help with rhythms

[docomo]

I've been through classes on this, reviewed books, and still suck at recognizing cardiac rhythms on the fly. Any advice on how to make it easy to recognize specific cardiac rhythms quickly and easily?

[MunoRN, RN]

ECG Simulator | SkillStat Learning - Fast, Fun and Effective!

[MiGab]

I second skillstat. I used it last week and it really helped. I found this from an old post about heart blocks:

"If your R is far from P, then you have a 1st degree.

Longer, longer, longer, drop...then you have a Wenckebach.

If your Ps don't go through, then you have a Mobitz 2.

If your Ps don't agree, then you have a 3rd degree."

[Esme12, ASN, BSN, RN]

While there are subtleties...... which will come with practice......in an emergency room you need to remember slow, fast, absent, irregular....wide QRS.....is this new? 1st degree AV, Mobitz 1, II, count in report....but the bottom line is what are the vitals and what are there symptoms, do you need to treat any underlying cause.....K+, dig tox etc. Cardiac Transplants won't respond to atropine.

Extreme brady, VTach, Vfib, SVT....do they have a pulse? What is the B/P, Does it need to be shocked.......you get that part down you're good. I mean that. Get strips to look at in down time. Go to tele/ICU and collect them to look at on break...it will come.

[Morainey, BSN, RN]

I love the Skill Stat simulator!!!

I've taken a couple of telemetry refreshers, but I don't see it every day (we're not a telemetry floor) so when I float I try to immerse myself in it and look at all the strips and monitors. The more I do it, the more naturally it comes :) and always remember, treat your patient, not the monitor? Do they have a pulse? Can they keep a blood pressure? That's the important stuff!

[LaceyRN12]

I first look at the QRS (count how many there are to see what the heart rate is). Then see if it's regular or irregular (example: PVCs).

Then I look to see if there are P waves, and go from there.