ACLS

Study Guide for Precourse Self-Assessment

20 rhythm strips on Precourse Self-Assessment with the following matching choices:

Agonal rhythm/Asystole Pulseless Electrical Activity
Atrial Fibrillation Atrial Supraventricular Tachycardia
Flutter Ventricular Second-Degree Atrioventricular Block (Mobitz I, Wenckebach)
Fibrillation Second-Degree Atrioventricular Block (Mobitz II)
Monomorphic Ventricular Tachycardia Sinus Bradycardia
Normal Sinus Rhythm Sinus Tachycardia
Polymorphic Ventricular Tachycardia Third-Degree Atrioventricular Block

RHYTHM & CRITERIA UNIQUE SAMPLE STRIPS
ETIOLOGY OVERVIEW CRITERIA
Normal Sinus RHY Regular None, normal
Rhythm R 60-100 rhythm
P Upright
Normal, None PRI 0.12-0.20
QRS 0.04-0.10

Sinus RHY Regular Rate 100-160

Tachycardia R 100-160
P Upright
Exercise PRI 0.12-0.20
Anxiety QRS 0.04-0.10
Caffeine
Nicotine
Fever
Shock
CHF
Hypotension
Pain
Hypoxemia
Anterior MI

EXPRESS TRAINING SOLUTIONS 444 CAMINO DEL RIO S STE 108 SAN DIEGO, CA 92108 (888) 815-0313 EXPRESSTRAINING.COM
Additional material created to enhance and supplement the learning experience and is not AHA approved
Cardiac Dysrhythmia Overview is courtesy of Key Medical Resources, Inc. Terry Rudd
Cardiac Dysrhythmia Overview to Help with ACLS Precourse Self-Assessment May 2016, Page 1 [TCL]
 ACLS Study Guide for Precourse Self-Assessment

RHYTHM & CRITERIA UNIQUE SAMPLE STRIPS
ETIOLOGY OVERVIEW CRITERIA

Sinus Bradycardia RHY Regular Rate below 60
R Below 60
Damage SA P Upright
Normal sleep
PRI 0.12-0.20
athletes
QRS 0.04-0.10
Vagal
Glaucoma
Hypothermia
Inferior MI
Drugs MS,
digoxin, Inderal
IICP

PVC/PVD AN ECTOPIC SR, early

Premature Ventricular BEAT beat has
Contraction/Depolarization RHY Irregular Vent beat
Hypoxia R 60-100 (wide &
Hypotension P Upright bizarre)
Anemia PRI 0.12-0.20
Ischemic heart QRS 0.04-0.10
disease

Electrolytes
M.I.
Myocarditis,
pericarditis
CHF
Stress, fatigue,
smoking,
Overeating, caffeine
Hypoglycemia
Sepsis
Cyclic anti-
depressants
Supraventricular
Acidosis RHY Regular Rate above
Tachycardia R 160 - 250 160-250
P Upright
Not visible sudden PRI 0.12-0.20
start or stop QRS 0.04 0.10

EXPRESS TRAINING SOLUTIONS 444 CAMINO DEL RIO S STE 108 SAN DIEGO, CA 92108 (888) 815-0313 EXPRESSTRAINING.COM
Additional material created to enhance and supplement the learning experience and is not AHA approved
Cardiac Dysrhythmia Overview is courtesy of Key Medical Resources, Inc. Terry Rudd
Cardiac Dysrhythmia Overview to Help with ACLS Precourse Self-Assessment May 2016, Page 2 [TCL]
 ACLS Study Guide for Precourse Self-Assessment

RHYTHM & CRITERIA UNIQUE SAMPLE STRIPS
ETIOLOGY OVERVIEW CRITERIA
Atrial Flutter RHY Regular or Regular or
Irregular Irregular
Ischemic heart R Atrial 250-400
disease
Vent: 70 - 150 No Ps
MI
P None, Fs (called Fs)
Digoxin toxicity
PRI None Saw tooth
Mitral, Tricuspid
valve disease QRS 0.04-0.10
Stress
PE
Hyperthyroid
Often temp

Atrial Fibrillation RHY Irregular Irregular, no

R Atrial 350-600
Ischemic heart Vent. No Ps (called
disease Fs)
Below 100
Digoxin toxicity
controlled
CHF
MI
Above 100
Mitral or Tricuspid uncontrolled
valve disease P None Fs
PRI None
QRS 0.04-0.10
PEA
Pulseless
Electrical Activity
Looks like any
rhythm that should
have a pulse but
does not

2nd Degree AV RHY Irregular Irregular

Block Type I PRI Vary
P Extra Ps EXTRA Ps
Mobitz I PRI longer &
Wenckebach QRS 0.04-0.10
longer
Dropped QRS

EXPRESS TRAINING SOLUTIONS 444 CAMINO DEL RIO S STE 108 SAN DIEGO, CA 92108 (888) 815-0313 EXPRESSTRAINING.COM
Additional material created to enhance and supplement the learning experience and is not AHA approved
Cardiac Dysrhythmia Overview is courtesy of Key Medical Resources, Inc. Terry Rudd
Cardiac Dysrhythmia Overview to Help with ACLS Precourse Self-Assessment May 2016, Page 3 [TCL]
 ACLS Study Guide for Precourse Self-Assessment

