crotchitymedic1986 Posted November 12, 2008 Share Posted November 12, 2008 If someone has already posted this previously, i apologize. I offer you an easy way to differentiate the four main heartblocks for your ACLS or Paramedic test. It is called the CICI's Pizza Method (I realize many have not heard of this chain of restaurants, but it helps you remember). Write C I C I vertically on your paper, then write your blocks in order beside it 1-3rd degree: C 1st degree I 2nd type 1 (wenkebach) C 2nd type 2 I 3rd degree "C" stands for consistent PR interval --- so if your PR interval is consistent, the rhythm is either type 1 (which just has a longer pr interval) or it is 2nd type 2 -- where there are more than one p-wave, but the p waves march out and stay consistent. "I" stands for inconsistent PR interval -- if your PR interval is inconsistent then it is either 2nd type 1, which would be indicated by a dropped QRS, or it is 3rd degree which would be indicated by multiple random "p" waves that do not relate to the QRS *** In real life, patients may go back and forth from one block to another as you monitor them. This is to help you pass your test only. It helps you whittle it down until you get very familiar with the blocks. Link to comment Share on other sites More sharing options...
firedoc5 Posted November 13, 2008 Share Posted November 13, 2008 You still have to treat the patient and not the monitor. We had a guy in full arrest. Put him on the monitor and had a rhythm. No pulse. The rhythm showed a Wenkebach, text book. But was in PEA (for you old farts- EMD) We got a strip of it. I have it somewhere for posterity. Of course CPR and ACLS protocols followed. Of course he didn't make it. Link to comment Share on other sites More sharing options...
ERDoc Posted November 13, 2008 Share Posted November 13, 2008 Sometimes you need to treat the monitor. I've seen people in 3rd degree who were asymptomatic, they might not be for too long if you don't treat the monitor. Link to comment Share on other sites More sharing options...
mobey Posted November 15, 2008 Share Posted November 15, 2008 Nope... no acronyms from me, but I will offer a one pointer. Start calling a 3rd degree a "Complete AV block" helps you remember that one anyway! Link to comment Share on other sites More sharing options...
WolfmanHarris Posted November 15, 2008 Share Posted November 15, 2008 Want to always remember 2nd degree type 1? Watch this. Diagnosis Wenkeback Wanna get a laugh about the others? Watch this. Everybody dance now! Link to comment Share on other sites More sharing options...
njmedic1485 Posted November 15, 2008 Share Posted November 15, 2008 I was taught a version of this and it was helpful. I found this version in the blogosphere at JBontherocks.blogspot.com "If the P is far from me, The block is known as First Degree. "Because farther, farther, farther, drop Will then be called a Wenckebach. "If it's P-P-Q and P-P-Q, This you call the Mobitz 2. "When the P and me do not agree, Then we've found the Third Degree." Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted November 15, 2008 Author Share Posted November 15, 2008 I wished I had a copy of one i had last year that perplexed me for several minutes -- the patient had a pacemaker which was firing with every beat. The "p" wave initially looked as though it was "moving", indicating a complete heart block, but when you measured it out, you discovered that she was really in wenkebach, but the pacemaker wouldnt let the QRS drop. Link to comment Share on other sites More sharing options...
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