Cardiac Monitoring & Emergency Response Flashcards

During a rapid response event, the team identifies the rhythm as supraventricular tachycardia (SVT) with a rate of 170 bpm in a hemodynamically stable patient. The first-line pharmacologic treatment is:

Answer: Adenosine 6 mg rapid IV push

Adenosine 6 mg given as a rapid IV push followed by a saline flush is the first-line drug for terminating stable SVT by transiently blocking AV nodal conduction.

Which of the following ECG findings is most suggestive of digoxin toxicity?

Answer: Sagging ST depression with a scooped appearance and slow ventricular rate

Digoxin produces a characteristic scooped or 'Salvador Dali mustache' ST depression along with bradyarrhythmias due to increased vagal tone.

A CCT observes fusion beats and capture beats during a wide complex tachycardia. These findings are diagnostic of:

Answer: Ventricular tachycardia

Fusion beats (partial sinus and ventricular depolarization) and capture beats (brief sinus capture) are pathognomonic criteria for ventricular tachycardia per Brugada criteria.

What is the correct pad placement for anteroposterior (AP) defibrillation?

Answer: One pad on the left anterior precordium and one pad on the posterior left thorax

AP placement positions one pad over the left precordium (cardiac apex area) and the second pad on the posterior left thorax directly behind the heart.

A patient being monitored post-cardiac catheterization develops sudden onset of hypotension, distended neck veins, and muffled heart sounds. The ECG shows low voltage and sinus tachycardia. The technician should suspect:

Answer: Cardiac tamponade

Beck's triad (hypotension, JVD, muffled heart sounds) combined with low-voltage ECG after cardiac catheterization strongly suggests pericardial tamponade from procedural complication.

In a paced rhythm, which ECG feature confirms ventricular pacing (not atrial pacing)?

Answer: A pacing spike before each QRS with a left bundle branch block morphology

Ventricular pacing shows a spike immediately before a wide, LBBB-morphology QRS because the right ventricle is stimulated first via a right ventricular lead.

When a cardiac monitor shows 60-cycle interference artifact, the most appropriate corrective action is:

Answer: Check and reattach electrode leads, ensuring good skin contact and proper electrode placement away from power sources

60-Hz AC interference is usually resolved by improving electrode skin contact, ensuring leads are not near electrical equipment, and verifying electrode placement.