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  /cardSim    @  100 # FSCommand:fullscreen true  FSCommand:allowscale true  FSCommand:showmenu true  ?
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ҀL4Y-pKε%̐@:<S `e;Y@Lǆ\xih5cf FpSU @%9)/8vn	l|A3xBr8,j5P^z^4B*RR `&,j+ٰo@%f B
  5jۄr^5xi82dv+
U'a-}k3	r}pSI/f/@	>c" 5i']Hn8KH 5fv >ptAxU~9h*0	
I6mATFUMUO60SL:$ M̘r,˾f  5fe	7NavM%hlK yM  &ސLPE1A RMk؞	x5f %?=i9 'E ɑ@w 8 5fS峖Ia9> 5F雀V`yP'jU iΑrwu/͆a44Xݼ8E̍l3T%C*|Ѯ\ `) 5hƑVf\j`& } _' ^HX@&Y AJ7 U&w%by+ ؖ%5K4ۗ
%q" q/x,դgpDȤꇂ(@	P-RތMʛQ61E@`M6ej 5cZP,%b9)S(rRg"#7ܹ V|uI6g%@e#.B=MD n\i4 5cZPӖ#XJfr 5c.SFi xeNDIQ@=R.|7^o=IfQ-KT3z,7.q 5dx MO58`4& ߚ{m 
I."@ޘu8 7	RT&1.[zڭ$@[U6Px 5Keb"MJryy%nR?  0123456789CEGSTcdehinox x ::::::::::r:r:rrr: X+@XQ2t  X@Ԁ  X'AԀXDT  X.CtX,BX,A  X*AX!ATX1U\XKO  X1[\X%O4\XK  X+D X*F4 X!B7 XIE  XJԌ  XIE  X)I XF  e 11ATAVAWAYAvAwAyAAF,F.FALTLVLWLYLyLLP,|P.|PAPRVRWRYT,T.T:T;TATOTaTcTeTiToTrTsTuTwTyTV,V.V:V;VAVaVeViVoVrVuVyVW,W.W:W;WAWaWeWiWoWrWuWyWY,Y.Y:Y;YAYaYeYiYoYpYqYuYvYYf r,r.r& v,v.w,w.y,y.sAY	*    h 0          (  Loading... G ?     _serif   	@    n_ǀ0        (  Dynamic Cardiac Rhythm Simulator F `	2    o 0 h        (  The Six Second ECG E { G    xB ^d/o    P    %ϥ0!o1>ץ!xIC^0 D       Unl@    -h4" : @ B5u   * , : [ o   y*<Kah 5-kutݺn# 5FP7-q)$\6Sn[8lx 5iO^/-)Jr 5cf? ~c	 pg 	 p¥  :*l̋Ʋ: b2Na2s9,%x=tO *3 HJfBʀ 5fS峖Ia9> 5df^ .qbh" \RL C(t$n]u󯧻帎)kjIt/%LK]Obnԟ)3e(
7˳||sKZnc]p RJX  <Dnj3p$PՖ 5F雀V`yP'jU iΑrwu/͆a44Xݼ8E̍l3T%C*|Ѯ\ `) 5K4ۗ
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v %f%,f ؖ%y@5cZP,%b9)S(rRg"#7ܹ V|uI6g%@e#.B=MD n\i4 5cZPӖ#XJfr 5-uUt{zJaq0FKm  5cZVӖ# 5jzvAT(` Orhc.UI%.b]D ܹ۳ YX&f#.b]PB n\one&dZ 	YLVTL+U:Qp  5c.SFi xeNDIQ@=R.|7^o=IfQ-KT3z,7.q 5dx MO58`4& ߚ{m 
I."@ޘu8 7	RT&1.[zڭ$@[U6Px 5c&S3afyUje$
p~J&Z.P˧-#AFdTـf! {b[ h&( N 5cS%E(MoDV ۨ-8@I.OM˧-A 5d.m 5$ԌQ}1&ӄ7,I`#&33a,ńs $͆i4:ѾD8ZSeY $K (6^ݭf Fc}   5d\6(7Z  5 %1Ya =$<w ݌l`ll lFW{      Arial .HLOTaceghiklmnoprst   	 P$      bu, 9	 ֑Հ%   
 Xa [       L#,Ib 8
 ݧ\	#    a>70         (  Stat 7 d&    b%>"
P  	    Fh!di 6  	0    h 0           (  proudly presents 5 - !    h s   ]'4:n3:Q 4 ۸BxCYR@ @ ?   
