Recognition of Second Degree Heart Blocks and Possible Interventions

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To pass the written ACLS exam and mega code, students need to be able to identify basic ECG dysrhythmias, including the two types of second-degree heart block.

One method of ECG rhythm identification is to ask a series of questions such as:

What's the rate (<60, 60-100, 101-149, or >150);
Is the rhythm regular or irregular;
What's the shape, width, and frequency of P waves and QRS complexes; and
What's the P-R interval and is it constant?

ECG characteristics of a second-degree Mobitz type I (Wenckebach).

Identification of unstable bradycardia and its treatment with Atropine.

ECG characteristics of a second-degree Mobitz type II.

Possible effect of using Atropine on patients with a second-degree type II AV block.

Treatment of unstable bradycardic patients refractory to Atropine using TCP, Dopamine, or Epinephrine drip.

Starting dose and titration of Dopamine and Epinephrine drips.

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Good luck with your ACLS class!

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