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NCLEX | 10 RHYTHMS TO MASTER YOUR ECG FOR THE NCLEX | NURSE LIFE

May 19, 2019



[Applause] hey listen man don't sweat about it I'm telling you what are you so stressed about it's just NCLEX I'm gonna teach you everything about ECG that you need to use in your anklets it's not much seven eight rhythms memorize them and then you are good to go that's it you don't need to memorize textbooks you don't need to memorize 200-page ECG PDF period man what's wrong with you it's just eight riddles hey listen I'm gonna teach you all about it just give me a second let me enjoy the weather oh my god I just finished my shift by the way yeah but you know I I heard you calling I heard your struggle so awful slice is here to help you out man listen if you haven't watched my other anklets videos I'm gonna link them all down and description box check them out actually my wife passed her anklets just a month ago she passed her anklets was 76 questions she followed the simple algorithm check her anklets videos down and description box but listen man just give me a second let me catch my breath I just finished my shift that's been a long-ass shift busy shit I guess what I'm not complaining we saved lice today for some of you guys who don't know me and just came across the channel it's alright I'm gonna tell you everything about me in a six-minute video my name is Muhammad and I'm gonna link the video up in the cards check it out you will not regret it alright guys it's getting a little bit windy let's go inside and show you the ten rhythms you need to master your ECG on your a clocks test let's go guys but first I want you to meet the family what do we have here let's see oh they're busy they're busy playing games let's see where's Angelina all right guys awesome welcome I'm glad you're here I'm gonna give you some help for the ECG but first let's talk basics this is a beat it's one single beat this is a p-wave that's a Q or s and a T wave our focus is gonna be on the P wave PR interval and then the QRS so for some of you guys who don't know what the PR interval it starts right there and it ends at the Q so that's a PR interval now I gotta show you some numbers but first I want you know some basics like this is a large square from here to here I'm gonna put it here we're gonna use this paper later but from here to here is a large square those small squares we have five small squares and one large square so one I say a small square that means that little dude right there and the large square is that one over there so let me zoom in a little bit you guys can see what I'm talking about so large squares and small squares all right guys I'm gonna move this to the side and then we're gonna talk some numbers B our interval first off one small square or one small box is gonna be 0.04 seconds one large box equal to five small boxes equal to 0.2 seconds that's a given you need to memorize that at interval training us from 0.12 to 0.2 seconds so that is three small squares and that is one large box or square all right so we got this down now the second most important is the QRS so what QRS interval is from 0.06 seconds to 0.1 seconds that is 1.5 small boxes and this is 2.5 small boxes okay if you forget the numbers then if you memorize the boxes then you would be fine okay another basic thing heart rate the normal is from 60 to 100 anything above that it's called tachycardia anything less than that is called bradycardia all right are you guys with me us so we're going to talk about three categories of rhythms first we're going to talk about atrial rhythm use then ventricular rhythm yes and then blocks right I don't this is your least favorite but we're gonna make it your favorite okay all right first I'm gonna start with atrial arrhythmias after your arrhythmias or atrial are two types bear in mind I'm not giving you a crash course about ECG I'm gonna give you the ten rhythms you need to know to pass your ankle experience and in each rhythm I'm gonna give you the bottom line of what you need to know so this is the first rhythm that we're going to talk about any time you see P waves like that they call them saw two or saw waves anytime you see saw waves that's atrial flutter period narrow QRS and C soul waves a trio flutter that's it moving to the next wave the second atrial algorithm you that I want you to know is atrial fibrillation how do you distinguish atrial fibrillation first off as we said narrow QRS which means it's from 0.06 to 0.1 seconds 1.5 boxes 2.5 boxes so if we count together let me zoom in a little bit so if we count together it starts right there one two boxes that's QRS that's a narrow QRS all right the second thing you're gonna notice about atrial fibrillation is this is called our wave this is another our wave this is another our wave so our two are is irregular our to our interval is irregular meaning that the distance from one R to another R is not similar or is not equal to the distance from here to here and you see this is way smaller than this so if you have narrow QRS irregular R to R then you call it after your fibrillation never mind about the p-wave sometimes they tell you you have multiple peas and sometimes they tell you you don't have a pea but never mind the p-wave all you need to know is narrow QRS irregular R to R then you call it a trio fibrillation here you moving to the next rhythm alright so the ones we talked about our atrial arrhythmias now we're going to talk about ventricular rhythm use actually there are three of them if we bring our beat here that's a P wave that's a narrow QRS that's a T wave right here I don't see any P waves I don't see another QRS and I don't see a T wave all I see is this