1.

2.

Interpretation:

Next course of action:

Rate: PRI: QRS:

Rate: PRI: QRS:

Interpretation:

Next course of action:

Telemetry Practice Strips

UMass Memorial Medical Center

When preparing for the telemetry competency, remember to go back to basics. Analyzeeach rhythm in the same sequence.

Step 1: Is the rhythm regular?

Step 2: Calculate the heart rate

Step 3: Are there P waves, is there one for each QRS, what is the PR interval?

Step 4: Is there a QRS with each P wave, are they all the same?

Step 5: Interpret, give the rhythm a name

For each of the following 6 second rhythm strips, determine the rate, PR interval (PRI),QRS interval, interpretation and next course of action.

3.

Rate: PRI: QRS:

Interpretation:

Next course of action:

4.

Rate: PRI: QRS:

Interpretation:

Next course of action:

5.

Rate: PRI: QRS:

Interpretation:

Next course of action:

6.

Rate: PRI: QRS:

Interpretation:

Next course of action:

7.

Rate: PRI: QRS:

Interpretation:

Next course of action:

8.

Rate: PRI: QRS:

Interpretation:

Next course of action:

9.

Rate: PRI: QRS:

Interpretation:

Next course of action:

10.

Rate: PRI: QRS:

Interpretation:

Rate: PRI: QRS:

Next course of action:

Next course of action:

Interpretation:

11.

Interpretation:

Next course of action:

Interpretation:

Next course of action:

Rate: PRI: QRS:

14.

Interpretation:

Next course of action:

Rate: PRI: QRS:

13.

Rate: PRI: QRS:

12.

Interpretation:

Next course of action:

Interpretation:

Next course of action:

Rate: PRI: QRS:

17.

Interpretation:

Next course of action:

Rate: PRI: QRS:

16

Rate: PRI: QRS:

15.

Interpretation:

Next course of action:

Interpretation:

Next course of action:

Rate: PRI: QRS:

20.

Interpretation:

Next course of action:

Rate: PRI: QRS:

19.

Rate: PRI: QRS:

18.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

ANSWERS

Rate: 100-110 PRI: 0.16 QRS: 0.08

Interpretation: Sinus Tachycardia (ST)

Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP

Rate: Underlying rhythm rate 80 PRI: 0.2 QRS: 0.08

Interpretation: Sinus Rhythm (SR) with a burst of paroxysmal supraventricular tachycardia (PSVT)

Next course of action: Check patient, obtain VS and notify MD/LIP

Rate: 70 PRI: unable QRS: 0.08

Interpretation: Atrial Fibrillation (a-fib)

Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP

Rate: 190 PRI: Unable QRS: 0.08

Interpretation: Supraventricular Tachycardia (SVT)

Next course of action: Check patient, obtain VS and notify MD/LIP

Rate: 80 PRI: 0.2 QRS: 0.06

Interpretation: SR with pause

Next course of action: Check patient, obtain VS and notify MD/LIP

Rate: 70 PRI: 0.2 QRS: 0.1

Interpretation: SR with peaked T waves

Next course of action: Check patient, check potassium

Rate: 70 PRI: 0.16 QRS: 0.08

Interpretation: SR with frequent premature atrial complexes (PAC)

Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP

Rate: 110 PRI: unable QRS: 0.08

Interpretation: Junctional Tachycardia

Next course of action: Check patient, obtain VS and notify MD/LIP

Rate: 50 PRI: 0.32 QRS: 0.08

Interpretation: SB with 1st Degree AV Block

Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP

Rate: 30 PRI: Unable QRS: 0.16

Interpretation: 3rd Degree Heart Block

Next course of action: Check patient, obtain VS and notify MD/LIP immediately, prepare to pace the patient

Rate: 50 PRI: variable QRS: 0.08

Interpretation: 2nd Degree AV block Type 1 (Wenckebach)

Next course of action: Check patient, obtain VS and notify MD/LIP

Rate: 40 PRI: 0.16 QRS: 0.06

Interpretation: 2nd Degree AV Block Type 2 (Mobitz)

Next course of action: Check patient, obtain VS and notify MD/LIP immediately, prepare to pace the patient

13.

14.

15.

16.

17.

18.

19.

20.

Rate: 90 PRI: 0.16 QRS: 0.08

Interpretation: SR with PVC Couplets

Next course of action: Check patient, obtain VS and notify MD/LIP if couplets persist

Rate: 70 PRI: Unable QRS: >0.16

Interpretation: 100% Ventricularly Paced

Next course of action: Continue to monitor patient

Rate: 70 (underlying) PRI: 0.2 QRS: 0.06

Interpretation: SR with 6 beats of Ventricular Tachycardia (VT)

Next course of action: Check patient, obtain VS and notify MD/LIP

Rate: 40 PRI: None QRS: 0.4

PRI: None QRS: None

Interpretation: Idioventricular

Next course of action: Check patient, obtain VS and notify MD/LIP immediately, if pulseless, call code

Rate: 40 PRI: 0.2 QRS: 0.08

Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP

Interpretation: Asystole

Next course of action: Call Code Blue, being CPR

Rate: 70 PRI: Unable QRS: 0.06

Interpretation: A-Flutter

Interpretation: Ventricular Fibrillation (VF)

Next course of action: Call Code Blue, obtain AED and prepare to shock the patient

Rate: None PRI: None QRS: None

Interpretation: Sinus Bradycardia (SB)

Next course of action: Continue to monitor patient

Rate: None