TL;DR
Cardiac Dysrhythmias: Abnormal rhythms from impulse formation or conduction disturbances: sinus, atrial, junctional, ventricular.
Cardiac Dysrhythmias
Definition
Abnormal rhythms from impulse formation or conduction disturbances: sinus, atrial, junctional, ventricular.
Troubleshooting
Troubleshooting cardiac dysrhythmias in the field:
- King airway: If supraglottic blind-insertion airway device fails, verify connections, check battery, try alternate equipment. Available sizes: Size 3 (4-5 ft), Size 4 (5-6 ft), Size 5 (over 6 ft)
- IO drill: If intraosseous access device for emergent vascular access fails, verify connections, check battery, try alternate equipment. Available sizes: EZ-IO: 15mm (peds), 25mm (adult), 45mm (obese)
- Waveform capnograph: If measures end-tidal co2 continuously with waveform display fails, verify connections, check battery, try alternate equipment. Available sizes: Mainstream (inline), Sidestream (sampling)
Historical Context
The modern EMS system in the United States traces to the 1966 "Accidental Death and Disability" white paper (NAS/NRC). Understanding of cardiac dysrhythmias has advanced significantly with evidence-based protocols. The NREMT, founded in 1970, standardized certification levels. Current ACLS and PALS guidelines are updated every 5 years by the AHA based on the International Liaison Committee on Resuscitation (ILCOR) evidence review.
Related Procedures
Procedures related to cardiac dysrhythmias in the EMS setting:
- Trauma assessment: scene safety then MOI then primary survey (XABCDE) then rapid transport then secondary survey en route
- AHA ACLS cardiac arrest algorithm: CPR then rhythm check then shock if VF/pVT then epinephrine q3-5min then amiodarone
- STEMI protocol: 12-lead ECG within 10 min then aspirin 324mg then NTG if SBP >90 then notify cath lab then transport code 3
Key Values & Ranges
Key values and ranges relevant to cardiac dysrhythmias in prehospital care:
| Parameter | Adult | Pediatric |
|---|---|---|
| blood pressure | 90/60-120/80 mmHg | 70+(2*age) systolic minimum |
| SpO2 | 95-100% | 95-100% |
| ETCO2 | 35-45 mmHg | 35-45 mmHg |
| blood glucose | 70-140 mg/dL | 60-100 mg/dL (neonates lower) |
| temperature | 97.8-99.1 F (36.5-37.3 C) | same range, rectal preferred under 2yo |
Why It Matters
Rhythm interpretation and ACLS pathways extensively tested on Paramedic exam.
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