ACLS Rhythm Pretest

The ACLS Rhythm Pretest is now available on www.richacls.com. An ACLS Rhythm Review is available for a rhythm refresher. Also available is the ECG Analysis section.

ACLS Written Pretest

The ACLS Written Pretest is available on www.richacls.com to test your knowledge of Advanced Cardiac Life Support issues. This is not the official ACLS Pretest which is supplied with your AHA ACLS Provider Manual.

ACLS Preparation

The formula for success at www.richacls.com is:

• Memorize Algorithms
• Memorize ACLS/BLS Flashcards
• Study Rhythms
• Study AHA ACLS Manual

We understand memorization with out understanding is not learning. The memorized flashcards and algorithms on this site gives the user a solid foundation on which to build with AHA ACLS Provider Manual information.

A new Respiratory Sinus Arrhythmia Section has been added to the ECG Analysis Module on www.richacls.com.

Below are some of the Key Learning Points (KLP)

Inspiratory Effects on the Sinus Node

• Inspiration causes slightly decreased blood pressure, which decreases vagal impulses to the heart, thereby increasing the heart rate.

Inspiratory Effects on the Sinus Node

• Expiration causes slightly increased blood pressure which increases vagal impulses to the heart thereby decreasing the heart rate.

Sick Sinus Syndrome

A new Sick Sinus Syndrome Section has been added to the ECG Analysis Module on www.richacls.com.
Below are some of the Key Learning Points (KLP)

Characteristics

• Sick Sinus Syndrome is uncommon and becomes more common with advancing age.
• A dysfunctional sinus node can be just the “tip of the iceberg”,
• a warning that the heart has significant disease in other areas.
• Sick Sinus Syndrome is a group of very dissimilar rhythms related by Sinus Node dysfunction.
• Electrical conduction disruption in Sick Sinus Syndrome is commonly caused by fibrosis or scarring.

Sinus Tachycardia

A new Sinus Tachycardia Section has been added to the ECG Analysis Module on www.richacls.com. Below are some of the Key Learning Points (KLP)

Sinus Tachycardia: Introduction

• Sinus tachycardia is defined as a sinus rhythm with a rate greater than 100 beats/min.
• Sinus tachycardia differs from other tachycardias in that it is the body’s response to an underlying issue.
• Since Sinus tachycardia is a symptom of an issue, it is the underlying issue which needs to be treated, not the rhythm.

Terminology, Supraventricular

• Supraventricular is used to describe any rhythm which originates from above the ventricles, specifically abovethe bifurcation of the bundle of HIS(a.).
• Supraventricular Tachycardia is used to describe the various supraventricular rhythms with rates above 100 beatsper minute

Characteristics

• Sinus Tachycardia usually begins and ends gradually.
• The rhythm is regular.
• The heart rate is above 100bpm (adults).
• P wave before each QRS.
• All p waves are the same shape.
• PR Interval 0.12-0.20 sec.
• QRS duration equal to or less than .10 seconds.

Sinus Bradycardia

A new Sinus Bradycardia Section has been added to the ECG Analysis Module on www.richacls.com. Below are some of the Key Learning Points (KLP)

Sinus Bradycardia: Introduction

Any rhythm less than 60 beats per minute can be labeled as bradycardia or called bradycardic.
The rule-of-ten rate measuring tool becomes less accurate with slow heart rates.

Sinus Bradycardia: Characteristics

• Since Sinus bradycardia is generated by the sinus node, it has the same characteristics as sinus rhythm except for the rate.
• The rhythm is regular.
• The heart rate is below 60 beats per minute.
• There is a P wave before each QRS complex.
• •P Waves will be the same shape.

Sinus Bradycardia: Normal-Abnormal

It is not uncommon to see heart rates below 60 beats per minute in athletes and individuals with good cardiac health

Sinus bradycardia is abnormal or symptomatic when the slow heart rate causes the cardiac output to drop below the body’s circulatory requirements, evidenced by low blood pressure and or cardiac shock symptoms; cool extremities, moist skin etc.

There are various situations which can cause symptomatic sinus bradycardia.

• Myocardial infarction
• Disease of the SA node
• Vagal stimulation
• Medications

Normal Sinus Rhythm

A new Section has been added to the ECG Analysis Module. This is the first rhythm to be added after the ECG Essentials Module. Keep in mind the user needs to understand the concepts in the ECG Essentials Module as the concepts are used in the rhythms modules and are not reviewed.

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