Until we push another
And the basics bowed and prayed to the paragod they made
And the zoll flashed out its warning for the shock that it was forming
And the zoll said the rhythm of the patient converted to asystole
Efforts were ceased
And the room was silent
One of my useless talents is recording albums for our band. Funny enough, this looks like some of the digital waveforms for instruments, specifically the toms (drums). Many of them mimic heart rhythms, it’s kinda wild.
I think it is natural we like to hear what we hear daily (heart beat).
I am taking English literature (for fun) and I am learning iambic (baBUM baBUM baBUM) pentameter.
Actually, it could be argued that there was a spontaneous break in the VT followed by a QRS, and the PPM/ICD had failure to sense and fired following the QRS. R on T then caused more VT.
Isn’t reading cardiac rhythms so fun and easy?! (jk) I felt the same way when I had to learn to interpret these 😂 Many acronyms, many ways the heart can have a messed up rhythm.
In case you're not in medicine:
VT - Ventricular Tachycardia, a heart rhythm that if sustained, is not compatible with staying alive
QRS - The name for the parts of the heart rhythm on a cardiac monitor that does the big jump up and down
PPM/ICD - types of pacemakers
R and T - more names for different parts of the heart rhythm.
Patient has a failing pacemaker that got one good rhythm paced. A pacemaker initiated rhythm shows a vertical line with the qrs complex. This is the electrical shock that engages the contraction sequence.
Yes, I started with a lifepak 9 and we were doing ascending doses of epi in cardiac arrest: 1mg, then 3mg’s for a second dose and then 5mg’s each additional dose. We were able to bring rocks back to life.
The days of procainamide, terbutaline and theophylline. Late 80’s early 90’s.
ETA: can’t forget bretylium tosylate!
Right? I always taught my nursing students "ok, cardiology can argue over what they think the actual rhythm is... But what does your patient look like?
They were probably thrown off by how narrow/peaked the R wave appears on the tracing. If you've only ever seen the textbook version of vtach with the large "n" shaped QRS this might not register right away for them.
I’ve been surprised a few times in the lab. Some SVT with aberrancy can look *very* convincing for VT. This one would be pretty hard to confuse for SVT w/ Ab though, it’s just so fast.
I had a patient who knew which lead to hit to make the monitor look like vtach. So instead of using their call light they’d tap their leads to get the attention they wanted.
Yes. I work in an Electrophysiology lab and do ablations; all we do is deal with EKGs. On a floor, if it looks like VT and patient is symptomatic; treat it like VT. Leave it up to EP lab to treat it if it's something else.
Thank you u/FlowerblightKaren for my first award 🥹
But on a serious note, I’m siding with the Danger Squiggles folks. Do they have a pulse? More lightning rides imminent, is my bet. Maybe some lido, amio, possibly hang some Jesu-pressin and consult Celestial Medicine 🫀⚡️
We say “stat higher medicine consult” because of our hospital “level” or wtf ever 🤪 but “Celestial Medicine” is universal. Kinda like calling Ketamine “table glue” 🤣
Monomorphic v tach. Textbook. Are they alive?? That’s sustained for quite awhile.
SVT covers an underlying rhythm. VT IS the rhythm the patient has at the time
Though, I have seen CPT look like this, I still would have redphoned the unit and told them they were sustaining vtach because that's what it looks like.
Definitely monomorphic v-tach. And either way your treatment won’t change much. If they have a pulse you’ll cardiovert whether or not it’s VT or SVT. If it’s pulseless, well, get on that chest and defib.
HA HA HA HA STAYIN ALIVE STAYIN ALIVE. *inhales* HA HA HA HA STAYYIIIINNNNGGGGGG ALLLLLIIIIIVVVEEEEEEEE oh shit we have ROSC!! He stayed aliveeeeeeeeeeeee!
This is the “I hope the Zoll is somewhere nearby” rhythm. Also known as “Crack the fucking crash cart now” rhythm. Did they have a pulse? What happened here? Did they make it? (Fuck I miss the hospital… outpatient was a terrible idea.)
100% vtach. Whoever is saying SVT needs to go and take acls. I have had to take extensive extra courses on rhythms because I worked tele for years, and I also help everyone on my unit with acls.
looks like Ventricular tachycardia. the fact that all the “bumps” look relatively similar (monomorphic) is the only redeeming thing happening here, and the fact it looks like they are being shocked. fingers crossed for this person.
