m3d1c_89

I agree with the general theme of the comments here. I would like to add is I believe you should never 'diagnose' a rhythm based on rate or let the rate be the deciding factor when you're thinking "It's either rhythm A or rhythm B" unless you're referring to something like this where you'd think Junctional Rhythm or Accelerated Junctional Rhythm. Another thing I'd like to add about this rhythm is I believe the focus is just narrowly superior to the bundle of His/inferior most aspect of the atria. You see absent or inverted p-waves on all leads except V1-V2. V1 has VERY minute upright p-waves for every QRS and V2 has barely distinguishable p-waves with even less amplitude than V2 and very well hidden. Finally, the only other things I noticed, which I can't be confident in because the tracing is not as clear as it would be in-hand, to me it appears V2, and V3 seem to have S-waves that (most noticeably on the 2nd complex, but present in all 3) slur before returning to isoelectric line. MAYBE a possible q-wave formation or early stage development of a BBB? Slurring of R-wave in V4, again, most noticeable in complex 2 but present in all 3.

Hello, My name is Daniel and I figured I'd 'formally' introduce myself and a little about me here. I'm a paramedic and also a premed student. I'm 25 and been in EMS 4-5 years. I love what I do and have a nearly endless list of hobbies. The things I do outside of work regularly is training (in the process of training for amateur MMA fight) and to any with this same interest my focus is Jiu Jitsu/Judo because ground game is where it's at . I've been involved in music since I was 12 and play a slew of instruments and am also self-teaching/learning music production. Oh, and I can't forget to mention having the two best babies [my dogs] in the world. Any questions, just ask. :]