atrial fibrillation
First Glance:
From across the room it looks like afib with RVR.
Discussion:
Look at the baseline in the lower trace. It looks fibrillatory with no organized P waves seen. The rhythm is irregularly irregular. This is atrial fibrillation.
The QRS’s look like they might be 120 ms wide. The lead II axis is normal, and we can’t evaluate the chest lead axis because we don’t know where it is placed.
Final Impression?
afib @ ~110 bpm, suspicious for nonspecific aberrancy.
Management implications:
the usual afib stuff.
One star strip. Students should identify the rhythm correctly.