rhythm you print this out and you hang it in front of your desk anytime you see this rhythm that's a ventricular tachycardia they also call it v-tach moving to the next rhythm actually this is the same rhythm this is a v-tach as well so it has a different form instead of having that form it's a wide QRS maybe you can see a P wave here maybe you don't there's no T wave but this is called a v-tach usually it is regular from our to our same distance but definitely it's a wide QRS this is another shape that you can see v-tach and you just memorize the rhythm period I don't want you to think much about it anytime you see this that's v-tach this is not ECG this is more of a CLS and algorithms but but anytime you see a VTEC you gotta think of two options you gotta think of no pulse and then you start chest compressions some drugs that they might give during a pulseless v-tach or cord are on they call it amiodarone as well then you've got little cane and then you've got DC shocks all right the other situation of V tags where the patient has a pulse also that could be two situations first situation the patient could be stable which means hemodynamically stable when we talk about hemodynamically blood pressure is normal and then you think of drugs which is mu Dhahran or lead O'Kane the other situation is when the patient is unstable means low blood pressure then you you would be thinking of DC shocks plus drugs that's all you need to know about it period all right this is another type of v-tach they call it towards side a do 20 and excuse my French genes but they call it tor solid aplenty you can pronounce it however you like to pronounce it but it's basically like a DNA shape and then if you draw like that smaller bigger smaller bigger smaller bigger so if you draw the DNA right here we go like that and so it's getting smaller what the heck did I do bigger smaller bigger so any DNA like arrhythmia with a wide QRS you call it tore sided Puente it's a form of v-tach and the first thing you need to think of in terms of treatment is magnesium so you give mg s o4 and then the patient most probably will convert to normal sinus rhythm so that's about it this rhythm is another ventricular arrhythmia it's chaotic so it's like that you don't see P waves you don't see qrss it's just chaotic that's a V that's a v-fib they call it a ventricular fibrillation basically what the heart is doing it's shivering like that so the treatment is to first you start CPR and then after you put the patient on AED and you find that rhythm that's a shockable rhythm then you give a DC shock and then continue CPR print this rhythm and put it in front of your desk all right now we're going to talk about blocks we're gonna start with first-degree AV block okay when we talk about blocks I want you to think of rate rhythm B wave PR interval and QRS so five categories that you need to think of in terms of blocks great how to calculate the rate it's our waves times ten so this is an R this is another R so one two three four five six times ten this heart rate is 60 beats per minute alright the rhythm here its regular so R to R equals R to R equals R to R and if you check P to P and then P to P and then P to P it will show that it is the same distance then that's regular P wave it's normal normal amplitude normal direction PR interval so the P starts right there and it ends right there so if you look up closely it's more than one large box so we said the normal PR interval is 0.12 to 0.2 seconds so it's three small boxes to one large box more than one large box then the PR interval is prolonged so here it's almost seven small boxes which means greater than 0.2 seconds prolonged QRS it's narrow narrow QRS which is normal okay so let me get the red color so PR interval is prolonged everything else is normal and it's constant constant prolongation so from here to here it's seven boxes from here to here it's another seven small boxes here to here another seven another seven another seven then that's a first degree AV block narrow QRS prolonged PR interval with constant speed then that's a first degree AV block [Applause] so now we're going to move to the second rhythm and we're gonna talk about second degree AV block mo bits one or they call it Winkie bucks excuse my German so second degree AV block mob it's one or wink about how we differentiate that it's pretty easy as we said there are five things we need to look at rate rhythm p-wave PR interval and then QRS right so the rate it's our times ten one two three four five times time that's 50 the rhythm if I check R to R this one is wide then it's not regular if I check P to P it is regular so regular at real rate a regular ventricular rate P waves normal so the PR interval if I check PR interval here it starts right there it's right there so it's almost six small boxes then if I check right here to right there that's almost seven small boxes let me check right there right there that's ten boxes so it's progressive prolongation until it dropped a beat so when there's pollination of PR interval and then it dropped a beat that's called second degree AV block bear in mind the QRS is normal narrow QRS so narrow QRS narrow QRS prolongation and then a drop beat you call it second degree AV block mobitz one or wanky buck oh this is fancy this is colored all right so we're gonna put the rhythm like that this is second degree AV block type two or mobitz type two okay so same thing here we're going to talk about the rate the rhythm P wave then B or interval and then QRS so here you'll notice that you have more P waves and less qrs's which means atrial rate is greater than ventricular rate so you're not getting a QRS after every single P here sometimes there are missing beats