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Also posted at Paramedicine101

I am bringing these back to the patient care forums.


What do you think?

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Edited by FL_Medic
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You could approach this from two perspectives...

First off, I need to see a 12-lead from this pt for further evaluation.

1). This appears to be a 2nd degree AV block type II with 3:1 conduction ratio. However, this type of block almost always originates in the bundle branches which would widen the QRS (not present). So the possibility is present for type I block.

2). You might be able to force 3rd degree AV block on this, but it seems that the third P wave in each cycle does conduct. 3rd degree block is usually wide as well unless you have an escape at or above the AV junction. I just don't see av dissociation here either.

My two cents...

Edited by EMS_Cadet
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