PDA

View Full Version : What do you see??

EMS Guru
10-23-2005, 08:16
Below are a couple of rhythm strips, just wanted to see what everyone's interpretation is. More to follow....

I apologize that these arent appearing, but I went ahead and attached them below. :bang:
WELLAGEDEMT
10-23-2005, 12:56
First one looks like a blockage and second one looks like bradycardia, this is just a guess because I'm just an EMT-B and untrained at reading strips. How far off am I ???? I only looked at the first 2 strips on the first attachment.
IAMedic
10-23-2005, 16:50
I have never claimed to be a cardiologist, so if I'm wrong...bite me!! hehe



#1 - Sinus Arrhythmia

#2 - Sinus Rythm with low QRS voltage - It could be Brady, but at 60 bpm it is most likely SR

#3 - ST Depression, meaning old infarct, age undetermined

I hate being the first one, other than Well Aged, anyways.... :hehe:
EMS Guru
10-23-2005, 17:10
I have never claimed to be a cardiologist, so if I'm wrong...bite me!! hehe



#1 - Sinus Arrhythmia

#2 - Sinus Rythm with low QRS voltage - It could be Brady, but at 60 bpm it is most likely SR

#3 - ST Depression, meaning old infarct, age undetermined

I hate being the first one, other than Well Aged, anyways.... :hehe:

FOR THE RECORD, the 2nd and 5th QRS complexes in the Lead MCL4 strip, look funny because the stylus in the machine is on its way out. For the sake of debate, consider these complexes to look like all of the others in the strip.

Also the rate didnt print on the MCL1 strip, but it is about 70 BPM.
RyanEMVFD
10-25-2005, 10:05
I concur. The first one looks like Sinus Dysrhythmia from respirations. The other two don't look like anything out of the ordinary.

Is there something else we should know about the strips?
hageremtp
10-25-2005, 15:34
I have been out of practice for a month or so, and in the Bioterrorism world we dont worry about how the heart beats (anymore) but rather if it is beating or not. I would tend to agree with AIMEDIC and call it Sinus Arrhythmia, only for a lack of anything better to call it. However, when marched out, there are a couple of beats that do not meet the "Sinus Arrhythmia rules".
EMS Guru
10-25-2005, 18:38
Sinus arrythmia, is sort-of-"it, but there is something else subtle about the lead II strip that is uncommon and easy to miss. (and its not the T waves as I mentioned below)

Maybe its just me, but does anyone think the T waves are wide on lead II?

I dont see any ST depressions on any of these strips, these were done at rest, no cardiac-related complaints.
IAMedic
10-25-2005, 22:53
Maybe its just me, but does anyone think the T waves are wide on lead II?

Maybe just a little, but nothing uncommon or unusual that I can see.
RyanEMVFD
10-25-2005, 23:12
I noticed over on FH the same strips and the word WPW is being mentioned.
EMS Guru
10-25-2005, 23:22
I noticed over on FH the same strips and the word WPW is being mentioned.

Yes, I posted this here and on FH. This is likely Wolff-Parkinson White, because the pt. had a history of exercise induced SVT, and inappropriate sinus tachycardia. Pt. was taking Prinivil 10mg, and Metoprolol (Toprol XL) 50mg, all once a day.
If you look at lead 2 there is a evidence of a delta wave, indicative of WPW

Kudos to all.
IAMedic
10-26-2005, 00:01
Hmmmm....very interesting......Thanks now I have some more researching to do.

:p
RyanEMVFD
10-26-2005, 06:46
Interesting enough, we just ran a call and looking at the EKG in lead 2, our patient showed a really good delta wave. If I can get a way to scan it, I'll post it here.
EpicThought
09-09-2006, 14:13
Ok guys help me out here. I thought that a delta wave was an outward curve to the left side of the R wave. Am I mistaken or just not able to see it?
RyanEMVFD
09-11-2006, 10:26
It is, this example you can see it on the Lead II post.
Bruce Baker
10-09-2006, 21:18
1.) NSR with 1st degree AV block
2.) Sinus arrythmia with ST segment elevation
3.) Sinus rhythm with ST segment depression

That's my take on these? Any more strips for me to evaluate?