If R is too (0.2) far from P, then you have a first degree. Longer, longer, longer drop, then you have a wenckebach. If some P's don't get through, then you have a Mobitz II. If P's and Q's don't agree, then you have a third degree.
I watched all 6 parts and your explanations are very clear and easy to understand. Also the use of analogies makes the lecture more interesting and easy to follow. Thank you for breaking this down to a "kindergarten level" !!! Also I saved all 6parts for constant reviewing!!
This is the most organized, well explained EKG interpretation video I've ever seen. Thank you so much for your time and the effort! These videos (part1-6) helped me A LOT!
i really appreciated the outstanding demonstrations & interpretations of these lessons. thank you again for the pain-staking efforts & exceptional abilities to teach so many of us the right way.
Just thought I'd drop a comment and say I love your videos, man. I'm not in the ICU yet, but in a demanding cardiac tele unit. You've helped me feel somewhat prepared for some RRTs I've had to call lately. As a new grad, it's given me some confidence. Keep it up!
I am elated that I found your teaching , it is simplified and very informative, Suburb teaching , I think it the best I've seen, It is done in such a way that I can understand and remember and know the rational, Thank you very much !!!
I appreciate your effort to present this series and make it easy to learn, and I hope to make more lectures about ICU procedures like this.. thanks for helping us ❣️☺️
Thank you and that's awesome to know. I think I intentionally didn't cover interventions as this series was more designed at recognition and identification. At future points, I will cover interventions for these.
Its borderline, but the point isn't to trick you by having it slightly off. Most cases, for people new, the wide will be obviously wide. This is probably a result of my actually drawing the rhythm on the paper and not something trying to trip anyone up.
@@ICUAdvantage You are totally right. Wide is more important than narrow. Thank you for these videos btw. It really made a HUGE difference learning EKGs at orientation this week. I told everyone that was having trouble in class to watch your videos. Thank you for the amazing content.
I’ve got a bad situation where cardiologist can’t tell if I’m mobitz 1 or 2. I only have 1 PR lengthing before the missed beat as opposed to the usual 3-5 lengthenings that occur in mobitz 1. It seems closer to Mobitz 2 in the sense there are zero PR lengthenings but at the same time it’s hard to say as there’s still one. Always happens a couple times during sleep only.
Thank you, thank you, thank you! This series has really helped me to understand the pathophysiology and interpret the rhythms. Would recommend everyone who uses ECGs should watch these 6 videos.
Thank you so much for the lecture. It has really enhanced my understanding of heart block. I appreciate it. It could be better if you outlined the treatment for each.
Something that might help some of us is if for a while at least, you would add an image of the standard complex and label the normal landmarks for rapid identification during the discussion. Further, when bringing up a structure on the line, a brief description of it's function as related to normal heart function, such as a P rise being the signal to start the following complex, replaced or modified by the pulse from a generator. It took me years trying to get practitioners to at least attempt to explain this stuff to me in the short time allotted them for a visit. I was actually able to get more from the nurses, but only after convincing them that I had the requisite knowledge of the anatomy and physiology to understand the whole process. It was then that I found that many of them knew even less than I did which explained why they were being so dodgy in their responses. When teaching such a complicated subject, redundancy is reinforcement and never a bad thing. It's how we learn!
I just binged all 6 of the ECG Interpretation series, it was super helpful! Thank you so much! Can you recommend a website where we could practice to identify them?
