I would like your opinion about a funky EKG

[Dustdevil]

You can't actually diagnose anything with a three lead ECG, you need a twelve or fifteen for that.

Thank you! Would you be interested in teaching paramedic school in Texas? I just got out of a refresher class where all the medics yelled "BUNDLE BRANCH BLOCK!!!" at every notched QRS they saw. They were so captivated by those notched complexes that they usually completely missed the underlying rhythm.

When I showed them that those were not BBB's, they were shocked and said they had been taught that all notched QRS's were BBB's :?

[Ridryder 911]

Close. Paroxysmal Nodal Tachycardia. Originating in the AV node. PNT is a type of SVT also. As far as the V-tach. Your right. I was tired when I posted that and had sleep in my eyes. I'll prolly let this debate be carried on by people more skilled than I to do so. =)

oh... you mean Junctional tach...the same thing.. True you cannot diagnose in 3 leads.. not that you can not diagnose with a 3 lead monitor.. such as using multiple lead placing.. even MCL[sub:955ea64636]1[/sub:955ea64636] etc..

Be safe,

R/R 911

[Jeep_911]

accelerated junctional escape rythm with a lot of other stuff I have no clue what it is...ventricular bigemeny... can't be that because the QRS's would have to wide wouldnt they??

[flightmedic608]

This is only my interp.....for what it's worth. To me I see a prolonged and changing PR interval making the initial rhythm sinus tach/borderline SVT with 1st HB or maybe a sick sinus transitioning into a bigemeny of junctional escape. I would lean more towards the sick sinus theory..... It is a very poor copy online. Sorry..to those who think maybe A-Fib...I would suggest reviewing the R to R's, they are regular and equal making A-Fib not possible, do not look only at isoelectric line in determining EKGs, take a minute and review the whole complex..Also on the issue of V-Tach...remember the parameters for a vent rhythm...wide complex....

[Medic553]

When I was going through paramedic school and a strip like that came up, one of the instructors jokingly said, "Shock it 'til ya know it!"

[Kingfisher]

I'll take a stab. Looks like the begining of the strip is an accellerated third degree that degenerates to a slower rate. There are P waves that march out through most of the strip but there is no connection to the complexs. Think there is some buried P's under some of those complexes. The complexes are borderline wide. That's my two cents

[vs-eh?]

I'll take a stab. Looks like the begining of the strip is an accellerated third degree that degenerates to a slower rate. There are P waves that march out through most of the strip but there is no connection to the complexs. Think there is some buried P's under some of those complexes. The complexes are borderline wide. That's my two cents

Disagree.

Accelerated 3rd degree? I don't that term exists, you might as well call it VT. Especially when the initial rate is about 150. And with all things being equal with only a lead 2 interp, hard pressed to call it a VT for various reasons...

[UMSTUDENT]

Thank you! Would you be interested in teaching paramedic school in Texas? I just got out of a refresher class where all the medics yelled "BUNDLE BRANCH BLOCK!!!" at every notched QRS they saw. They were so captivated by those notched complexes that they usually completely missed the underlying rhythm.

When I showed them that those were not BBB's, they were shocked and said they had been taught that all notched QRS's were BBB's :?

"If you're in lead-2 you ain't got shit"

Old parody of the Johnny Cochrain saying from the O.J trial. Heard a medic say it once.

[Kingfisher]

I,ll have to ask for my money back from med school. I still say there are dissociated P waves at a tachy rate, through out most of the strip. The ventricles are probably being controlled at the junctional level, the initial part of the strip over 150, which should have been called a junctional tach and not an accellerated rhythm (my bad). I would have liked to see more of the rhythm strip to see if it stayed slow.

[Airmedic999]

Dunno if it is or was ever AF...far too regular. starts off by the looks of it over 150 with narrow complex tacy i.e SVT and then progresses to multiple ectopy in bigeminal rhythym. QRS complexes are regular in amongst the bigemini are they not?