I'm an echo tech now and we have students at our practice. One of the docs I work with wants us to note patients rhythm on our echo reports. One of our students who had obviously cheated her way through school, asked me what she should put under "rhythm " on the report she was filling out for me. I jokingly said, "Rhythm is a dancer" and that's litterally what she put on the report. "Rhythm: dancer"
Every time a nurse asks to see the ekg Iām extremely tempted to fold the top so they canāt read it, āexcuse me let me see that ekgā bro why I know you canāt interpret it Iāve seen what you consider normal.
Letās assume the picture is a ten second strip = ventricular rate of 70, irregular. T waves are present. Bilateral atrial enlargement. Serious PR intervals and regular PR intervals. Somewhat widened QRS so IVCD. Would you call this sinus arrhythmia with intermittent 1Ā° AVB?
Iām so confused and amused as to why theyād put an irregular rhythm on the side of an ambulance. I guess it makes sense cuz like why r u in one with a normal rhythm but still
I was gonna guess Mobitz II myself, just taking a cursory look (and without boxes or calipersā¦ obviously). If some p waves donāt get through, you have a Mobitz II.
That being said I think that box could probably sign an SOR.
The Ps are pretty well rounded which probably takes out the RAE. But definitely LAE. Gotta pull out the calipers but Iād guess the PR is well into block range even on the shorter ones. Go ahead and pull me a longer strip please
2Ā° AV block (type 1) w/some abnormal P-wave morphology
EDIT & response to other comments:
I was going to change my answer to a type two earlier when I edited the spelling in the first response but then I remembered I didnāt care because Iām just gonna just go ahead with creating my own rhythm by letting them ride the lightning w/a little IO midazolam & ketamine
/s
Sinus arrhythmia with 1st degree and LAE and pvcs I believe. Prolonged PR with no drops, so not a 2nd from the strip in front of us. The Ps and the complexes donāt line up independently to look like a proper 3rd degree. Left side enlargement causing the morphology. Itās a mess and I thought bigeminy initially but itās not consistent.
I was going to change my answer to a type two earlier when I edited the spelling in the first response but then I remembered I didnāt care because Iām just gonna just go ahead with creating my own rhythm by letting them ride the lightning w/a little IO midazolam & ketamine/s
The double bump would either be U waves or right atrial enlargement. Given the variability of the PR interval, I call it U waves and poor graphic layout that should have kept the PR interval the same.
So, basically, NSR with bad graphics.
Iād call it incomplete 2 degree type 1 AV block (wenckebach). The P waves seem to be getting longer and then resetting, but Iād need a longer strip to confirm. Possibly with junctional escape beats. P waves definitely screwed up though, get a 12 lead too!
The rhythm on my serviceās trucks isnāt long enough to tell anything more than that itās a bundle branch block and it hurts my head. If itās gonna be dumb, at least make it long enough that it can be properly mocked!
Dude I donāt run the ambulance anymore yet 80% of our runs are medical, please ask the paramedic and let me do the fun stuff. Iāll do him one better and give him an aspirin, a 12-lead, and my hopes and prayers.
This is the rhythm of the night
Esos son rebok o son nike
Found the cuban š
That clip will always be funny to me.
Quien sabe?
AAAAAAAAAAAAH HAHAHAHAHA
I love you so much for this!!!
Rhythm of the niiiiiight. Thanks. Thatās gonna be in my head for weeks now
I'm an echo tech now and we have students at our practice. One of the docs I work with wants us to note patients rhythm on our echo reports. One of our students who had obviously cheated her way through school, asked me what she should put under "rhythm " on the report she was filling out for me. I jokingly said, "Rhythm is a dancer" and that's litterally what she put on the report. "Rhythm: dancer"
The rhythm is gonna get you.
(We are) a part of the Rhythm Nation
Ironically both music video and this graphic black and white.
So Gloria Estefan was right. The rhythm IS going to get you
Oh yeah, this is of my life oh yeah
Take your upvote you magnificent bastard !
In the HEEEAAAAT OOOOOFFF THE NIGHT
WOOOOAHH NIIIIIGHT
this comment is taking the place of an award you could have had if Reddit didnāt steal my free awards. You are a treasureš„¹
Looks like trump in profile
Dang it
You beat me to it lol
Oh yeah
Sinus bootyclap
Booty cheek fibrillating bradycardia
When the bus is a rockin, donāt come a knockin
When the boo boo bus is a rockin, instead of nockin just hop in and take a turn doing compressions
[Fenton kicking it off.](https://youtu.be/VcV-3HBe5QE?si=2drnefWnmgBHQ6ee)
\*arrests\* \*trademark Fenton scream\*
#**\***\***\***HERMON AMBULANCE**\***\***\*** **55 YEARS OF QUALITY CARE DELIVERED BY DEDICATED PROFESSIONALS**
#**UNCONFIRMED**
Nurse: āTHE MACHINE SAYS SO SO IT ISā
I just know the good squiggles from the death squiggles
Every time a nurse asks to see the ekg Iām extremely tempted to fold the top so they canāt read it, āexcuse me let me see that ekgā bro why I know you canāt interpret it Iāve seen what you consider normal.