I thought the epidural injection i had in my neck 11 days ago for a c6-c7 herniated disc was possibly causing the high BP or the actual herniated disc itself? I read that could be possible. I’ve been on trt for a yr or little longer under the care of my urologist labs are always good and my levels were extremely low thats why I started it. i have stopped now until i see my cardiologist on the 2nd and im not doing any exercising either. the er doc told me i should lay off caffeine, trt, the gym and a few supplements (l-argenine, L-carantine) until i find out what is going on. i’ve been on 200 mg test cyponiate 1cc every 10 days. if it’s causing the high BP i will quit it for good. never had high red blood cell count or any bad labs when my urologist asks for them. don’t drink alcohol or use illicit drugs either. My son had SVT like 9 yrs ago and did fine with an ablation he was 14 then. if you have any opinion on these PVC’s and high BP i would appreciate it. thank you and have a safe holiday. ✌🏼
I'm a heart failure survivor who 15 years ago was diagnosed with dilated cardiomyopathy with a left bundle branch block, and a 15 % ejection fraction. Hypertensive with A flutter, and bouts of V tach. Needless to say, I was pretty messed up and most of it was from stress brought on by a woman! Oh, to be fair, a high stress job may have had a little to do with it but it was actually fun! No drugs or drinking, EVER! Unlike their first assumption every time, even without any evidence what so ever from years of testing .They called it idiopathic until I dumped the woman and got a new one that was as perfect as could be. Suddenly, all my symptoms changed and my prognosis went from maybe a 1.5 year survival rate to ... Well, we don't know now. 15 years later, I'm starting to have significant problems again. They haven'r figured out the problem as yet, but your programs are helping me to understand the pathology a bit better and I can relate it to my extensive engineering background and contribute in my diagnosis and treatment program. Thanks guys. I just had endocarditis brought on by a round of sepsis with 2 pulmonary embolisms just for fun and then was severely burned when I had a seizure in the shower after getting in while adjusting the water temp. There's no regulator in this thing and the hot temp is a s high as 180 degrees which scalded the skin right off my legs and lower ass. 3rd degree burns requiring 2 month in the burn ward sedated . It took all the steam out of my engines so I've got a lot of physical therapy to catch up on.30 seconds of exertion and I'm huffin and puffin trying to catch a breath. It's not anything minor either. I mean I'm seriously fighting to get oxygen to my brain like I have a bag of helium over my head. All the while my pulse oxygen concentration is in the low 90's it's just not circulating like it should. Any thoughts? grrrwink@yahoo.com
I might add that I've had 4 stints, 2 anterior and 2 posterior, 3 ablations, one on the septal wall, one in the upper right for flutter, and one very recently in the upper left for A fib with a atrial rate of over 340 which delivered 2 very powerful shocks to capture and control which caused a lightening storm in my damn eyes and made me piss my pants! I'm in serious pain from injuries to my lower back over the years resulting in the fusion of two lumbar vertebrae and the associated hardware. The pain raises my blood pressure and it causes stress on my heart which responds in a higher rate and all the associated rhythm problems that happen once it gets above 130 or more. What I hate the most is when my heart starts beating to jazz music! I hate jazz music! It's uneducated lazy garbage with no organization played by drunks to be listened to by drunks! But even that's better than this pathetic rap crap! I play soft progressive 70's pop music and some well produced rock and roll, so long as it has cadence and lyrics that aren't repulsive. I mention music because it's some of the best therapy there is to control your emotions and moods which control the speed and power of your heart rhythms, reducing the possibilities of receiving therapy from a defibrillator, which as anyone who has had this will tell you is no fun at all! Unless your a woman having sex with a man who has it happen to him. I read that she will feel a mild tingling sensation that can be very stimulating. But trust me guys.... It's not worth it and no woman is good enough to put yourself through the agony of getting the shit or piss shocked out of you just for that! Put a capacitor and a freyed wire in her vibrator and she can get a 9 volt thrill out of that. I've been shocked 17 times over the 15 years since I had this thing installed. At least 9 of them were needed, but the rest may have been because of the adjustments not being quite right. I think they still haven't figured out the root cause of my issues and have been treating the symptoms almost blindly. This shortness of breath is severe and sudden and brought on with very minimal exertion, often times just by bending over to tie a shoe and recently simply by thinking about getting physical but doing nothing! It's like flipping a switch and it comes on, lasts up to 15 minutes and fades away, but during that time, I'm suffocating! 6 L of O2 and no movement make no difference, only time and concentration will reverse the situation. I've tried Adivan at up to 4 mgs and it helps a little, but it's certainly not a magic bullet. My greatest fear is that I'm going to die this way and it will be like half an hour of suffocating before the strain stops my heart and I go. I'm not afraid of dying, I believe in reincarnation and am actually looking forward to the journey that waits beyond our present experience. That's why I place so much value on being a good person and not lying or stealing or taking from others just to improve my situation in some minor fleeting way unless I can give back what I took and many times that. We create our own hell and conversely, our own heavens as well. I would love to discuss this with anyone as well. I'm kinda of a lonely guy due to my restrictions lately.
We use the husband and wife analogy in the NHS, which is a surprise as it's all woke here now. I like to think of an ectopic as the mistress who pops up once in a while.
Well... I was not technically kinda.. ECG kind of guy... But i followed this series following my hospital postings.... And now Alhmadulillah I can judge things pretty smoothly.
First off, thank you so much for this EKG series. It made understanding them so much easier. I was wondering if you have any lessons on the identification of J point in real-life EKG strips, and go in-depth of identifying ST elevation/depressions. Also, a lesson on pacemakers on EKG strips would be great! Thank you.
