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FL_Medic

Strip Tease 9

Strip Tease answers  

14 members have voted

  1. 1. Should the answers be posted as seperate topic?

    • Yes
      2
    • No
      7
    • I don't care, I don't even read these!
      0
    • I don't care, just keep them coming!
      5


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ecg_12lead0571.gif

your patient presents with syncope and refractory dizziness

For Larger Viewing

Click the top of the ECG then hold Ctrl and hit +/- or scroll your mouse

I need some feedback on these, what do you think??

Should I post the answers as a seperate topic titled "Strip Tease # Answer"?

Would you like more of an explination of the rhythm, would this help you learn more?

Edited by FL_Medic

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FL, I think what you are doing is great and you should keep doing it. I would recommend allowing more time for people to discuss the EKG before giving the answer. Also have people back up what they are saying as we did in the Strip Tease #8. It is good to know what you are looking at but it is even better to know why. I would also put the answer in the original thread so that when someone wants to know the answer a few months down the line they don't have to search through other threads.

This one looks like NSR. :P

Edited by ERDoc

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FL, I think what you are doing is great and you should keep doing it. I would recommend allowing more time for people to discuss the EKG before giving the answer. Also have people back up what they are saying as we did in the Strip Tease #8. It is good to know what you are looking at but it is even better to know why. I would also put the answer in the original thread so that when someone wants to know the answer a few months down the line they don't have to search through other threads.

This one looks like NSR. :P

Thank you sir, and your interpretation is correct!! Haha, just kidding. I will wait longer to reveal the answer and have people elaborate. I was doing that with the first few, and I guess I lost the mojo. Glad to see they are appreciated, I actually got the idea from my training captain who does this for my agency through emails. If you are looking for an outlet to teach a little, we can always use another author on the blog. I will soon be conducting these strip teases simultaneously on here and on there.

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I like the answers being here, too. I'm going to guess it's an an accelerated junctional rhythm with a BBB. I'm not sure where the block would be, so I won't even go there.

My reasoning is that I see few if any p waves, but the rate is about 120-130 which is fast even for a sinus rhythm. I was going to call it ventricular(still might be) but I noted the "rabbit ear" and recalled that it was indicative of a BBB, and would account for the wide qrs.

Thanks for posting these. I'm learning alot! Just hope I'm not driving y'all up the wall in the process! :lol:

On a side note, the view from v6 was on one of our tests and was called v-tach but was represented as being from lead II. What kind of difference would that make as far which lead it's seen in? I don't even think I worded that right, as I know different leads look at different parts of the heart(we learned the SALI mneumonic) but I'm hoping you'll know what I'm trying to ask here. Also, in my effort to more fully understand, are the pt's symptoms more from the lack of atrial kick or from the decreased ventricular filling time? We were told that a rate under 150 usually didn't cause significant symptoms because while you'll have decreased cardiac output it's usually not much till you hit 150.

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Regular, wide complex tachycardia at 120-130ish. This is either going to be VT or SVT with abbarancy. This one I think I would call VT because of the rightward axis (about +150 degrees, so not extreme right axis), and the reversed R wave progression through the precordial leads. Wide complex tachycardias are notoriously difficult to identify though, so I admit I could be wrong about this one.

Edited by fiznat

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I like the answers being here, too. I'm going to guess it's an an accelerated junctional rhythm with a BBB. I'm not sure where the block would be, so I won't even go there.

My reasoning is that I see few if any p waves, but the rate is about 120-130 which is fast even for a sinus rhythm. I was going to call it ventricular(still might be) but I noted the "rabbit ear" and recalled that it was indicative of a BBB, and would account for the wide qrs.

Thanks for posting these. I'm learning alot! Just hope I'm not driving y'all up the wall in the process! :lol:

On a side note, the view from v6 was on one of our tests and was called v-tach but was represented as being from lead II. What kind of difference would that make as far which lead it's seen in? I don't even think I worded that right, as I know different leads look at different parts of the heart(we learned the SALI mneumonic) but I'm hoping you'll know what I'm trying to ask here. Also, in my effort to more fully understand, are the pt's symptoms more from the lack of atrial kick or from the decreased ventricular filling time? We were told that a rate under 150 usually didn't cause significant symptoms because while you'll have decreased cardiac output it's usually not much till you hit 150.

This is a good example of why we need 12 lead ECGs.

Can you imagine trying to diagnose this arrhythmia using lead II?

Yikes!

Tom B.

Regular, wide complex tachycardia at 120-130ish. This is either going to be VT or SVT with abbarancy. This one I think I would call VT because of the rightward axis (about +150 degrees, so not extreme right axis), and the reversed R wave progression through the precordial leads. Wide complex tachycardias are notoriously difficult to identify though, so I admit I could be wrong about this one.

With the exception of hyperkalemia, you're never wrong to presume that a broad complex rhythm is ventricular! The burden of proof is on the person who says it isn't.

Tom B.

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Uh oh, Tom "The Guru" is here, and I mean that as a compliment. Lets hope he can help me teach these. I'm going to let this one go a little longer to get some more impressions.

Tell me why you think it is what it is, if you haven't.

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I messed up my vote, sorry! I misread the question and voted "yes" when I should have voted "no." I think the answers should be posted in the original topics, to avoid clutter. If you want to obscure the answers you can highlight them with black so that users need to specifically "reveal" the text before they can read it...

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Uh oh, Tom "The Guru" is here, and I mean that as a compliment. Lets hope he can help me teach these. I'm going to let this one go a little longer to get some more impressions.

Tell me why you think it is what it is, if you haven't.

I'm not a guru, Adam. Just a guy with strong opinions. Some of them might even be right!

Tom B.

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I like the answer as part of the post as well. Nice strip, I think if one uses the "rules" they should be able to flesh this one out.

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