Help with critical care studying (Dysrhythmias, ECG reading, Meds)

[C0SM0]

I'm in my 4th (and final) semester of nursing school and we hit the ground running by starting with dysrhythmias, reading ECG's, and meds used for those dysrhythmias. Does anyone have an easy way to remember how to recognize all the different dysrhythmias on an ECG, and how to remember all the different meds (first, second, and third line meds) and dosages to treat them?

My problem is some of the dyrhythmias look so similar (I'm talking about you V Fib and Torsades de Pointes) and the meds to treat them are similar as well. I've scoured the internet looking for an easy way to remember all this information, but seem to be coming up short.

Any advice is greatly appreciated!

[Castiela]

Your Acls algorithms will be your best bet for memorizing what to do with almost all dysrhythmias. They are made as simple as possible and are pretty succinct. As for memorizing the different wave forms, you're probably better off understanding the patho behind what is happening for the electrical signal to understand the wave form.

For example, a present p wave means your sa node has fired off a signal. No p wave means an electrical abnormality has occurred and the heart has to go to its secondary pacemaker(av node) (junctional) or 3rd site (ventricular). Junctional and ventricular pacemakers are not as effective as the atrial, so your heart rate will be slower (j=40-60, v=20-40). This is important for two reasons 1)35-40% of cardiac output (co) is from the atrial kick (p wave). Furthermore, a rate of 20-50 is generally too slow, also resulting in decreased co if the body's compensation mechanisms can no longer keep up.

When I quickly glance at an egg, I am looking at the ecg for 1) p wave present 2) regular/ irregular (quivering atria = loss of atrial kick) 3) too fast/ too slow (decreased cardiac output) 4) st elevation/ depression (heart muscle death = decreased contractility = decreased co) 5) narrow or wide qrs ( wide qrs = slow conduction time through the ventricles = ventricular rhythm/ bundle branch blocks.

Once you have a good foundation of the basics of the patho, I highly recommend googling "skillstat ecg simulator." Its a great resource to recognize what rhythms are which and explain why. I like the test mode and seeing how many I rhythms I get right in a minute. Reading ecgs, like anything else in nursing, is just a matter of practice. We covered the basics of ecgs in nursing school, but never truly understood them until I did my critical care advanced certificate and had a fantastic instructor who made the patterns make sense. Hopefully this helps

[C0SM0]

Thank you! Very helpful!

[RainMom]

I second the skillstat simulator. Was introduced to it in school & now, I revisit it every time I need to renew ACLS.