here there's a missing being here there's a missing beat alright the rhythm it's obvious from P – P – P – P – P it is regular so regular a tree algorithm but from QRS to QRS to QRS it's not the same so irregular ventricular rhythm p-wave looks normal PR interval here looks normal because the distance here looks normal for small boxes you cannot measure it you cannot measure it I mean it could be normal or prolonged but it is constant distance the QRS is wide complex it's obvious wide complex it starts here and here that's almost two large boxes and that's abnormal so there you have it guys two very important aspects that you need to distinguish a second degree AV block type 2 which is the rhythm regular atrial rate the regular ventricular rate and the QRS is wide complex then immediately call it second degree AV block mobitz – and now you're gonna see the difference between second degree AV block mob it's two and a third degree the block so the same we're gonna check the rate rhythm V wave PR interval and QRS and then we're gonna put them side to side and compare them the rate same thing at real rate is greater than ventricular rate and the reason being you've got peas more than you've got qrs's is here it dropped a beat here dropped a beat drop the beat drop the beat the rhythm it is regular B to P or regular atrial rhythm and it's regular our to our for regular ventricular rhythm and I'm gonna explain this I'm gonna show it to you let me grab this pan right here so this is the first B and then you're gonna see a P right here you're gonna see P right here that's a P right there a P P and P P and then you're gonna say mo ok the distance from here to here similar to here somewhere similar to here somewhere but here like it's wide how can you consider this regular and I'm gonna tell you look at this right here there's a hidden P right there there's a hidden P if you compare this QRS this QRS and here you can see that there is a hidden P right there now if you measure the distance between this P and this P and then this P and this P and this between this P that's an equal distance that's why it's regular sometimes you have hidden piece just look for a little bit of abnormal wave sometimes it's hidden behind the QRS so regular R – R R – R – R it's regular so this is very important aspect that you need to have in this rhythm P wave it's normal PR interval it varies like here it's prolonged but then here you cannot measure it prolonged I don't know prolonged it's not consistent so it varies not consistent and then the QRS it's a wide complex alright so there are a few things that you need to know so we said wide complex QRS and then you've got regular P 2p and regular R – R whenever you have this combination then you call it third-degree AV block and sometimes I like to say like what the is going as if there is dissociation between the atrium and the ventricle so you know the heart looks like that this part is beating on its own and this part is beating on its own they are not communicating together so whenever you have regular p2p regular or tall and wide complex and you will have the impression of what the heck is going on then and only then that's a third degree if your block and let me put them side to side and compare them with each other this is the second degree AV block on this third degree AV block and here you can clearly see that part or are not regular while here they are regular p2p are regular here and are regular here and both of them have white complex the only variation is the regular R to R so this is how you distinguish second-degree AV block type 2 and a third-degree AV block I got to show you another version of third-degree AV block here you clearly can see that this is a the QRS is a narrow complex so I'm gonna put here third-degree AV block and we'll walk through this together so as we said the rate the rhythm P wave and P or interval so the rate you guys see there's a P here there's a hidden P here this is a T wave but if you compare it with this T wave if you can see that this is higher and there's where the other P is hidden it's hidden behind the T wave and then there's a P here there's a P here that's a P as well that's a P as well that's a P P and P if you measure the distance between the peas it's the same that's why I would say the rate the atrial rate is the atrial rate is regular and then the ventricular rate the distance from here to here from R to R – R – R – R – R its regular ventricular rate or regular R – R ok the p-wave for me these P waves are normal PR interval here it varies from I mean here you cannot say because there's a drop B here it's normal here it's very wide but again there's there might be a drop beat here and then here the P is delayed and then here it's prolonged so I would say interval there is it's not consistent narrow complex QRS I mean this rhythm here give me the impression of what the fuck is going on and then whenever I have this impression I would say that's a third-degree AV block if it meets that criteria at real rate is regular ventricular rate is regular and narrow or wide QRS I would immediately say that this is a third-degree AV block remember this guy's yes it is almost 2:30 a.m. I still have to edit this video and post it and tomorrow I've got work at 7:00 a.m. if you liked what you saw please share it and subscribe your word of mouth is my oxygen if you like this video and you would like me to speak about different topics please drop a comment down below and don't forget to smash that like button and if you are new to this channel please and I'm saying please punch that face down below subscribe and if you have a watch yesterday's vlog click over there to watch it until next time be an alpha slice

