UNDERSTANDING THE HEART'S ELECTRICAL CONDUCTION SYSTEM - QUIZ QUESTIONS

The Electrical Conduction System of the heart

The SA (sinoatrial) node is the pacemaker of the 
heart and is part of the electrical conduction system.
It is located in the upper part of the right atrium.
When the SA node fires, the right and left atria
contract simultaneously and blood is forced into
the right and left ventricles.

The electrical stimulus then travels to the AV ( atrio-
ventricular) node which is located in the lower part 
of the right atrium. The AV node fires, causing the 
right and left ventricles to contract simultaneously.


 Scenario: Jim was admitted to the medical floor, with
complaints of abdominal pain. The nurse arrives at his
bedside and finds him unresponsive. She presses the code
button, to alert the code team. She then begins CPR.

What does CPR mean? 

CPR means Cardiopulmonary resuscitation. When the
heart stops beating and there is no circulation of blood
throughout the body, CPR is initiated.

Lack of blood supply to the brain and vital organs,
may permanent damage if left untreated. Above,
medical personnel are being given instructions
about the correct techniques to use when doing CPR.   


                                        


The image above shows a Code blue in progress. This is 
happening in the emergency Room. Always follow your
Institution's policies and procedures for Code Blue. 

The role of the nurse who is assigned to the Code Blue

The nurse has an important role in effective communication.
There are many responsibilities.
- staying calm in a chaotic situation
- giving clear instructions to coworkers
- ensuring that MD orders are conveyed correctly
- proper documentation of vital signs and all treatments ,
  interventions that take place ( defibrillation for example)
  - the nurse becomes the " binding force

Quiz questions

1) What is the SA node known as?
2) Where is the SA node located?
3) What happens when the SA node fires?
4) Where is the AV node located?
5) What happens when the AV node fires?
6) What does CPR mean?




Addressing lethal rhythms

There are some EKG rhythms that are considered to be lethal.
Instant intervention is necessary for good outcomes. Here are
the most lethal rhythms:

Asystole - sometimes referred to as " flat-line. The electrical
heart's conduction system is not functioning. There are no
ventricular contractions. The patient is pulseless and
unresponsive.

Ventricular Tachycardia - There may or may not be a pulse
present. The ventricles are beating rapidly and there is no atrial
activity. Blood flow to the vital organs is compromised.

Ventricular Fibrillation -  There is a chaotic rhythm and no
atrial activity. The ventricles are quivering , so there is no 
cardiac output. There is no pulse and the patient may become
unresponsive. Immediate action to defibrillate is usually done.

***American Heart Association has protocols in place for each
EKG rhythm.

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