RHYTHM & CRITERIA UNIQUE SAMPLE STRIPS
ETIOLOGY OVERVIEW CRITERIA
2nd Degree AV RHY Regular or Regular or
Block Type II Irregular Irregular
Mobitz II PRI Constant
P Extra Ps EXTRA Ps
QRS Normal
or wide

3rd Degree AV RHY Regular Regular

Block PRI vary
EXTRA Ps
Complete Heart P Extra Ps
Block QRS Usually PRI varies
wide greatly
Same as 1st degree

Ventricular RHY Regular R over 100

Tachycardia R Above 100
P None All Vent beats
Monomorphic
All complexes are PRI None
the same shape QRS Wide,
and look the same bizarre
Wide complex
tachycardia
Ventricular RHY Chaotic Chaotic wavy
Fibrillation R None line
P None
Following V Tach PRI None No pulse
Acute MI QRS None,
Electrolyte fibrillatory line
Imbalance

EXPRESS TRAINING SOLUTIONS 444 CAMINO DEL RIO S STE 108 SAN DIEGO, CA 92108 (888) 815-0313 EXPRESSTRAINING.COM
Additional material created to enhance and supplement the learning experience and is not AHA approved
Cardiac Dysrhythmia Overview is courtesy of Key Medical Resources, Inc. Terry Rudd
Cardiac Dysrhythmia Overview to Help with ACLS Precourse Self-Assessment May 2016, Page 4 [TCL]
 ACLS Study Guide for Precourse Self-Assessment

RHYTHM & CRITERIA UNIQUE SAMPLE STRIPS
ETIOLOGY OVERVIEW CRITERIA
Torsades de RHY Chaotic Chaotic wavy
Pointes waves line
Polymorphic R None
No pulse
Ventricular P None
Tachycardia PRI None Points twist
QRS Points
Best treated with twist
magnesium
Agonal RHY Regular Slow wide
R Slow bizarre
Dying heart P None stretched out
Drugs used in
PRI None waves
cardiac arrest
provide some QRS Very, very
wide No Pulse
electrical waves

Asystole RHY None Straight line

unless only Ps or only Ps
Primary event in R No Vent rate
cardiac arrest P May be No Pulse
Untreated V-tach
present
or V-fib
PRI None
QRS None

Calculating Heart Rate - note strips on pretest are longer than 6 seconds.

Table for Small Box Method

To calculate the heart rate, count the number of 0.04 squares (or small boxes) between two QRS complexes (1500 divided by X = HR)

Small Boxes
from R to R 9 = 168 14 = 107 19 = 79 24 = 63 29 = 52 34 = 44 39 = 38 44 = 34
5 = 300 10 = 150 15 = 100 20 = 75 25 = 60 30 = 50 35 = 43 40 = 37 45 = 33
6 = 250 11 = 136 16 = 94 21= 72 26 =58 31 = 48 36 = 42 41 = 37 46 = 33
7 = 214 12 = 125 17 = 88 22 = 68 27 = 56 32 = 47 37 = 41 42 = 36 47 = 32
8 = 188 13 = 115 18 = 83 23 = 65 28 = 54 33 = 45 38 =40 43 = 35 48 = 31

EXPRESS TRAINING SOLUTIONS 444 CAMINO DEL RIO S STE 108 SAN DIEGO, CA 92108 (888) 815-0313 EXPRESSTRAINING.COM
Additional material created to enhance and supplement the learning experience and is not AHA approved
Cardiac Dysrhythmia Overview is courtesy of Key Medical Resources, Inc. Terry Rudd
Cardiac Dysrhythmia Overview to Help with ACLS Precourse Self-Assessment May 2016, Page 5 [TCL]
 ACLS Study Guide for Precourse Self-Assessment


Heart Blocks and Tricks for Analysis
2nd Degree AV block Type I
Mobitz I
Wenckebach

Extra Ps
Rhythm is always irregular from QRS
to QRS
PR intervals get longer and longer

2nd Degree AV block Type II
Mobitz II

Extra Ps
PR intervals on conducted beats are
the same - the only heart block with
extra Ps that has this

3rd Degree Heart Block
Complete Heart Block

Extra Ps
Rhythm is always regular from QRS
to QRS
PR Intervals different

EXPRESS TRAINING SOLUTIONS 444 CAMINO DEL RIO S STE 108 SAN DIEGO, CA 92108 (888) 815-0313 EXPRESSTRAINING.COM
Additional material created to enhance and supplement the learning experience and is not AHA approved
Cardiac Dysrhythmia Overview is courtesy of Key Medical Resources, Inc. Terry Rudd
Cardiac Dysrhythmia Overview to Help with ACLS Precourse Self-Assessment May 2016, Page 6 [TCL]
 ACLS Study Guide for Precourse Self-Assessment

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EXPRESS TRAINING SOLUTIONS 444 CAMINO DEL RIO S STE 108 SAN DIEGO, CA 92108 (888) 815-0313 EXPRESSTRAINING.COM
Additional material created to enhance and supplement the learning experience and is not AHA approved
Cardiac Dysrhythmia Overview is courtesy of Key Medical Resources, Inc. Terry Rudd
Cardiac Dysrhythmia Overview to Help with ACLS Precourse Self-Assessment May 2016, Page 7 [TCL]