Disrhythmia...

An abnormal rhythm.

As a Nurse, as an Emergency Nurse, and as a former Paramedic...  I know disrhythmias!  Abnormal rhythms!  Usually used to describe cardiac (heart) abnormalities.


I met myself a few days ago.  Not really myself, just someone very similar to me.  A Paramedic, who was interested.  Wanted to stay, watch, ask questions, learn...


He showed me the EKG (ECG) strip, which his machine identified as Sinus Tachycardia, and he was reporting to me.  I asked him, where is the "P" wave?  He identified what he thought was...

I asked him to watch.

A simple val-salva technique.  A vagal maneuver, temporarily slowed the heart rate to reveal the true underlying rhythm. 

Nothing he had at his disposal, could have affected this.  Therefore, no harm, no foul.


A 1:1 Atrial Flutter, is somewhat rare.  Those "P" waves the machine and he saw, were 'flutter' waves.  Yet it was in the 'zone,' so to speak, regarding rate.  Slowed, the 'saw-tooth' pattern was evident.  A few minutes later, Atrial flutter in a 4:1...  an hour later, back to baseline.


The difference between an emergent cardiac catheterization, and an admit for monitoring and further non-emergent testing.