Pediatric Arrhythmias and EKGs for the Health Care Provider / Edition 1

by Kathleen J. Prater CCT

Overview

This time-tested publication has successfully trained numerous pediatric nurses from a leading children's hospital. Pediatric advanced practice registered nurses and clinical nurse specialists working in acute or critical care settings, as well as physician assistants and medical residents, need to understand the principles of accurate pediatric EKG interpretation and the appropriate follow-up steps necessary for the best patient care. With a total of 100 EKGs, rhythm strips, and interpretations, this comprehensive but concise text analyzes all levels of arrhythmias to allow pediatric health care providers to interpret normal and abnormal pediatric EKGs and rhythm strips with confidence.

This user-friendly, quick reference outlines the basic rules for pediatric arrhythmias and EKG interpretations using a multitude of different EKGs and rhythm strips and basic but critical figures and tables. With the use of a systematic checklist for standard evaluation, the text walks the reader through the essential signs that health care providers must learn to recognize when examining the EKGs and rhythm strips of their pediatric patients. This book culminates in a robust selection of 50 EKGs and additional rhythm strips for practice and a self-test on the material presented in the preceding chapters. The answers can be compared with the cardiologist's interpretations for reinforcement of understanding and application.

Pediatric Arrhythmias and EKGs for the Health Care Provider teaches readers in a quick, at-a-glance approach:

• To obtain an interpretable pediatric tracing
• To implement a proper measurement method
• To understand both normal and abnormal EKGs
• To learn the quickest and most accurate QTc method
• To follow an organized format for rhythm analysis
• To systematically use tables, diagrams, figures, and graphs for interpretation
• To interpret with confidence even very complicated tracings
• To know which tracings need a pediatric cardiologist's attention

Product Details

ISBN-13:	9780826194466
Publisher:	Springer Publishing Company
Publication date:	05/22/2017
Pages:	296
Product dimensions:	10.00(w) x 8.00(h) x (d)

About the Author

Kathleen Joan Prater, CCT, became a certified cardiac technician through Cardiovascular Credentialing International in 1993 and had a career in cardiac testing that spanned 35 years.

Table of Contents

Contents

In Memory of Joyce Ellis Hubbard, MD

Foreword Margaret C. Slota, DNP, RN, FAAN

Preface

Acknowledgments

Important Aspects of EKG Interpretation

Section I. Mechanics

1. The EKG Machine

Computerized Digital EKG Machine

Key Points When Operating an EKG Machine

EKG Settings

Some Reasons for Ordering an EKG

2. How to Produce Quality Tracings

Distractions

Limitations

Artifacts

Artifact Example

Residue

EKG Machine Representative

Section II. Criteria for Pediatric Rhythms and EKGs

3. Technique

Pediatric EKG Hookup Diagram

Pediatric EKG Hookup Instructions

Standardizations

Correct Labeling of Pediatric EKGs

Systematic Checklist

Rhythm Strip Use and Lengths

Dextrocardia

Dextrocardia Hookup and Explanation

4. Fundamentals

Electrical Pathways

Heartbeat Components and Explanations

Normal Pediatric Heart Rates

Determining Heart Rate

Electrocardiographic Paper Grid Dimensions

Tools for Heartbeat Measurement

Determining the Axis of the Heart

Axis Quadrants

Heart Rates of Some Dysrhythmias

Premature Ventricular Complex/Contraction (PVC) Frequency Events Chart

Section III. Pediatric Rhythm Strips and Interpretations

5. Arrhythmias Associated With Specific Medical Conditions or Drugs

Sinus Bradycardia (SB)

Sinus Tachycardia (ST)

Supraventricular Tachycardia (SVT)

Atrial Flutter (AFL)

Atrial Fibrillation (AF)

Junctional Rhythms (JR)

Long QT Syndrome (LQTS)

Ventricular Tachycardia (VT)

Ventricular Fibrillation (VF)

First-Degree Atrioventricular (AV) Block

Second-Degree AV Block Mobitz I

Second-Degree AV Block Mobitz II

Third-Degree AV Block

Left Ventricular Hypertrophy (LVH)

Right Ventricular Hypertrophy (RVH)

Wolff–Parkinson–White (WPW) Syndrome

6. Normal to Advanced Rhythms

Normal Sinus Rhythm (NSR)

Sinus Arrhythmia (SA)

Sinus Bradycardia (SB)

Sinus Tachycardia (ST)

Wandering Atrial Pacemaker (WAP)

Supraventricular Ectopic (SVE) Beat

Supraventricular Tachycardia (SVT)

SVT Pre-Adenosine

SVT Post-Adenosine

Atrial Flutter (AFL)

Wolff–Parkinson–White (WPW) Syndrome

Junctional Rhythm (JR) Morphologies

Premature Junctional Complexes/Contraction (PJC)

Junctional Rhythm (JR)

Junctional Escape Rhythm (JER)

Accelerated Junctional Rhythm (AJR)

Junctional Tachycardia (JT)

Premature Ventricular Complexes/Contractions (PVC)

Multiform Ventricular Couplet

Ventricular Tachycardia (VT)

Torsades de Pointes (TdP)

Ventricular Flutter and Fibrillation (VFL and VF)

Ventricular Fusion Beat (VFB)

First-Degree Atrioventricular (AVB) Block

Second-Degree Atrioventricular Block (AVB) Wenckebach Mobitz I

Second-Degree Atrioventricular (AVB) Block Mobitz II

Third-Degree Atrioventricular (AV) Heart Block (Complete Heart Block)

