While it is an important part of EMS development right now I think it’s impact on preventative care will be tapped as a source to help control overall health care costs. Whether or not it actually works and how other professions, such as Nursing, react to it is still left to be seen.
Shamelessly borrowed from a JEMS Facebook post.
Congratulations to NREMT-Intermediate at Humboldt General Hospital EMS Rescue in Winnemucca, NV awarded the ‘Star of Life‘ award from the American Ambulance Association during the ‘Stars of Life’ event held March 18-20th, 2013 by the association in Washington, DC to recognize and celebrate member achievements.
Here is the press release!
In case one doesn’t know where Winnemucca, NV is I’ve linked a map below!
Do you know the difference between Heart Attack and Cardiac Arrest? Most people use the terms interchangeably when in fact they are two different things. Instead of typing up something that is easily read somewhere else I’ll simply link to an article from the American Heart Association as well as put up a couple of graphics to illustrate the main differences in a visual way.