Adam Thompson, EMT-P | 4:24 PM |
The P to P interval will not always be constant, since complete heart block can happen with atrial fibrillation. I had some comments on the way people will look at these ECGs. I ended up making it a separate post with your ECGs and my comments and cutting. Complete Heart Block Confusion.
The P to P interval will not always be constant, since complete heart block can happen with atrial fibrillation. Good point. I am going to see if I can find an a-fib with 3rd degree AVB, I don't think I have ever seen that.I had some comments on the way people will look at these ECGs. I ended up making it a separate post with your ECGs and my comments and cutting.Looks good, you are the master of cut & paste! I hope these posts are as helpful to others as they are to me. I enjoy a second point of view. Tom could probably elaborate on some of these strips as well. I have to say that before I started looking at ECGs as in depth as I do that I would say "we don't have time for that" or "how is that going to change our treatment". Now I pitty the medic who doesn't. Not that they are going to change their treatment, but knowing what is happening inside your patient at this level is a valuable skill. I'm still not an ECG master, but I am leaps ahead of where I use to be.I think this goes for all of our assessment skills. Knowing a lot of different assessment findings or patient presentations may not change your treatment by much, but it gives you a better piece of mind. I think it makes you a better over-all clinician, and shows that paramedics are more than just ambulance drivers.
The Heartsim 2000 Cardiac Simulator can simulate this nicely. Set it on 3rd degree block press the slow button twice and that should create 3rd degree AVB with A Fib. It has been a while since I used one of these rhythm simulators, but I definitely recommend this brand/model. The ability to produce a variety of rhythms is unmatched by any other simulator I have used. Even better versions and competition should be available as computer technology improves. This also allowed for a self test mode. It would show a rhythm. You have to press the buttons that describe the rhythm and whatever ectopy is present.Here is a link to AFib and complete heart block.
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