Nursebob's MICU/CCU Survival Guide
Cardiology in Critical Care
Arrhythmia Recognition
© October 06
I. Impulses.
A. Originate in the SA Node.
II. Rate
A. 60-100 Beats per Minute in Adults.
B. 90-110 in older children.
C. 100-120 in small children.
D. 120-160 in infants.
III. Rhythm.
A. Regular
IV. P Wave - uniform size and contour from beat to beat.
A. Before each QRS.
B. P waves upright in L2
C. Negative in AVR
D. Each P followed by QRS with resulting P: QRS ratio 1:1 QRS ratio 1:1
V. PR Interval.
A. 0.12 to 0.20 milliseconds
B. PR interval 0.12-0.20 sec and constant when A-V conduction normal
C. PR prolonged and/or variable when A-V block present.
VI. QRS
A. Less than 0.12 milliseconds
B. Less than 0.11 sec or QRS wide and bizarre when bundle branch block present
C. RR intervals may be slightly irregular especially in the young and elderly
VII. Treatment
A. None
Normal Sinus Rhythm
Normal Sinus Rhythm
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