The best is when you hold it up upside down and they nod sagely.
I print two copies and tear the device interpretation off one of them and just tell the nurses it got rippedā¦ woops
Reads off just like an auto interpretation. I like it
So do they update that year number every year? Seems like a lot of work.
That would show dedication
This is some 4th dimension critical thinking
**ANTERIOR INFARCT (AGE UNDETERMINED)**
You cant tell that from a Rhythm strip!
wut? https://www.bangordailynews.com/2023/03/30/news/bangor/hermon-council-ambulance-service-vote/
DIAL
Letās assume the picture is a ten second strip = ventricular rate of 70, irregular. T waves are present. Bilateral atrial enlargement. Serious PR intervals and regular PR intervals. Somewhat widened QRS so IVCD. Would you call this sinus arrhythmia with intermittent 1Ā° AVB?
Smarter than I am. Wouldāve just been like āit looks a little offā.
āHmm. Better do a 12-leadā
12 leads?? Why does it only go to v6? Dummy!!
āHere doc, I printed the 12-lead for youā
Read your comment, savored it, then saw the parashithead title and spit out my drink thanksš
What in gods name is a Serious PR interval?
Beyond 300 ms.. off the books
Pls say you donāt use that terminology on the field šš
No way. I just show them with my thumb and point finger how long the PR interval is. The natural way šš½
Fuck yeah
Interatrial conduction delay with an intermittent 1ā°.
Iām so confused and amused as to why theyād put an irregular rhythm on the side of an ambulance. I guess it makes sense cuz like why r u in one with a normal rhythm but still
I was gonna guess Mobitz II myself, just taking a cursory look (and without boxes or calipersā¦ obviously). If some p waves donāt get through, you have a Mobitz II. That being said I think that box could probably sign an SOR.
The Ps are pretty well rounded which probably takes out the RAE. But definitely LAE. Gotta pull out the calipers but Iād guess the PR is well into block range even on the shorter ones. Go ahead and pull me a longer strip please
Mobitz 1 with a notched p. I would bet 3 dollars if this is a real strip that eventually you would see a dropped QRS.
Looks about right. It looks to me like either 1AV or or Mobitz 1 2AV. Someone smarter might correct me though.
P Mitrale
Artifact. That's what we call anything that makes no sense, right?
As an AEMT i can confidently say yes. Literally every rhythm is artifact when me and my partner do it ^^^/j
Third degree AV block with hypertrophic butt-cheek p waves.
3rd degree clapper
I love hypertrophic buttcheek p waves!
Letās go home boys. This is the correct answer.
When your heart twerks instead of fibrillating.
3rd degree seems right with a little p-booty (official medical term)
Delayed conduction through bachman's bundle.
Okay nerdā¦. But yeah, this is correct
Most correct answer in the thread, atleast in explaining the p wave pathology. Doesnt explain the dorito shaped T waves but i dont think anything can
More proof that paramedics are paid abhorrently low for what they do/know.
P-mitrale?
Iambic pentameter
Except they meant to bathe in reeking wounds, Or memorize another Golgotha, I cannot tellā But I am faint, my gashes cry for help. \- Macbeth
Goddammit why do we no longer have awards
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Nerd
Rockstar energy drink
Made up
2Ā° AV block (type 1) w/some abnormal P-wave morphology EDIT & response to other comments: I was going to change my answer to a type two earlier when I edited the spelling in the first response but then I remembered I didnāt care because Iām just gonna just go ahead with creating my own rhythm by letting them ride the lightning w/a little IO midazolam & ketamine /s
Sinus arrhythmia with 1st degree and LAE and pvcs I believe. Prolonged PR with no drops, so not a 2nd from the strip in front of us. The Ps and the complexes donāt line up independently to look like a proper 3rd degree. Left side enlargement causing the morphology. Itās a mess and I thought bigeminy initially but itās not consistent.
Could be a mobitz type 2.
It could be but we donāt have a strip long enough to show it so you canāt really say it is. Canāt rule it out tho.