  loadText   20%  ; `	&    W{(1        ( seconds 00 	&    W{1        ( minutes 00 	   2 
   Reset ?N   	  minutes   00 	  seconds   00   now   0   timeSaved   0    Z   g@ @ @ @ @ @ @ @ @ @ 
   Start ?/     startTime 4  timeSaved   now    @ @ @ @ @ @ @ @ @ @ 
	   Get Time ?+     now 4  startTime   timeSaved 
 @ ?      @ @ @ @ @ @ @ @ @ 
   Display Time ?    1000   now  | 	  minutes   now   1   now   3   60 	  seconds   now   1   now   3 	  minutes   60 	  tPeriod   _level0:timePeriod 	  minutes 	  tPeriod  
 (  _level0 
  infoBack    @  1 #
  gameDone   1 
  feedback       _level0:avTime   timePeriod   60   numCorrect   /contMask   7 "  0    score   80  n  name     .   InfoTxt_Header   Congratulations!  <   InfoTxt_Header   Congratulations,    name !  ! !	  INFOtxt    You have correctly identified    numCorrect !   rhythms of  !
  attempts !   for a total score of  !  score !?  %. Well done.The average time taken to interpret each ECG is  !  avTime !   seconds. ! D  score   80   score   60    name     #   InfoTxt_Header   name     InfoTxt_Header     	  INFOtxt    You have correctly identified    numCorrect !   rhythms of  !
  attempts !   for a total score of  !  score !  %. A little more practice should get you to consistently and correctly identify all of the rhyhms. The average time taken to interpret each ECG is  !  avTime !   seconds. ! ~  name     ?   InfoTxt_Header   More practice,    name !  . ! .   InfoTxt_Header   More Practice Needed! 	  INFOtxt    You have correctly identified    numCorrect !   rhythms of  !
  attempts !   for a total score of  !  score !l  %. Hang in there.  More practice should get you to consistently and correctly identify all of the rhythms. !   score   80  w  name     A   InfoTxt_Header   Congratulations,    name !  ! ! )   InfoTxt_Header   Congratulations! 	  INFOtxt    You have correctly identified    numCorrect !   rhythms of  !
  attempts   1 !   for a total score of  !  score !@  %. Well done. The average time taken to interpret each ECG is  !  avTime !   seconds. !   score   80   score   60    name     B   InfoTxt_Header   name   , you have what it takes! ! 0   InfoTxt_Header   You have what it takes! 	  INFOtxt    You have correctly identified    numCorrect !   rhythms of  !
  attempts   1 !   for a total score of  !  score !  %.  A little more practice should get you to consistently and correctly identify all of the rhyhms. The average time taken to interpret each ECG is  !  avTime !   seconds. ! }  name     ?   InfoTxt_Header   More practice,    name !  ? ! '   InfoTxt_Header   More practice? 	  INFOtxt    You have correctly identified    numCorrect !   rhythms of  !
