ACLS 8hyLhms CheaL SheeL

Amanda Pooper
2008Ŵ2009
-ormal Slnus 8hyLhm
ArresL 8hyLhms
AsysLole
ÞLA
vflb/pulseless vLach
Agonal 8hyLhm/AsysLole
Þulseless LlecLrlcal AcLlvlLy (ÞLA)
-oLe LhaL ÞLA can look llke any rhyLhm (any organlzed
elecLrlcal acLlvlLy)ţ buL lf no pulse lL ls ÞLA
Course venLrlcular llbrlllaLlon
llne venLrlcular llbrlllaLlon
-onŴArresL 8hyLhms
· ne very lmporLanL Lhlng LhaL seems llke lL should be
easy buL l always have Lo remember how Lo doť
Jetetmloe tbe toteŧ
· llnd a C8S complex LhaL ls closesL Lo a dark verLlcal
llneŦ 1hen counL Lhe number of ºblg boxes" unLll Lhe
nexL C8S complexŦ lor each ºblg box" you passţ
selecL Lhe nexL number off Lhe mnemonlc ƍ300Ŵ130Ŵ
100Ŵ73Ŵ60Ŵ30ƍ Lo esLlmaLe Lhe raLeŦ
· AlLernaLlvelyţ you can counL Lhe number of blg boxes
beLween Lwo C8S complexes and dlvlde 300 by LhaL
numberŦ
Slnus 1achycardla
Note the rate is > 100 bpm
ALrlal llbrlllaLlon
-oLe lL ls ºlrregularly lrregular" and Lhere are
no deflnlLe p waves
ALrlal fluLLer
-oLe Lhe ºsawŴLooLh" paLLern
8eenLry SupravenLrlcular 1achycardla
%his is a regular, narrow
complex tachycardia without P
waves, usually with a sudden
onset and cessation
,onomorphlc venLrlcular 1achycardla
ith ventricular rhythms, QRS is usually wide. V tach is
more organized electrical activity than v fib, but v tach
often deteriorates into v fib so both are very bad!
Þolymorphlc venLrlcular 1achycardla
1orsades de ÞolnLes
special type of polymorphic Vtach-
Note the "spindling¨ in the QRS complexes
Slnus 8radycardla
Note the rate <60 bpm. Could be physiologic or
symptomatic depending on the patient.
1
sL
uegree Av 8lock
Note the increased PR interval
2
nd
uegree Av 8lockť ,oblLz Lype l
(Wenckebach)
Note the progressive lengthening of the PR interval
until one P wave (arrow) is not followed by a QRS
2
nd
uegree 8lockť ,oblLz Lype ll
Note the regular PR interval until beats are dropped.
3rd uegree Av 8lock
Note the regular P waves and regular ventricular "escape
beats¨ but no relationship between the P waves and
escape beats.

¯¾

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