2. Normal Heart Behavior
• Heart Rate between 60 –
100 beats/min
• Begins with electrical
signal in upper right part of
heart (sinoatrial node)
• S.A node is heart’s
pacemaker
5. THE SHAPE OF ECG
•Contraction of atria - P wave
• Ventricular depolarization - QRS complex
• Ventricular repolarization - T wave
6. NORMAL SINUS RHYTHM
Looking at the ECG you'll see that:-
• RHYTHM - Regular
• RATE - (60-100 bpm)
• QRS DURATION - Normal
• P WAVE - Visible before each QRS complex
• P-R INTERVAL - Normal (<5 small Square)
Indicates that the electrical signal is generated by the
sinus node and travelling in a normal fashion in the
heart.
9. • In this case heart rate is
greater than 100
beats/min
• Causes:
– Exercise (physiological)
– Emotional states
(physiological)
– Anxiety (physiological)
– Hyperthyroidism
(pathological)
– Drugs
– Increased body temperature
e.g. fever (pathological)
SINUS TACHYCARDIA
10.
11. • It means a slow heart rate
usually less than 60 beats
/min.
• Causes of sinus
bradycardia:
– Bradycardia in athletes
(physiological)
– Vagal stimulation such as
during vomiting,
– Hypothyroidism
(pathological)
– Hypothermia,
– Raised intracranial pressure
(pathological)
– Drugs.
SINUS BRADYCARDIA
12.
13.
14. • Definition of
arrythmia: variation
from the normal
rhythm of the heart
beat, encompassing
abnormalities of the
rate, regularity, site of
impulse origin and
sequence of
activation.
ARRYTHMIAS
15. Two features of arrhythmias
• Site of origin
– Atria
– Atrioventricular node (AV node)
– Ventricles
• Affect on heart rate
– Too slow heart rate
(bradycardia)
– Too fast heart rate
(tachycardia)
16. Common types of Arrhythmia
• Atrial Fibrillation
Ventricular tachycardia
Ventricular Fibrillation
• Heart blocks
• Supra-ventricular
tachycardia
17. Ventricular Tachycardia & Ventricular Fibrillation
• More serious.
• Caused by abnormal electrical signals from
ventricles.
• Can develop during heart attack or early
complications from a damaged heart.
• Often leads to cardiac arrest.
18. Ventricular Tachycardia
Tachycardia: Heart rate over 100 bpm. Can cause
palpitations, light headedness, dizziness, weakness,
fainting and drop in blood pressure. Can survive for
hours without treatment BUT can progress to Ventricular
fibrillation which is fatal.
22. Symptoms of Ventricular Fibrillation
Loss of consciousness or fainting is the most common sign
of ventricular fibrillation.
Early pre-ventricular fibrillation symptoms (may start
up to an hour before ventricular fibrillation & fainting):
– Chest pain
– Rapid heartbeat (tachycardia)
– Dizziness
– Nausea
– Shortness of breath
23. Treating Fibrillation
• CALL 911 IMMEDIATELY!
• Use Automated External Defibrillator if
available (AED) OR
• Begin chest compressions (100/minute)
26. Page 26
Automated External Defibrillator
(AED)
AEDs are pre-programmed devices used to provide
treatment/care for cardiac arrest victims.
AEDs provide an electric charge that interupts the
fibrillation, or rapid uncoordinated contractions of the
heart & allows it to begin beating regularly again.
Immediate defibrillation carries the only hope of survival in
cardiac arrest victims.
27. (AED)
When defibrillation is delivered within one minute,
survival rates can be as high as 90%.
If defibrillation is delivered in < 5 minutes, survival can be
as high as 50%.
For every minute that passes prior to receiving
defibrillation, a victim's chance of survival declines by
about 10%.
After 10 minutes chances of survival are near zero.
28. Cardiac Arrest
When the heart stops beating. Usually caused by
Ventricular Fibrillation (VF), which begins where
the heart muscle is injured.
Without blood flow and no pulse the person
becomes unconscious and stops breathing and
collapses.
VF and cardiac arrest may be the only symptom of
a heart attack.
AED is only thing that will stop a VF.
29. How to use an AED
1. Turn on AED
2. Place pads on victim
3. Analyze the heart rhythm
4. Shock if prompted
30. 1. Turn on the AED
Follow the voice and / or visual commands
AED’s can be turned on with either:-
• A button
• OR BY
• Opening clear face plate
31. 2. Expose chest
• Remove any medication patches
• Make sure chest is clean and dry
32. 3. To Attach Pads
• First:
• Remove pads from packet
• Remove backing, one at a time, from pads,
then
33. 3a. Attach Pads
1. One pad goes on the upper right chest below collarbone.
2. One pad goes on lower left side chest wall.
34. 4. Plug in Connector
• If necessary plug in
pad connector to unit.
• There is a flashing light
beside the slot.
35. 5. Stay Clear
• Make sure nobody , including yourself, is
touching the victim.
Say “Everyone stand clear!”
36. 6a. Analyze the Rhythm
• Once the pads are in place the AED
will “analyze” the heart rhythm.
• Some AEDs require a button to
be pressed to analyze.
37. 6b. Analyze the Rhythm
• There are 4 electrical rhythms that the heart
can be in when the heart stops beating.
• Only 2 of these rhythms are shockable.
• If “shock advised”, shock victim and start
CPR
• The other 2 are non shockable.
• If “No shock advised” then start CPR
38. 7. Deliver Shock
If AED Prompts a Shock :
• Make sure no one is
touching victim
•Push the “shock” button
(some AEDs will shock
automatically)
39. 8. After Shock
• Do not turn off AED….
• It is now safe to touch Pads and patient
40. 9. Perform CPR
• After shock, or if no shock is advised,
continue CPR.
• Every 2 minutes follow the AED prompts
• Stop CPR if you see signs of life
– (breathing, movement.)
41. 10. Special Circumstances For:
1. AED and children
2. AED and wet person
3. AED and hairy chest
4. AED and pacemaker
5. AED and bras
6. AED and jewelry
42. 11a. AED and Children
• AEDs can be used on children as young as
newborns
• Some AEDs have child pads
• Use child pads if child is younger than 8 and
less than 55 lbs
• If no child pads ,adult pads may be used
43. 11b. AED and Children
Pad Placement in Children
•Follow manufacturer directions
•One pad goes in center of chest and 2nd pad
goes on center of victim’s upper back
44. 12. AED and Wet Person
• Dry off victims chest (and back if a child under
age 8.)
• Attach pads following manufacturer directions
• The rest of the victim does not need to be dry.
• AEDs can be used on wet surfaces and snow
so long as patient is dry and not in a puddle of
water.
45. 13. AED and Hairy Chest
• AED may not stick to victim with hairy chest.
• Some AEDs a have a razor in the kit
• Shave ONLY the area of chest that pads will attach to
• Wipe off hair and attach pads
• If no razor present attach pads
to chest and see if AED will work
• If AED does not work continue CPR
46. 14. AED and pacemaker
• Pacemakers are located under the collarbone
on right or left side of chest
• If located on right side place AED pad 1 inch
below pacemaker
• Continue with AED prompts
47. 15. AED and Bras
• Many bras contain metal (Clips, underwire)
• Remove / cut bra if AED pads will touch the
metal
48. 16. AED and Jewelry
• Ignore jewelry if it will not touch AED pad
• If in the way push jewelry to side of neck
away from AED pads.
• Do not waste time
removing jewelry