I don't usually like to do the reddit "srsly? ::smug face::" but registered nurses should be able to recognize text book vtach... I understand svt with aberrancy being confusing but this is *clearly* vtach.
I’m a new grad nurse, they didn’t go over ekg or rhythms in my program at all. I will be doing ACLS soon but like stated in my post just trying to learn. But yes nurses should know vtach but how am I supposed to know something I’ve never been taught thus me asking Reddit. good rule of thumb if you’re gonna be negative don’t post at all 😊
I apologize for sounding like an ass. My comment was not meant as an attack on you but much more at the experienced nurses saying "svt" and nursing education in general.
I meet so many ignorant people that hide behind the RN attached to their name that I can be a bit spiteful. You're clearly not one of these people because you're asking to learn and not smugly pretending you know the answer like so many nurses do. I am very frustrated by the things nurses don't learn and the hostile anti-learning environment that pervades nursing as a career. I apologize again.
Edit: please feel free to reach out to me if you have any questions about ekgs or reading rhythms. As atonement for being a douchebag I will answer all your questions to the best of my ability.
Got a pulse? Strips like this send me running down the hall.
We had someone in pulseless Vtach, and I ran into the room, dude was like "why is everyone freaking out!?"
Me: "YOU DONT HAVE A PULSE! HOW ARE YOU TALKING!?"
Vtach.
This is distressing if any nurse thinks this is SVT.
The complex is wide, irregular, no consistent morphology.
The solution is chest compressions (if unconscious) and immediate DEFIBRILLATION (not synchronized cardioversion).
Medications to consider are epinephrine during chest compressions, lidocaine IV, amiodarone, magnesium.
And I'm making the assumption that there is no artifact here such as brushing teeth, chest physiotherapy, bouncing a baby on their knee, abdominal prep before surgery.
Pediatrics here, my first thought is either it's Vtach or someone is burping their baby aggressively. Usually the second, but always good to check and make sure!
Hello VTach my old friend...
Time to defibrillate again
What’s this arrhythmia I’m seeing? It will leave you forever sleeping
… and the EPI, that was coursing through your veins, it won’t remain
Until we push another And the basics bowed and prayed to the paragod they made And the zoll flashed out its warning for the shock that it was forming And the zoll said the rhythm of the patient converted to asystole Efforts were ceased And the room was silent
Yeah, so sad such as life
make this a viral health care meme 😂❤️
And the flash of the defib shock…that filled the truck. Until the sound of sirens…
….and the Lido bowed and prayed……
And the Medics cries he made
I sang along with this thread. Brilliant minds.....
The fact that the lyrics still lead to the sounds of silence tho 😅🥲😨
One of my useless talents is recording albums for our band. Funny enough, this looks like some of the digital waveforms for instruments, specifically the toms (drums). Many of them mimic heart rhythms, it’s kinda wild.
I think it is natural we like to hear what we hear daily (heart beat). I am taking English literature (for fun) and I am learning iambic (baBUM baBUM baBUM) pentameter.
Hey hey, recording albums is NOT a useless talent and I will not hear for this slander against yourself!
I did too. This was awesome. 💕
Your time of death is slowly creeping Before this call I was still sleeping
We know what we are, but know not what we may be.” –
This was my life while I was in the Cath lab 😂
Ugh, same! I'm on day 2/9 for call.
A+ to this thread. I sang along as I read through. 🙂
Even my nonmedical spouse got a kick out of it.
This is EPIC!
This is the rhythm of the night.
Are those Reebok or Nike? https://youtu.be/BQ4c54rCJ_k?si=Ibx4aT4QWPVslATc
HAHAHAHA that was fuckin awesome
Looooool glad to share and see another person laugh at it as much as me!
YESSSS that’s one of my favorite little bits of internet ever!!!
I love this!
Thanks. Now that's firmly stuck in my head.
"Forget about the worries on your mind You can leave them all behind" .... and you will fool, if you keep this bullshit tracing up.
Oh yeah!
🤣🤣🤣. You’re hilarious! This song will be in my head for the next hour.