  attempts   1 !   for a total score of  !  score !k  %. Hang in there.  More practice should get you to consistently and correctly identify all of the rhyhms. !  /contMask    @  1 #  	  seconds   10  ! 	  seconds   0 	  seconds !	  minutes   10  ! 	  minutes   0 	  minutes !   @ @ @ @ @ @ @ @ @ @ 
   Stop ?    @ @ @ @ @ @ @ @ @ @   %  R :   }AAm  <   %w5EtTr8;օWQWV8N}*ڲ
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+P(  <   %JL MhU~FDV8N}*ڲl(-5UHeoLAlE?LPR]qHO:W*dלWkB-X7ǢwޫϹC] gJu3aWՐ][O:*$N2L0`2	^7
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cAs@}Ɔ2`\H]:8]/k[/6<cęQc8(hL\,֗5C$t&NܬàSPvߔy
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zbuyI(,_Ȱ_7AnT)пMt?9׭͢WZE95'JiDiRJ9FZ[:E)O{uBmF2Us!^p1әuix~3T=BIGA|Pa^LPQ_1t$zՓ;5w"T×V&ћ#ɜҴrxUs3jCftD|羲$\R*?)Qn
M%<ts:"#ԍn%rrR>?`-Uo:"6tZ-Q&$m-3H$!YAw:3!ntK`㣝ҘRCFtJJQس~p3:܅l P(gޱOC,ݤGs`qLyU|SJgr\ZD0Rnοٝv><5)c$gd~bD+Δ2s@b由TygtJXr3sy3VT
fmHlΕȂBdJSG<=AҡR?uB$DpĮS"UJGZeQQ!SgLNҏԍ-3H$!YAw:3!ntK`㣝ҘRCDIJU
V Ŝ󅩝A֠6FΰV+e c:^LPQ[1KqǦ1D@RLsDcOg-p#R"c6\+ɝRZH8*Cj%-$5t9Klb^LPQ[|F2`]z]3:8]/k[Z5C$tTBĬàSPvߔy
 Ѹ3rӵ&#%HPZMY݌䨼-ҡZȌ|WE(HVP$h$ʏYF@_ZbຒpJ mǒޟc"$>w#;wZ#9Oq'OmPΠSBfzdI۴F΋H~E(4H&@+,锄XR3nul%'+RDL˩N/*Rj=a ԈKħG֎t;*(H^" x }\&Ī2։HnNP1Fw?ZdrĄj0MS'åD0r札9mhiDy]hjR>?`:.E0;3*l4Χ"6e<	M( )fJ+YI<y,
fkYf2VF4fԓ}(l)(3FNyI(,_$X/lr
ꋷ*_&:/[sSRtdg**PG(ӞK`H84ZyIzNCRJbd?:s .}P(gޱOC,ݤGsMe#⬃ບP3;!ejڞA3vg]OA|JXęX#Q-?sྨ./_K	J:(Bfz <   %/m;8Nv$ΑkL'LPTg  <   %Ȳm;8Nvנ:E03T=BYQ  ZP`Q   |F6,}  <   %Pv66vQV6#FxQB=X/R\9[y#Y`M"`%0#͆=mD{NCb<h7d.ł v <uY"'b]	s1r+2[yu10\xG[;
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ډvQF	7Pv66vQV6#FxQB=ξi̎Ĩ.a#}`6</jӰѰѨa!ti`X[lG,{-{(v$k<LFw\b>bv?!uI"!^K.f1.EfH6%#Uy,sbFۺ

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z_x+	̗i15Fp'Gqw}MĎ&=E{QBgxf[Hޕuj2.Q]&f8UDK PE+r,
zYd(S|TgArj@H*m*-h.gyr51ª"\0HE1=3&U2ǀBTf4^ ȹEtEU/K<H^{FAu	 )382~Ԩضh/U SqոC,6&GaaQ=aW1T A_- )W*l9 b"0J`e`^ ~҆a3PXd6| aC/2n$v5(~ڌs {!r2 B΀W²b*1Ar
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@ <   %^[RIux&qg- &h}b&jL8]Ns/
DL  <   %GKF'gwrtQ^^{֘OP2D˙v8N}CKӫAa rOt|  <   %KKF'gwrtQ^^{֘OP2D˙v8N}CKӫAa *Y0 <   %*WKF'gwrtQ^^{֘OP2D˙v8N}CKӫAa Vp@ <   %(u/WgKFrfyyf/Za=Bfzʯθ.e:8]/;+Y0 <   %U9Կhv^	w}/'EH	:_E籘i	*:0zN<k(gt::LfX**0 q A 2 '   B XQw p  	    H   "r'8穛 I   C <   C!L  YaR  YaR  YaR       	#   D _}?` 0           (  Game   E <   C!L  YaR  YaR  YaR     _level0 	  rChosen   R   mode   G  gStart   /st_resetMask    @  0 #   _level0/infoBack       @  1 #   _level0/timeClock       @  1 #   _level0/scorebox       @  1 #   _level0/contMask       @  1 #   _level0/grid       @  0 #    _level0:feedback      _level0/Clock   Reset       _level0:gameTime   (1 minute)   _level0:timePeriod   1   _level0:attempts   0   _level0:score   0   _level0:numCorrect   0   _level0:InfoTxt_Header   Try Out the CardiacSim Game!   _level0:INFOtxt  The "CardiacSim Game" , Game 1, begins by clicking on "Start". The objective is to correctly identify as many rhythms as possible within a certain timeframe. Clicking "Freeze" will stop the rhythm and provide a grid, but the clock continues. Click on "Reset" to restart the game.   _level0:title   The CardiacSim Challenge  	$   F _}?` 0            (  Learn   G <   C!L  YaR  YaR  YaR     _level0  lStart 
  feedback       title   Cardiac Rhythm Generator   mode   L   /st_resetMask    @  1 #   _level0/infoBack       @  1 #   _level0/timeClock       @  0 #   _level0/scorebox       @  0 #   _level0/contMask       @  1 #    _level0:InfoTxt_Header   Explore. Review. Play   _level0:INFOtxt & The "Cardiac Rhythm Simulator" generates 26 of the most common cardiac rhythms for you to explore, review and play. Simply click on any rhythm name and the rhythm is diplayed. Click on "Freeze" to stop the rhythm and display a grid. Clicking the "Start" button resumes the rhythm once again.   	#   H _}?` 0           (  Exit W   I <   C!L  YaR  YaR  YaR     FSCommand:quit      J 
            	  K  ?    
   Hide  B P@ ܍ C <s@ @ @ @ @   ?    
   Show  D _@  E ?/&  F _@ ̐	 G ?m+N   B R@ ܏ ) ?s  H _@  I ?/`  J ɡ7^@ @ @ @ @ @ @   \ K $J     L        Z L 
B ?   M      C!L  YaR  YaR  YaR X M  W  w  N }&I_9M <   %y1wۋĶoq}Zn/.b1ak1[
@w{=G  <   %gq_}Zl94%-r-Ŧc+aqd.B.b-Q΃d/+ɨAL+AMcϽV	b&jL8]Nsbi37H.&}>0V  4,/:N/  <   %z6f\kb&jL8]Nsbi37H+Zn  <   %<ϙwŴR^{֘OP2D˙v8N}CKӫAa 40$OtLaqiW!7q7Q.AMEVB.B+  <   %[A6w;qsChlR-73aAG	%[	zu4.sS1yY籘i	*:0zN<k(gt::Lfӌo= aى_ <   %/`rb&jL8]Nsbi37H/$	DL _I_4	:V N ^Ɔ@ @ ?   
  loadText   60%  ? Z`	.   O g77	0            (  Accelerated IVR 	.   P g77	0  fff       (  Accelerated IVR 	.   Q g77	0  fff       (  Accelerated IVR `   R      5/YO     :)/WP     6/XQ     2M/  R V[ 
 	.   S g2/	0            (  Idioventricular 	.   T g2/	0  fff       (  Idioventricular 	.   U g2/	0  fff       (  Idioventricular `   V      Ř|7/XPS     ş*:)/T     ş*6/U     ş*<h/  V ?) 
 	"   W _@` 0            (  PVC 	"   X _@` 0  fff       (  PVC 	"   Y _@` 0  fff       (  PVC `   Z       褿YW     
񠿇UX      (\Y      񠿋V  Z o 
 	/   [ g;	0  f f       (  Junctional Tachy 	/   \ g;	0  f       (  Junctional Tachy 	/   ] g;	0  f       (  Junctional Tachy `   ^      H:)/ʠ[   I  ;I/I\   I  =/H0]   I  6/P  ^ I#3 
 	0   _ g;	0  f f       (  Accel. Junctional 	0   ` g;	0  f       (  Accel. Junctional 	0   a g;	0  f       (  Accel. Junctional `   b      6/X_     9
/W `     9
/Wa     9
/W  b $ 
 	1   c o; 0  f f       (  Junctional Rhythm 	1   d o; 0  f       (  Junctional Rhythm 	1   e o; 0  f       (  Junctional Rhythm `   f      Bոc     d     e     Kd  f . 