Thank you so much for this series. I have struggled with trying to understand ECG rhythms from merely reading about them and these videos really helped me get my head around it. Much appreciated!
Awesome! Really happy to hear this Cassidy. Sometimes it helps hearing things different ways until you find the one that makes it click. Glad to be able to help.
These videos quite literally saved my life!! I'm studying exercise physiology and you covered everything that we needed! I wish I'd found these videos before the night of my exam 😭
thank you for this quick and easy refresh! this is truly helpful to an easy and early recognize any compromise might come to our patients in health care setting. working in cardiac icu here by the way. Keep damn saving lives 🥰
I really like your videos. I do think that you should put just a bit more focus on the wide QRS on the 3rd degree Block. First, visually the reader identifies the wide QRS first. This automatically should distinguish the 3rd block from the 1st and the 2nd. A reminder of the 0.06-0.12 normal QRS (less than 0.14 pulling from your EKG 5 Step video) would be ideal. Second, the dissociation between P's and QRS's takes the viewer longer to interpret... Simply its more data...Just think about how many waves you need to process to see the dissociation. So lead with and focus on the wide QRS. Finally, there is an AHA ACLS 3rd block strip that I always found hard, until I realized (thanks to your videos) that the ventricle was contracting on it's own and thus 1st and 2nd should be discarded immediately as candidates. So in summary, I suggest when instructing about the 3rd degree heart blocks, lead with the wide QRS, re-emphasize what wide "is", and then show the associations between P and QRS as non-correlating. -- Great Videos.
Unfortunately the wide QRS is not definitive as the patient could naturally have a BBB giving them a wide QRS. It is a good clue though. Once you get used to seeing the blocks the PR intervals seem random and then first thought is to try and march them out, which usually happens pretty quickly. I do appreciate the feedback on the lesson and glad you enjoyed it!
The best nursing lectures one could have while in nursing school. I am starting my ICU rotation on Monday, and I feel so prepared and confident after listening to your lectures during the summer. Thank you so much for your hard work, I appreciate you very much.
Every time i learn about ECG, id forget about them after few days. So when the time comes that I need to re-learn them all, I’m truly thankful that I got your videos handful. You earned another subscriber today!
Thank you so much for this video! It would be awesome if you could include another series or video going over the typical treatments for each of the rhythms you described.
I love the husband and wife analogy but since the p wave is there in the weinkebach, but the dropped QRS isn’t, shouldn’t it be...the husband came home later and later each night until finally his wife was tired of his bullshit so she wasn’t there when he got home?
Thank you tremendously for compiling these videos for our benefit. Now that we’ve got an extensive general overview of the EKG patterns I was wondering if you could incorporate patterns that are more relevant to the real life scenarios like what we see on a typical 12 lead EKG. Identifying these patterns in patterns provided by textbook drawings are so much easier to pick up than looking through an actual 12 lead EKG. Far too many times, real life 12 lead EKG does not depict anything that we are accustomed to seeing in the textbook drawings. Always have the trouble of identifying which lead is supposed to have inverted waves and which one is not. If you ever have the time of providing such video tutorials, I would really appreciate it.
I am so thankful for these. I was so frustrated trying to complete a learning module regarding these earlier. Now I can go back to it with a clear head and even temper ❤
Let’s keep some things in perspective Laura….theres a reason he ain’t comin home. On another note, I just want to say, these are by far some of the best videos I’ve ever seen on rhythms and dysthymias. Our instructor busted his a$$ teaching us this in medic school, 15 yrs ago. This has been very detailed, but very easy to understand. Still kinda spin on blocks, but I can definitely differentiate the differences between them better. THANK YOU. It’s always amazed me the durability of the human body. The backups upon backups we see in the heart with the automacity is amazing just in itself. Been wanting to do a REALLY good 12 lead class for some time. Gonna check the rest of your channel. 😁👍
Thanks so much for taking the time to leave this comment. Really glad to hear the videos helped to explain things in a concise way that makes sense. I have been working on a 12-lead series that is getting close to being finished. You'll have to check that out and see if you like that one too.
Honestly it doesn't matter. They aren't dependent on polarity to identify. Lead II is usually the most common and easiest to read, as well as the polarity is in line with most pictures that you'll see. But for the AV blocks, its really just about identifying the P wave and the relative QRS complexes and finding the pattern.
Mr watson..God bless you. Just got done watching all 6 vidoes in this category, they really truly helped me alot with my ekg school. Very understandable and helpful. Keep up the awesome job.