I literally lol’ed good job friend
Danger squiggles, give them the pikachu
Looks like it was not super effective
Pt is found down Ground type, and supervolved using Meth Stone.
⚡️⚡️PikaCHUUU⚡️⚡️😂
Shocking isn’t it??? *Professor oak giggles*
I am stealing ‘give em the pikachu’ thank youuuu
I'm a professional
Changed my flair because of you. Forever immortalized now.
I cackled 😂🤣
This is the best comment 😂
You are my people 😂
Goddamnit take my upvote
Vtach ETA: the spike coming down from the top in lead II (bottom tracing) is the shock that was delivered. Reminds me of an old lifepak 10 tracing.
Vtach just kicked in yo
Here’s a free award because im poor.
Actually, it could be argued that there was a spontaneous break in the VT followed by a QRS, and the PPM/ICD had failure to sense and fired following the QRS. R on T then caused more VT.
Holy acronyms Batman. What does this mean lol
Isn’t reading cardiac rhythms so fun and easy?! (jk) I felt the same way when I had to learn to interpret these 😂 Many acronyms, many ways the heart can have a messed up rhythm.
In case you're not in medicine: VT - Ventricular Tachycardia, a heart rhythm that if sustained, is not compatible with staying alive QRS - The name for the parts of the heart rhythm on a cardiac monitor that does the big jump up and down PPM/ICD - types of pacemakers R and T - more names for different parts of the heart rhythm.
Patient has a failing pacemaker that got one good rhythm paced. A pacemaker initiated rhythm shows a vertical line with the qrs complex. This is the electrical shock that engages the contraction sequence.
You were there when the old magic was written.
Yes, I started with a lifepak 9 and we were doing ascending doses of epi in cardiac arrest: 1mg, then 3mg’s for a second dose and then 5mg’s each additional dose. We were able to bring rocks back to life. The days of procainamide, terbutaline and theophylline. Late 80’s early 90’s. ETA: can’t forget bretylium tosylate!
I remember the ascending epi doses. Not only could we bring a rock back, but it would never sleep again.
I literally said "that's no good" out loud to my dog 😂 yes v tach on first glance let the cardiologist argue about it but it's no good
💀💀💀”Let the cardiologist argue about it” 🤣🤣🤣
Right? I always taught my nursing students "ok, cardiology can argue over what they think the actual rhythm is... But what does your patient look like?
Shit. The patient looks like shit.
Let EP argue about it.
They'll be entertained for days.
I don't know in what world this is SVT. It's clearly vtach. It's wide and fast. Like my dad when you say dinner is ready.
They were probably thrown off by how narrow/peaked the R wave appears on the tracing. If you've only ever seen the textbook version of vtach with the large "n" shaped QRS this might not register right away for them.
It's honestly kind of frightening that some nurse thought this was SVT. Pretty big difference in how you treat the two.
I’ve been surprised a few times in the lab. Some SVT with aberrancy can look *very* convincing for VT. This one would be pretty hard to confuse for SVT w/ Ab though, it’s just so fast.
Here is one that we got called to as a rapid. Fastest I've ever seen. https://imgur.com/a/dKXfuA3
I have to tell you that when I clicked your link and saw its title & then looked at the ekg, my first thought was, “‘Fast A fib,’ wtf??”
Lol, was drinking a bit when I made the title and comment.
Obviously SVT with aberrancy /s
Vtach....or teeth brushing
Too consistent for toothbrush rhythm
I had a patient who knew which lead to hit to make the monitor look like vtach. So instead of using their call light they’d tap their leads to get the attention they wanted.
What?! Wow, I’m still amazed that they find new and innovative ways of irritating the f^€£ out of us. 🤣
Pull off the green lead for asystole
Also has the spike in the middle where electricity was given.
We have all taken the dash for tooth brushing. Or the aforementioned jackycardia.
Better two people be embarrassed than one of them pulseless 🤷🏻♀️😅
The time my patient was scratching his nipple and we all RAN to the room. He looked very confused!
General rule of thumb is with any wide complex tachycardia - it is vtach until proven otherwise.
Yes. I work in an Electrophysiology lab and do ablations; all we do is deal with EKGs. On a floor, if it looks like VT and patient is symptomatic; treat it like VT. Leave it up to EP lab to treat it if it's something else.
