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1 CE HOURClinical Medical Assisting

Cardiac Emergencies in the Outpatient Setting

Key Terms: 
  • P Wave: Atrial Depolarization / Atria Contraction
  • QRS Complex: Ventricular depolarization / Ventricles contract. A normal QRS complex is 0.04-0.12
  • T Wave: Ventricles repolarize / Ventricles relax
  • U Wave: Depolarization of Purkinje Fibers, usually not seen
  • PR Interval: Measured from the beginning of the P wave to the beginning of the Q wave. This is the time it takes the electrical impulse to go from the atria to the ventricles. A normal PR interval is 0.12 - 0.2 seconds. 
  • QT Interval: Measured from the Beginning of the QRS complex to the end of the T wave. This is the total time it takes from ventricular depolarization to repolarization. A normal QT interval is 0.32 - 0.4 seconds.
  • ST-segment: The time between ventricular depolarization and repolarization. The ST segment can be normal, elevated (could mean MI or electrolyte imbalance), or depressed (may indicate cardiac ischemia, electrolyte imbalance or drug toxicity)
  • EKG: Electrocardiogram (from the German “Elektrokardiogramm”); A medical test that records the electrical activity of the heart over a period of time using electrodes placed on the skin. This test helps identify heart rhythm problems, heart attacks, and other cardiac conditions.
  • ECG: Electrocardiogram (English spelling); A medical test that records the electrical activity of the heart over a period of time using electrodes placed on the skin. This test helps identify heart rhythm problems, heart attacks, and other cardiac conditions.


 
Outline:
  • Introduction
    • Keyterms 
    • What is a cardiac Emergency
  • Cardiovascular: System and Anatomy
    • The Cardiovascular system
    • The heart
      • The three layers
      • The sublayers of the endocardium
    • The electrical conduction system
    • Cardiac anatomy overview video
    • Chambers and blow flow through the heart
      • Right atrium
      • Right ventricle
      • Left atrium
      • Left Ventricle
  • Cardiac Emergencies
    • Sinus Bradycardia
      • Sinus Bradycardia ECG readings
    • Sinus Tachycardia
      • Sinus Tachycardia ECG Readings
    • Ventricular Tachycardia (V-Tach)
      • Ventricular Tachycardia (V-Tach) ECG Readings
    • Ventricular Fibrillation (V-FIB)
      • Ventricular Fibrillation (V-FIB) ECG Readings
    • Atrial Fibrillation (A-FIB)
      • Atrial Fibrillation (A-FIB) ECG Readings
    • Atrial Flutter (A-FLUTTER)
      • Atrial Flutter (A-FLUTTER) ECG Readings
    • Asystole
      • Asystole ECG Readings
    • 1st Degree AV Block
      • 1st Degree AV Block ECG Readings
    • 2nd Degree AV Block Type I - Wenckebach
      • 2nd Degree AV Block Type I - Wenckebach ECG Readings
    • 2nd Degree AV Block Type II - MOBITZ 
      • 2nd Degree AV Block Type II - MOBITZ 2 ECG Readings
    • 3rd Degree AV Block
      • 3rd Degree AV Block ECG Readings
    • Pulseless Electrical Activity (PEA)
      • Pulseless Electrical Activity (PEA) ECG Readings
    • ST-Elevation Myocardial Infarction (STEMI)
      • ST-Elevation Myocardial Infarction (STEMI) ECG Readings
    • Hyperkalemia-related changes
      • Hyperkalemia-related changes ECG Readings
    • Junctional Escape Rhythms
      • Junctional Escape Rhythms ECG Readings
  • The Technician's Roles
    • Before 
    • During 
    • After
  • Conclusion
  • References 