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50 Comments

  • Reply Aihle Rivera May 19, 2019 at 4:59 pm

    ST Elevation please.

  • Reply Liline Saintfleur May 19, 2019 at 4:59 pm

    Thank you

  • Reply Karim dad May 19, 2019 at 4:59 pm

    OMG, Allah Almighty has blessed you with so cute babies Masha Allah

  • Reply Shena Shenesa May 19, 2019 at 4:59 pm

    ty for sharing. love the part where you look in on your kids. shows where your heart is!

  • Reply shida bells May 19, 2019 at 4:59 pm

    This really helps a lot. Thank you 😊

  • Reply Mark Fabitz May 19, 2019 at 4:59 pm

    What happened to normal qrs of 0.08-0.10 sec?

  • Reply Jinat Jahan May 19, 2019 at 4:59 pm

    Thanks a lot brother…

  • Reply Cam-Tu Vuong May 19, 2019 at 4:59 pm

    Thank you so much for this!

  • Reply iTzYoBoySupreme May 19, 2019 at 4:59 pm

    I’m wanting to become a cardiologist or cardiothoracic surgeon. I wanna fix those with a broken heart to heal from their struggles. I’m tired of being hurt and so I wanna change my life becoming a great doctor.

  • Reply Jordan P May 19, 2019 at 4:59 pm

    Beautiful family.
    And the most entertaining ECG class ever!
    Good bless…
    RNS/M8

  • Reply Mo Menissy May 19, 2019 at 4:59 pm

    very helpful! ty

  • Reply Carol Rivera May 19, 2019 at 4:59 pm

    This was an awesome video I really enjoyed learning this! Great job sir!

  • Reply Marlana Sutton May 19, 2019 at 4:59 pm

    This video is AHMAZING thank you so much I had to pass my ecg to pass nursing school and you did that for me thank you so much

  • Reply Oluwafisayo Oladayo May 19, 2019 at 4:59 pm

    Thank u.very helpful

  • Reply Nacho MAFIA Gaming May 19, 2019 at 4:59 pm

    Intro song name?? lol
    also thankyou xD

  • Reply Alexis Gaston May 19, 2019 at 4:59 pm

    So helpful 🙂🙂

  • Reply Marie C May 19, 2019 at 4:59 pm

    Thank you for this!

  • Reply Emily Sulich May 19, 2019 at 4:59 pm

    video starts at 2:32

  • Reply Jeylani Sherif May 19, 2019 at 4:59 pm

    Thank you so much. It's very helpful lesson.

  • Reply Gulf Students May 19, 2019 at 4:59 pm

    I'm new doctor i will start tomorrow working in emergency. Please post A video about how to diagnose MI from ECG . Im so worry 😣😭

  • Reply Carly Morgan May 19, 2019 at 4:59 pm

    You made this SO easy! Thank you so much!

  • Reply Gulf Students May 19, 2019 at 4:59 pm

    What aboit MI diagnosis?