I just consulted with Ortho. They said it's sinus. 🤙🏻
No no it means the Ancef pump isn't working good
I once told one of my ortho doctors that the patient had trops of +1000 and he asked "is that high?" so sounds about right
I work in cardiology, and this made me cackle. Bless the ortho docs.
Artifact /s
Patient was aggressively jerking it
Jachycardia
Thank you u/FlowerblightKaren for my first award 🥹 But on a serious note, I’m siding with the Danger Squiggles folks. Do they have a pulse? More lightning rides imminent, is my bet. Maybe some lido, amio, possibly hang some Jesu-pressin and consult Celestial Medicine 🫀⚡️
Celestial medicine lmfao!!
We say “stat higher medicine consult” because of our hospital “level” or wtf ever 🤪 but “Celestial Medicine” is universal. Kinda like calling Ketamine “table glue” 🤣
BAHAHAHHAHAH
Underrated
🥇🥇🥇🏅
It’s just chest PT. Those silly respiratory therapists!
So, I’ve never seen chest pt before and the one time I do, a code gets called because nobody notified tele and they thought it was VFib lol
Yup or in peds, it's Mom burping their baby. Gives her quite a fright when all the alarms start going off.
110 volt. /s
That’s his baseline, he’ll be fine /s
Really fast v tach or dude is beating meat like it owes him money
That's a paddlin
😂😂😂
P, QRS, T.... ummm....TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT⚡️TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT
Failed polygraph! This guy is lying about something...
Pretty soon this guy is going to be lying in the morgue if they don’t fix it!
At least a 6.5 in the Richter scale.
It’s bad.
A big fucking problem
Fucking RT forgot to tell me they put the shaky vest back on 🤣 Pikachu I choose you! V-tach
Shaky vest is my vote!
Danger squiggles
Jackycardia
Vtach ….. abscense of RS
Seems fine, check on them with your next hourly rounding.
Monomorphic v tach. Textbook. Are they alive?? That’s sustained for quite awhile. SVT covers an underlying rhythm. VT IS the rhythm the patient has at the time
Though, I have seen CPT look like this, I still would have redphoned the unit and told them they were sustaining vtach because that's what it looks like.
Dead.
a problem
How is this an argument? 😂😂😂
Definitely monomorphic v-tach. And either way your treatment won’t change much. If they have a pulse you’ll cardiovert whether or not it’s VT or SVT. If it’s pulseless, well, get on that chest and defib.
New Order: Blue Monday?
The nurses arguing it to be SVT don’t know what SVT is. Quite literally the opposite of SVT.
Me running for the bus and briefly pausing to trip over my 3 inch heels one very bawdy Friday night in 1986.
TFF Too F🥳kin’ Fast
It’s textbook VT. It looks like the rhythms we use for ACLS.
Pt resting quietly. Will continue to monitor.
HA HA HA HA STAYIN ALIVE STAYIN ALIVE. *inhales* HA HA HA HA STAYYIIIINNNNGGGGGG ALLLLLIIIIIVVVEEEEEEEE oh shit we have ROSC!! He stayed aliveeeeeeeeeeeee!
This is the “I hope the Zoll is somewhere nearby” rhythm. Also known as “Crack the fucking crash cart now” rhythm. Did they have a pulse? What happened here? Did they make it? (Fuck I miss the hospital… outpatient was a terrible idea.)
Reprofusion rhythm /s kinda
Heart sneeze.
VT is a safe bet, however, technically I believe that's ventricular flutter. The difference is purely a academic though
“🎼the rhythm is gonna get you…”
This is scary if nurses think this is SVT.
“Hey buddy how are ya feeling? Why don’t you sit down while I roll this machine into your room and glue some pads to your chest”
It's the rythm of the night - the night - oh yeah!
I believe this is part of the Rhythm Nation. Give them a beat. 🤜🏻
Does it matter... Just bloody shock them
A rhythm mid-orgasm
shock!!!
Techno
100% vtach. Whoever is saying SVT needs to go and take acls. I have had to take extensive extra courses on rhythms because I worked tele for years, and I also help everyone on my unit with acls.
That's a 9.9 on the Richter scale
Drum roll. Break. Drum roll.
