CRAT Study Guide

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Lead I, II, and III are what kind of leads?

Bipolar (also frontal because they only show the front of the heart)

What makes Einthoven's Triangle?

Connecting leads I, II, and III at their ends

Causes of 60-cycle interference

Electrodes not properly applied, EKG machine not properly grounded, r by too many electrical devices nearby.

Pacemaker spikes with no P wave or QRS following it...

Failure to capture

No pacemaker spikes is...

Failure to sense

What does 60-cycle interference look like?

Fat highlighter marks on baseline

Which HB would you NOT need a pacemaker for?

First-degree AV block (prolonged PRI >0.20 seconds)

While in the resting state, myocytes are polarized and the interior of the cell becomes ________-ly charged

Negative

Failure to capture (loss of capture)

No P or QRS after the pacemaker spike

Gain

Normally set to 1

Pacemaker inhibition

Pacemaker doesn't work because it senses the heart is beating at or above the programmed rate

Undersensing

Pacemaker spikes in areas where they should not be (i.e. in the T wave, an ST segment, or on top of another QRS)

Causes of somatic tremor artifact

Patient keeps moving, Parkinson's disease

When cells contract, they become _______. (Negative or positive)

Positive

Causes of wandering baseline

Respiration or by lotion/sweat on the skin interfering with the signal

Lead I connects what?

Right arm to left arm

Lead II connects what?

Right arm to left leg

What is the natural pacemaker of the heart?

SA node

What is sensing?

The ability for the heart to sense and respond to the electrical activity of the heart

What is capture?

The pacemaker sends a stimulus to the heart which causes the heart to depolarize

Define intrinsic beats

The patient's own heart beat

How to fix 60-cycle interference

Unplug and re-plug somewhere else.

What causes leads reversed?

When the leads are placed on opposite limbs (i.e. left arm and right arm are switched)

A-V sequential pacing

When the pacemaker paces both the atrium and the ventricle

What does the P wave represent?

Atrial depolarization

What does the QRS complex represent?

Atrial repolarization and ventricular depolarization

Amplitude for one small box

?

Length of time for one small box

0.04 seconds

Normal QRS interval

0.11 or less

Normal PRI interval

0.12-0.20

3 types of pacemakers

1) single (either RA or RV) 2) dual chamber (RA and LV) 3) bi-ventricular (RV and LV --> Congestive Heart Failure)

Chart speed

25 mm/s

Memory method for calculating heart rate

300-150-100-75-60-50-43-37-33-30

Cardioversion vs. Defibrillation

Cardioversion: to change the heart rhythm (usually from SVT to sinus) Defibrillation: only used for pulseless VT and v-fib

Q wave indicates what?

Dead myocardial tissue. Always a negative deflection

Failure to sense

Lack of pacemaker spikes where they should have been. Battery can be dead.

Lead III connects what?

Left arm to left leg

How to fix somatic tremor artifact

Make sure leads are not placed over muscle and instead placed on bone, help patient relax, give a blanket.


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