  • Reply Gulf Students May 19, 2019 at 4:59 pm

    I never subscribed for any body in my life . This video force me to subscribe for first time

  • Reply meenakshi sherawat May 19, 2019 at 4:59 pm

    U saved my Life Just before exam
    Huge respect for u sir 😊 thanks a lot 🙏

  • Reply Jawan Brown May 19, 2019 at 4:59 pm

    Thank you sir! Passed NCLEX-RN!

  • Reply catr14 May 19, 2019 at 4:59 pm

    Hiii! I am a physical therapist and recently took the NPTE here in the US, and Thank God I passed!!! I really would like to thank you for sharing these easy-to-learn videos to all of us. You have been such a blessing. Thank you!!❤

  • Reply RAMCHANDRA JURIYA May 19, 2019 at 4:59 pm

    Finally got ecg good lecture💐💐💐💐💐👌👌👌👌

  • Reply Sonny Kessler May 19, 2019 at 4:59 pm

    Thank you so much!!! You made it so easy. I understood it so fast. Thanks again. I will definitely share it with my classmates. Take care! More power to you!

  • Reply Kae Sexy May 19, 2019 at 4:59 pm

    Awesome 👍👍👍👌👌👌

  • Reply Kevin Eontrainer May 19, 2019 at 4:59 pm

    I'm not even a doctor, nor a medical student… why am I here?

  • Reply Maria May 19, 2019 at 4:59 pm

    so helpful thankyou :))))

  • Reply Andriy May 19, 2019 at 4:59 pm

    What do you mean D/C shocks? at 11:30

  • Reply jahmilah c May 19, 2019 at 4:59 pm

    I thought epi can be used with v-tach as well

  • Reply Tatiana Pfalz May 19, 2019 at 4:59 pm

    The beginning was funny

  • Reply Dakshta Singh May 19, 2019 at 4:59 pm

    You just awesome…this video helps me alot to understand ECG thankyou so much please help us on more medical topics ..

  • Reply gineli1130 May 19, 2019 at 4:59 pm

    Hi sir. In the atrial fib part, you said 0.06-0.1s is a narrow QRS. I thought you said that is a normal QRS interval. Which is true?

  • Reply Kiran Bajagain May 19, 2019 at 4:59 pm

    That's a beautiful way to teach .liked the way u taught sir😊.interestin n understandin! !

  • Reply Onyapidi May 19, 2019 at 4:59 pm

    You left your car door open…haha, loved the review on ECG, Thanks

  • Reply Graciane Souza May 19, 2019 at 4:59 pm

    Thank you for making Nursing school a little easier for us… You are the best!

  • Reply Joshua Johnson May 19, 2019 at 4:59 pm

    Jj is a cutie and very smart

  • Reply Michelle Pelse May 19, 2019 at 4:59 pm

    At first I was thinking and WTF but I kept watching and I am so glad I did. I'm going into cardio next semester and you really helped out. You do have a great personality and it was enjoyable to watch and loved the brown hippo on your desk. Thank you

  • Reply chevvala Roja Rani May 19, 2019 at 4:59 pm

    Thank you sir

  • Reply Erik Epskamp May 19, 2019 at 4:59 pm

    Regarding medications for pulseless V-Tach or any pulseless rhythm a good tip is Epi (epinephrine), for Every Pulseless Individual.

  • Reply Chi Law May 19, 2019 at 4:59 pm

    Isn't that at 2nd degree AV Block, there is a dropbeat after the constant prolong PR Interval.

  • Reply Mahmood Abandah May 19, 2019 at 4:59 pm

    The greatest doctor in the world

  • Reply London 18 May 19, 2019 at 4:59 pm

    And depressing.

  • Reply London 18 May 19, 2019 at 4:59 pm

    Good by this its ridiculous

  • Reply London 18 May 19, 2019 at 4:59 pm

    To the point!!!!

  • Reply Robin Wilson-Sauls May 19, 2019 at 4:59 pm

    Please! You took lots of wasted joke time, (which is alright) but then quickly rambled about the very dmn thing I need your help with! PLEASE; use a better pen, and write so I can clearly link together what your teaching!. I trust you, but haven't been able to quite follow your ease!

  • Reply DP May 19, 2019 at 4:59 pm

    thx bro

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