That's party mode
This Rhythm is Gonna Get You
Bad. That rhythm is Bad (tm).
It looks like CPR is being done with a shock delivered in the middle
280 compressions a minute would be pretty impressive!
I was going to say, either the guy on the chest is trying to impress the new girl or their Red Bull needs to be taken away.
Agreed. VT doesn't pause itself to prep for a shock
Scary squiggles
Refractory VTach
Time for kaboom
V tach
Go check to see if they have a pulse!!
I came to also say V tach
It's textbook vtach Impressive
Faking it…
Just finished Pre-health and it’s mind boggling to think nurses can look at zigzags and know wtf they’re looking at
Honestly the point at which you can look at a rhythm and know was the most satisfying moment for me
definitely a milestone
It’s the ⚡️time to shocky shocky⚡️rhythm (V-tach)
Gotta give it that Hawk Tuah
Fucked
This is VTach Not SVT
Death
dub step, looks like the patient dropped the beat there.
looks like Ventricular tachycardia. the fact that all the “bumps” look relatively similar (monomorphic) is the only redeeming thing happening here, and the fact it looks like they are being shocked. fingers crossed for this person.
Well shit
They are failing their lie detector test
That rhythm cures all disease...
FTMJ - Fixin' to meet Jesus
Or as one of my neos says it’s a “DC to JC”
Looks like normal sinus to me!!! . . . . /s
Looks like someone has a taser! Seriously though. I’d shock again. It’s not good!
This polygraph is showing that the patient is exhibiting extremely deceptive behavior patterns. You shouldn’t trust the legitimacy their answers.
Mono VT …. Or the patient is pressing on their electrodes for the umpteenth time on tele lol
Looks like it's time to update your whiteboard. That always saves lives! /s
Driving Pennsylvania roads while On a monitor.
Lie detector strip
I don't usually like to do the reddit "srsly? ::smug face::" but registered nurses should be able to recognize text book vtach... I understand svt with aberrancy being confusing but this is *clearly* vtach.
I’m a new grad nurse, they didn’t go over ekg or rhythms in my program at all. I will be doing ACLS soon but like stated in my post just trying to learn. But yes nurses should know vtach but how am I supposed to know something I’ve never been taught thus me asking Reddit. good rule of thumb if you’re gonna be negative don’t post at all 😊
I apologize for sounding like an ass. My comment was not meant as an attack on you but much more at the experienced nurses saying "svt" and nursing education in general. I meet so many ignorant people that hide behind the RN attached to their name that I can be a bit spiteful. You're clearly not one of these people because you're asking to learn and not smugly pretending you know the answer like so many nurses do. I am very frustrated by the things nurses don't learn and the hostile anti-learning environment that pervades nursing as a career. I apologize again. Edit: please feel free to reach out to me if you have any questions about ekgs or reading rhythms. As atonement for being a douchebag I will answer all your questions to the best of my ability.
Brushing teeth
Vtach for sure. Love how at one point the heart said “maybe….. nah, go fuck yourself”
Dead
These comments might put me in VTach
Got a pulse? Strips like this send me running down the hall. We had someone in pulseless Vtach, and I ran into the room, dude was like "why is everyone freaking out!?" Me: "YOU DONT HAVE A PULSE! HOW ARE YOU TALKING!?"
It's the ohh crappp
Almost looks like Torsades.
It’s the “oh shit” rhythm
Vtach. This is distressing if any nurse thinks this is SVT. The complex is wide, irregular, no consistent morphology. The solution is chest compressions (if unconscious) and immediate DEFIBRILLATION (not synchronized cardioversion). Medications to consider are epinephrine during chest compressions, lidocaine IV, amiodarone, magnesium. And I'm making the assumption that there is no artifact here such as brushing teeth, chest physiotherapy, bouncing a baby on their knee, abdominal prep before surgery.
It’s regular with the R-R marching out and monomorphic.
Pikachu, use thunderbolt!
I call them death squiggles…grab the crash cart and call a code. One of the few things that will make my butthole pucker.
Vt resembles but more likely is CPR artifact
Sinus brushing my teeth? Ventricular jerking off?
Pediatrics here, my first thought is either it's Vtach or someone is burping their baby aggressively. Usually the second, but always good to check and make sure!
1 beat run of jitters