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Deteriorating Patient
 
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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