 
References: 
  1. Richmond University Medical Center. (2025, February 4). Types of cardiac emergencies. https://rumcsi.org/news/types-of-cardiac-emergencies/
  2.  Fortis Healthcare. (2025, April 22). Cardiac emergencies: Types, causes, symptoms, and treatment. https://www.fortishealthcare.com/blogs/cardiac-emergencies-types-cause-symptoms-and-treatment
  3.  Anderson, G. R. (2022). Fundamental Guide to Phlebotomy (E. K. Eaton, Ed.) (p. 39). NHCO- National Healthcare Certification Organization.
  4.  Arackal, A., & Alsayouri, K. (2023). Histology, Heart. StatPearls Publishing. https://doi.org/31424727 
  5.  Gurarie, M. (2024, June 9). How the Endocardium Supports Heart Function. Verywell Health. https://www.verywellhealth.com/endocardium-definition-5088789  
  6.  Hall, J.E., & Guyton, A.C. (2021). Guyton and Hall Textbook of Medical Physiology (15th ed.). Philadelphia, PA: Elsevier.
  7.  Cleveland Clinic. (n.d.). Heart chambers. https://my.clevelandclinic.org/health/body/23074-heart-chambers
  8.  Cleveland Clinic. (2022, March 7). Sinus bradycardia: Causes, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/22473-sinus-bradycardia
  9.  Nursing Bliss. (2021). Electrocardiogram [Packet]. Copyright Nursing Bliss.
  10.  Burns, E. (2024, October 8). Sinus bradycardia. In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/sinus-bradycardia-ecg-library/
  11. Cleveland Clinic. (n.d.). Sinus tachycardia: Causes, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/23210-sinus-tachycardia (my.clevelandclinic.org)
  12.  Burns, E., & Buttner, R. (2024, October 8). Sinus tachycardia. In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/sinus-tachycardia-ecg-library/
  13.  Mayo Clinic Staff. (2024, March 6). Ventricular tachycardia – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/ventricular-tachycardia/symptoms-causes/syc-20355138
  14.  Burns, E., & Buttner, R. (2024, October 8). Ventricular tachycardia – Monomorphic VT. In Life in the Fast Lane ECG Library. https://litfl.com/ventricular-tachycardia-monomorphic-ecg-library/
  15.  Cleveland Clinic. (n.d.). Ventricular fibrillation. https://my.clevelandclinic.org/health/diseases/21878-ventricular-fibrillation
  16.  Burns, E., & Buttner, R. (2024, October 8). Ventricular fibrillation (VF). In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/ventricular-fibrillation-vf-ecg-library/
  17.  Mayo Clinic Staff. (2025, March 23). Atrial fibrillation – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
  18.  Burns, E., & Buttner, R. (2024, October 8). Atrial fibrillation [ECG Library]. In Life in the Fast Lane (LITFL). https://litfl.com/atrial-fibrillation-ecg-library/
  19.  Cleveland Clinic. (n.d.). Atrial flutter: Symptoms & treatment. https://my.clevelandclinic.org/health/diseases/22885-atrial-flutter
  20.  Burns, E., & Buttner, R. (2024, October 8). Atrial fibrillation — ECG library [Webpage]. In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/atrial-fibrillation-ecg-library/
  21. Cleveland Clinic. (n.d.). Asystole: Causes, symptoms & treatment. https://my.clevelandclinic.org/health/symptoms/22920-asystole
  22.  Burns, E., & Buttner, R. (n.d.). Asystole – ECG Library. In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/ventricular-fibrillation-vf-ecg-library/
  23.  Cleveland Clinic. (n.d.). Heart block: Types, symptoms & causes. https://my.clevelandclinic.org/health/diseases/17056-heart-block
  24.  Burns, E., & Buttner, R. (2020). First-degree heart block [ECG Library]. In Life in the Fast Lane (LITFL). https://litfl.com/first-degree-heart-block-ecg-library/
  25.  Burns, E., & Buttner, R. (2024, October 8). AV block: 2nd degree, Mobitz I (Wenckebach phenomenon). In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/av-block-2nd-degree-mobitz-i-wenckebach-phenomenon/
  26.  Burns, E., & Buttner, R. (n.d.). AV block: 2nd degree, Mobitz II (Hay block). In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/av-block-2nd-degree-mobitz-ii-hay-block/
  27.  Burns, E., & Buttner, R. (n.d.). AV block: 3rd degree (complete heart block). In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/av-block-3rd-degree-complete-heart-block/
  28.  Cleveland Clinic. (n.d.). Pulseless electrical activity (PEA): Causes and treatment. https://my.clevelandclinic.org/health/symptoms/22920-asystole
  29.  Burns, E., & Buttner, R. (n.d.). Pulseless electrical activity (PEA). In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/pulseless-electrical-activity-pea-ecg-library/ (litfl.com)
  30.  Cleveland Clinic. (2021, November 15). STEMI heart attack. https://my.clevelandclinic.org/health/diseases/22068-stemi-heart-attack
  31. Burns, E., & Buttner, R. (n.d.). STEMI [ECG Library]. In Life in the Fast Lane (LITFL) ECG Library. https://litfl.com/stemi-ecg-library/
  32.  Cleveland Clinic. (2023, May 11). Hyperkalemia (high potassium). https://my.clevelandclinic.org/health/diseases/15184‑hyperkalemia-high-blood-potassium