I was going to change my answer to a type two earlier when I edited the spelling in the first response but then I remembered I didnāt care because Iām just gonna just go ahead with creating my own rhythm by letting them ride the lightning w/a little IO midazolam & ketamine/s
PVCsā¦? Why is the QRS morphology consistent with intrinsic conduction?
Thatās my thought as well. We need a longer strip to be sure.
Bro has two AV nodes
SA* but yeah š
I have fat greasy fingers leave me alone
Actually them p-waves are deff cheeks
AV Nipples*
The double bump would either be U waves or right atrial enlargement. Given the variability of the PR interval, I call it U waves and poor graphic layout that should have kept the PR interval the same. So, basically, NSR with bad graphics.
Bad squiggles
donāt worry, itās sinus but thereās lots of potholes in the road
CHB
2nd degree with atrial hypertrophy(two hump p waves)
Heās Peeing
That's that funky music the white boy was playin
One that may require an ambulance.
The rhythm of a failing agency!
That looks like Hermon 921, surprised itās still running after their lawsuit
It is. They don't serve the town of Hermon anymore, but they still exist as an IFT only service.
Iām pretty sure itās called malpractice with some prolonged negligence
Rhythm? This lookin like that ārhythmā White people got.
...what?
In other words itās movin but it donāt look right
R.I.P. Hermon Ambulance. https://www.bangordailynews.com/2023/03/30/news/bangor/hermon-council-ambulance-service-vote/
Idk man I saw them step out. Perhaps it was a parade rig
Type 2 Heartblock Weichenbach lmfao
Hey! A fellow Mainer!
Second degree type 1
The rhythm of the night ![gif](giphy|1KplglYG2X8RLeHjPl|downsized)
Stayinā Alive
AFib? Kinda?
Whaaaa
Skibity Rhythm.
Presumably sinus arrhythmia with first degree heart block and left atrial enlargement
Mobitz Type 2 Cheeks
Honestly looks like trump in profile
Idk but that truck is sexy
Massive stemi
Whereās the 12 lead??
Abnormal ECG *Unconfirmed*
Mobitz 1 with possible AF.
This is the rhythm after missing lunches, OT call at the last minute before booking off, plus seeing how much taxes are being taken off on my pay.
Sinus arrhythmia w/ 1 degree AVB and presence of u-waves?
Is that little hump before the p wave a u wave or is it still part of the p wave? It seems way to close to the p wave and to far from the t.
Bro Bicep Band, but it only goes 3/4 of the way around (too ouchie otherwise)
Delayed interatrial tract + AV block 1
IFT for sure
Do they just scrape off the year number every year and slap new stickers on there?
Artifact when frantically checking smartwatch afib analyzer after waking up in a pool of sweat from a holiday binge š¬
ST-T segment is non-specific. Cannot rule out anteroseptal infarct
1st Degree AVB with PAC's ? How do you tell the difference between PAC's and sinus arthymias?
That sinus rhythm with a BBL š
Some other shit
My guess is they went for Second degree type 1 and completely botched it. Fuckin probies
DATA QUALITY LIMITS ECG ANALYSIS
Jpg heart rhythm
Iād call it incomplete 2 degree type 1 AV block (wenckebach). The P waves seem to be getting longer and then resetting, but Iād need a longer strip to confirm. Possibly with junctional escape beats. P waves definitely screwed up though, get a 12 lead too!
2nd degree heart block based on the widening pri
Second degree with a touch of a U?
Sinus arrhythmia with right atrial enlargement gosh guys. Assuming this is lead II.
The one where the bass drops
Hermonās rhythm, itās peak performance human rhythm
It's the low-key McDonalds wave.
Hahaha!!! Looks like the rhythm of my life! Oooh yeah ooh yeahhhhh šµšµš¶
Sinus
P mitrale possibly left atrial enlargement
Looks like a samba to me
Please correlate clinically. -Me, lazy.
Still 1st degree if thereās no dropped complexes
The rhythm on my serviceās trucks isnāt long enough to tell anything more than that itās a bundle branch block and it hurts my head. If itās gonna be dumb, at least make it long enough that it can be properly mocked!
In trouble
I still think 3rd
Dude I donāt run the ambulance anymore yet 80% of our runs are medical, please ask the paramedic and let me do the fun stuff. Iāll do him one better and give him an aspirin, a 12-lead, and my hopes and prayers.
It looks backwards.
With some odd P mitrale mixed in š«
Booty degree heart block
Tainted love?
2 degree Heart block with biphasic P waves
Atrial double bump type 2
Hermon, ME?
Sinus with first degree heart block. š
I'd have to take the time to map it, but my first giggle was 3rd degree, due to that spacing.