A big day in the treatment room: ECGs

You’ve arrived to your shift as triage nurse. You walk into treatment and find the team doing CPR. They’ve stopped to do swap compressors and check for a heart beat. This is the ECG trace after compressions have stopped. What is this trace likely to be?

Asystole

PEA

Ventricular tachycardia

Ventricular fibrillation

You’re asked to do an ECG on a stable hospital patient that seems to be bradycardic. This is the trace the multi parameter shows you. Working through your ECG markers (identifying P, QRS, T and length between QRS complexes), what is this trace likely to be? (Hint: in the strip above, your patient has taken a breath).

Sinus arrhythmia

An AV block

Ventricular tachycardia

You’re presented with a poodle that’s been lethargic and has had bloody diarrhoea at home. His heart rate is 40 bpm and he’s quite pale and dehydrated. Your vet asks you to run some electrolytes and you find this patient has a potassium of over 8. Using your ECG markers (P, QRS, T), what abnormality can you see here?

�Wide and bizaare’ QRS

No T wave

No P wave

T wave is reversed

Using the previous ECG, what do you interpret this ECG as?

Atrial standstill

AV block

Asystole

Still working on your poodle from the last two questions, your vet has now gone to speak with the owner regarding treatment options for addisonian crisis. During the time they’re away, you notice the ECG trace change to the above. What is the abnormal beat?

Premature ventricular contraction

Escape beat

Whilst you’re with your poodle patient, another team member brings in a crashed patient for CPR. Your team does a round of compressions and ventilation and stop to assess the ECG. What rhythm does the above ECG show?

Asystole

PEA

Ventricular fibrillation

After a few hours away from your poodle patient, you return to do another ECG whilst your hospital nurse is on break. It’s been a long day… this is the trace you see. What’s happening here? (Hint: look at the ECG upside down)

A ventricular arrhythmia

Ventricular tachycardia

Normal sinus rhythm

Normal sinus rhythm with improper lead placement

Your very last patient is a stable ragdoll cat preventing for lethargy and vomiting. Given you’re used to seeing very stressed cats with high heart rates, you decide to do an ECG when you notice her heart rate is 132. This is the trace you see. Using the ECG markers (P, T, QRS and distance between QRSs), what rhythm is this?

Atrial standstill

Sinus arrhythmia

Normal sinus rhythm

Atrial fibrillation

After spending some time watching her ECG and patting her, you notice her ECG change. You check her over and she’s happier than when she first arrived and has curled up on the bench. What could this be? (Hint: is you auscultated her chest, you would hear some very loud vibrations)

Atrial fibrillation

Normal sinus rhythm

Ventricular fibrillation

Purr interference

As you hand your patient over to the next triage nurse, you note her ECG change once more. Her character hasn’t changed, but she’s not making biscuits on the towel. What happening with this ECG?

Ventricular fibrillation

Ventricular tachycardia

Movement interference

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A big day in the treatment room: ECGs

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