ANALYZING THE RHYTHM

Determine the Heart -Between 60 =100 = normal -Under 60 = Bradycardia -Over 60 = Tachycardia.

Rate

Determine the Rhythm -Is it regular? -Regularly irregular, occasionally irregular, irregularly irregular. - Assess the P to P interval to see if the atrial rhythm is regular - A slight irregularity in the PP intervals ( no more than 3 small blocks) is normal and considered regular if all the Ps are of the same shape. - This is a sinus arrythmia due to changes in the intrathoracic pressure during the resp cycle. - Assess the RR interval , Analyze the P waves -Are P waves present? -Are the P waves occurring regularly ? -Is there one P wave for each QRS? - Do they look similar? -Are the P waves smooth, rounded and upright or are they inverted. - Is the shape consistent throughout the strip? - If the shape is consistent , then atrial depolarization is occurring from impulses from one focus. usually the SA node. - Is there one P wave before each QRS

Measure the PR interval Measure from the beginning of the P wave to the end of the PR segment. Normal is .12-.20 seconds. PR interval should be constant throughout the strip If there are no P waves or the P waves occur after the QRS then the PR interval cannot be measured. Are the PR intervals greater than .20 second? Are they less than .12 second? Are they constant ? Measure the QRS Start at the beginning of the QRS and end where the QRS ends and the ST segment begins. ( J point) Normal duration is b/w 0.04 and 0.10 second. This measurement should be constant If they are narrow ( under .12 second) it means the impulse was not formed in the ventricles . If the QRS is wide, ( greater than 0.10 second) it indicates that the impulse is either from the ventricle or from the supraventricular area with aberrant conduction Are the QRS complexes similar throughout the strip?