Recognizing heartrhythm disturbances in psg
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Any change in the normal sequence of the electrical impulses from the sinus node ... Reanimation child < 8 years old. Arrhyhtmia-CPR. Reanimation pediatrics ...

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Presentation Transcript

Arrhythmias l.jpg
Arrhythmias

Any change in the normal sequence of the electrical impulses from the sinus node (SA) to the ventricles can cause arrhythmia


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Ecg in psg l.jpg
ECG in PSG

  • Mostly only 1 channel

  • Recognition of heartrhythm disturbances

  • Not a diagnostic tool for other heartpathologies s.a. signs of ischaemia


Tachy arrhythmia too fast 100 bpm brady arrhyhthmia too slow 60 bpm l.jpg
Tachy-arrhythmia (too fast: > 100 bpm)Brady-arrhyhthmia(too slow: < 60 bpm)


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Atrial arrhythmia

An atrial arrhythmia is an arrhythmia caused by

  • a dysfunction of the sinus node or

  • the development of another atrial pacemaker within the heart tissue that takes over the rhythm of the sinus node


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Sinus Tachykardia

A condition in which the heart rate is faster than 100 beats per minute because the sinus node is sending out electrical impulses at a rate faster than usual




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Atrial flutter

The electrical signals come from the atria at a fast but even rate.

When the signals from the atria are coming at a faster rate than the ventricles can respond to, the ECG pattern develops a "sawtooth" pattern, showing two or more flutter waves between each QRS complex.



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Ventricular arrhythmia

A ventricular arrhythmia is an arrhythmia caused by

  • a dysfunction of the sinus node

  • an interruption in the conduction pathways

  • the development of another pacemaker



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Prolonged pr-interval

(>200 msec)

Atrial ventricular AV Block 1st degree


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Atrial ventricular AV Block2nd degree

  • Wenckebach. Progressive prolongation PR interval until a p-wave is blocked

  • Mobitz Type II: pr-interval constant, evt. shorter after a p-wave block


Atrial ventricular av block 3 d degree l.jpg
Atrial ventricular AV Block3d degree

  • No atrial impulses reach the ventricles

  • Possibly lifethreatening if the subsidiary pacing in the ventricles is not sufficiant


Ventricular tachycardia l.jpg
Ventricular tachycardia

!! Life threatening !!


Pv c p remature ventricular complexe l.jpg
PVC:Premature ventricular complexe






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Ventricular flutter

!! Emergency !!


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Ventricular fibrillation

!! Emergency !!


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Asystoly

!! Emergency !!


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CPR Cardio Pulmonary Resuscitation

Newest guidelines


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Step 1: check consciousness










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No circulation:No AED available

Basic Life Support

  • 15 compressions on the chest

  • 2 breaths

  • Same rhythm, even if 2 reanimators






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No circulationAED available

  • In case of fibrillation or ventricular tachycardia connect the patient to the AED , perform analysis

  • Without pulse: defibrillation

  • Repeat ABC

  • No result: restart BLS and defibrillation after 1 minute

  • No fibrillation: BLS






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