Long QT Syndrome (LQTS)

Three Interesting Rhythm Strips

Answers to the Three Interesting Rhythm Strips

Section IV. EKGs and Interpretations

7. Pediatric Standards

Tables of Normal Values

Measurement of QT and Calculation for QTc

Sudden Death From Inherited Long QT Syndrome (LQTS)

8. Normal to Advanced EKGs and Interpretations

Normal Sinus Rhythm

Normal Sinus Rhythm Interpretation

Sinus Arrhythmia (SA)

SA Interpretation

Sinus Bradycardia (SB)

SB Interpretation

Sinus Tachycardia (ST)

ST Interpretation

Wandering Atrial Pacemaker (WAP)

WAP Interpretation

Premature Atrial Complexes (PACs)

PACs Interpretation

Supraventricular Tachycardia (SVT)

SVT Interpretation

SVT Pre-Adenosine

SVT Pre-Adenosine Interpretation

Post-Adenosine

Post-Adenosine Interpretation

Junctional Escape Rhythm (JER)

JER Interpretation

Accelerated Junctional Rhythm (AJR) Preceding SB

AJR Preceding SB Interpretation

Junctional Tachycardia (JT)

JT Interpretation

Junctional Ectopic Tachycardia (JET)

JET Interpretation

Permanent Form of Junctional Reciprocating Tachycardia (PJRT)

PJRT Interpretation

Atrial Flutter (AFL) With 2:1 Atrioventricular (AV) Conduction

AFL With 2:1 AV Conduction Interpretation

AFL With 4:1 and 6:1 AV Conduction

AFL With 4:1 and 6:1 AV Conduction Interpretation

Atrial Flutter/Fibrillation (AFL/AF)

AFL/AF Interpretation

Atrial Tachycardia With 2:1 AV Conduction

Atrial Tachycardia With 2:1 AV Conduction Interpretation

First-Degree AV Block

First-Degree AV Block Interpretation

Second-Degree AV Block Mobitz I

Second-Degree AV Block Mobitz I Interpretation

Second-Degree AV Block Mobitz II

Second-Degree AV Block Mobitz II Interpretation

Third-Degree AV Block

Third-Degree AV Block Interpretation

Premature Ventricular Complexes/Contractions (PVCs)

PVCs Interpretation

PVCs as Ventricular Couplets

PVCs as Ventricular Couplets Interpretation

Ventricular Tachycardia (VT)

VT Interpretation

Wide QRS Tachycardia

Wide QRS Tachycardia Interpretation

Possible Ventricular Fibrillation (VF)

Possible VF Interpretation

Ventricular Fusion Beat (VFB)

VFB Interpretation

Hyperkalemia

Hyperkalemia Interpretation

Hypokalemia

Hypokalemia Interpretation

Long QT Syndrome (LQTS)

LQTS Interpretation

T Wave Inversion

T Wave Inversion Interpretation

Left Axis Deviation (LAD)

LAD Interpretation

Right Axis Deviation (RAD)

RAD Interpretation

Left Ventricular Hypertrophy (LVH)

LVH Interpretation

Right Ventricular Hypertrophy (RVH)

RVH Interpretation

RVH and Intraventricular Conduction Delay (IVCD)

RVH and IVCD Interpretation

Biventricular Hypertrophy (BVH)

BVH Interpretation

Left Atrial Enlargement (LAE)

LAE Interpretation

Right Atrial Enlargement (RAE)

RAE Interpretation

Biatrial Enlargement (BAE)

BAE Interpretation

Wolff–Parkinson–White (WPW) Syndrome

WPW Syndrome Interpretation

Lown–Ganong–Levine (LGL) Syndrome

LGL Syndrome Interpretation

Left Bundle Branch Block (LBBB)

LBBB Interpretation

Right Bundle Branch Block (RBBB)

RBBB Interpretation

Dextrocardia

Dextrocardia Interpretation

Deep Q Waves

Deep Q Waves Interpretation

Heart Transplant

Heart Transplant Interpretation

Junctional Rhythm (JR), LAD, and RBBB

JR, LAD, and RBBB Interpretation

Sinus Tachycardia (ST), LAD, and Possible RBBB

ST, LAD, and Possible RBBB Interpretation

Section V. Self-Assessment Workbook

9. Review Worksheets and Questions

10. Answers

Acronyms

Index

Editorial Reviews

Reviewer: Jeremy Dugger Jordan, MSN. CRNP, CPNP-AC, CCRN (University of Alabama at Birmingham School of Nursing)
Description: This introduction to recording and interpreting pediatric EKGs also provides a workbook.
Purpose: The purpose is to explain the basic rules of pediatric arrhythmias and EKG interpretation using a systematic approach. Interpretation of pediatric arrhythmias is an important skill for all pediatric healthcare providers.
Audience: According to the authors, the audience includes nurses, physician assistants, medical students, paramedics, and telemetry/cardiac techs.
Features: The book uses many tools to teach readers how to perform and interpret pediatric EKGs. In particular, the checklists and workbooks help readers learn and retain the information. Rhythms and arrhythmias from a multitude of causes are presented along with how those rhythms change with intervention. Color images or larger images could help readers better interpret and learn from the rhythms.
Assessment: This book provides novice healthcare providers with a strong foundation in pediatric cardiac rhythms upon which to build their practice. Many books on this topic are either limited to adults or consist mainly of adult information with a small pediatric section.

Doody's Review Service