Medical emergency often need a transcutaneous

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More P waves than QRS complexes w/ no relationship between the two. MEDICAL EMERGENCY!!!! Often need a transcutaneous pacemaker or permanent pacemaker may experience syncope hypotension cardiovascular collapse death “If the P's and Q's don't agree, then you have a 3 rd degree” What are the two shockable rhythms? V-Fib coarse or fine coarse is more likely to convert after defibrillation very rapid, uncoordinated fluttering contractions of the ventricles, requires defibrillation Pulseless V-Tach V-Tach impulses only coming from the ventricles usually wide QRS complex poorly perfusing
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4 Pt. may present w/ or w/o pulse Pulseless requires defibrillation Unstable tachy w/ a pulse: Key treatment is synchronized cardioversion Identify Reversible causes: H's hypovolemia hypothermia hypo/hyperkalemia hypoxia hydrogen ion(acidosis) T's Tension pneumothorax Tamponade cardiac Thrombosis, pulmonary Thrombosis, coronary Toxins EKG intervals PR interval: 0.12-0.2 seconds 3-5 small squares QRS complex <0.12 seconds 3 small squares QT interval 0.35-0.46 seconds Short PR intervals: impulse may not be originating at SA node, may have extra pathway like in WOLF- PARKINSON-WHITE Syndrome or Lown Ganong Levine Syndrome: treat w/ meds to control heart rate/ cath. Abrasion, PR segment depression could indicate pericarditis small squares-1mm/0.04 sec large squares- 5mm/0.2 sec
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