Deteriorating Patient
 

Pulse Rhythm

 
 
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Overview

  • Palpate the radial pulse for at least thirty seconds and determine whether the beats fall in time or are irregular.
    • Interpretation

    • Regular: sinus rhythm
    • Sinus arrhythmia: rhythmic variations in vagal tone with respiration
    • Regularly irregular (regular heart rate with occasional missed or extra beats): sinus arrhythmia, second degree heart block, premature ventricular contractions
    • Irregularly irregular: atrial fibrillation
    • Causes of Irregular Pulse

    • Sinus arrhythmia
    • Sinus arrest
    • Second or third degree sinoatrial exit block
    • Atrial fibrillation
    • Atrial flutter with variable block
    • Multifocal atrial tachycardia
    • Second or third degree atrioventricular block
    • Premature ventricular contractions
 
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