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Telemetry Basics

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by

Adrian Hordon

on 1 December 2016

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Transcript of Telemetry Basics

62
ECG
bpm
Thank You!
Objectives

Label the major components of the telemetry graph paper and electrical heart tracings.
Explain the five steps of rhythm analysis.
Differentiate between normal sinus rhythm, sinus bradycardia, and sinus tachycardia.
Describe potential reasons or influences that could initiate sinus bradycardia or sinus tachycardia.
We've all seen it...
But what does it mean?
What happens in the heart......
...directly effects what is on the graph paper!
Labeling the graph paper
Adrian Hordon, MSN RN
Telemetry Basics
Five Steps of Rhythm Analysis
1. Rate
Normally between 60-100 BPM
2. Rhythm
regular (distance between three consecutive R waves is the same distance
3. P Waves
normally present, have the same morphology (shape), and they are married (one p wave for every qrs)
4. pr interval
normally between 0.12-0.20 seconds
5. QRS complex
normally less than 0.12 seconds
let's practice!
6 second strip
Rate - 60 PR Interval - 0.20

Rhythm - Regular QRS - .08

P Waves - Normal x3
Normal Sinus Rhythm!!!




So how do we identify sinus bradycardia?
bradycardia = slow heart rate <60bpm
6 second strip
Rate = 40 PR Interval - 0.16

Rhythm - Regular QRS - 0.10

P wave - Normal x4
Sinus Bradycardia

So what causes bradycardia?
secondary to decreased perfusion
Myocardial infarction (heart attack)
SA node disease
vagal stimulation
hypoxia
hypothermia
increased ICP
hypo/hyperkalemia
s/p heart transplant


How do we identify sinus tachycardia?
6 second strip
tachycardia = fast heart rate >100-180 bpm
Rate - 130 PR Interval - 0.16

Rhythm - regular QRS - 0.12

P wave - Normal
Sinus Tachycardia


tachycardia in action!
Sinus Bradycardia in Action!
what causes tachycardia?
exercise, fever pain
anxiety, hypoxia, CHF
myocardial infarction
infection
hypovolemia
pulmonary emboli
systemic nervous system stimulation
medication, recreational drugs
Full transcript