 	!   g W	0  f f       (  PJC 	!   h W	0  f       (  PJC 	!   i W	0  f       (  PJC ]   j      %rg     񠿉T@h     %ci     ô-_  j +
 	3   k o5 0  f f       (  Wandering Pacemaker 	3   l o5 0  f       (  Wandering Pacemaker 	3   m o5 0  f       (  Wandering Pacemaker `   n      7b\k     7b\l     8m     1  n 2 
 	"   o _N` 0   f        (  WPW 	"   p _N` 0   f       (  WPW 	"   q _N` 0   f       (  WPW `   r      M\(}]o     HX$}Xp     M\}Uq     K (^@  r K 
 	-   s g+	0   f        (  Atrial Flutter 	-   t g+	0   f       (  Atrial Flutter 	-   u g+	0   f       (  Atrial Flutter `   v      c9
/ s     c?/t     h?/Su     cV:)/V`  v ' 
 	2   w g9	0   f        (  Atrial Fibrillation 	2   x g9	0   f       (  Atrial Fibrillation 	2   y g9	0   f       (  Atrial Fibrillation `   z      Ԙ;I/0w     <h/Ux     Ԙ=/y     Ԙ>/Ԑ  z i 
 	1   { g>	0   f        (  Atrial Tachycardia 	1   | g>	0   f       (  Atrial Tachycardia 	1   } g8ȭ0   f       (  Atrial Tachycardia e   ~        @{      @|    ʒ6/Yp}  DyI
I       ~ P 
 	!    W	0   f        (  PAC 	!    W	0   f       (  PAC 	!    W	0   f       (  PAC `         `d      ̹x@     di     t   l_ 
 	+    g+	0           (  Sinus Arrest 	+    g+	0          (  Sinus Arrest 	+    g+	0          (  Sinus Arrest `         h5/X`     h4/X     h<h/Tp     h7/W   Cԕ 
 	/    g8	0           (  Sinus Exit Block 	/    g8	0          (  Sinus Exit Block 	/    g8	0          (  Sinus Exit Block `         ;I/U  (  7/W  (  n9
/׀  (  6/X   v{ 
 	/    g<?	0           (  Sinus Arrhythmia 	/    g<?	0          (  Sinus Arrhythmia 	/    g<?	0          (  Sinus Arrhythmia `         v=/T@     v<h/U     j;I/U     \>/   ^! 
 	0    g?7	0           (  Sinus Tachycardia 	0    g?7	0          (  Sinus Tachycardia 	0    g?7	0          (  Sinus Tachycardia `         :uX  솀     솀   D  솀  Kd   @ 
 	0    g?W	0           (  Sinus Bradycardia 	0    g?W	0          (  Sinus Bradycardia 	0    g?W	0          (  Sinus Bradycardia `         !K8     8=/`          	Kd   Nl 
 	+    g0	0           (  Sinus Rhythm 	+    g0	0          (  Sinus Rhythm 	+    g0	0          (  Sinus Rhythm `         ň4,W  A@  ŋh=,Q  A@  Ŏx6,  A@  ŏ<h,R    cT<
 	$    g _ 0 @         (  Reset 	$    g _ 0 @f        (  Reset 	$    g _ 0 @f        (  Reset +         h@  h@  h@8      } 
 @ @ ?   
  loadText   70%  @ *@ @ ?   
  loadText   80%  A ڪ蠿 O    |'j,   N,~'d:mCå,jxZwm	b-Е(7]ȾU [	/򾎉p    4 D    g+'  
    =(#jƌ0:SzFF03#1جHtRgж(H 	-    g0	0  3        (  2  AVB Type II  E    g+'  
    ='#jƌ01F4`fPG@cY ˡm8P 	-    g0	0  3       (  2  AVB Type II 	-    g0	0  3       (  2  AVB Type II H                           ő@Ed/Р   ]   D    gؤ 
    ='#jƌ01F4`fPG@c L7Bh	*    g(g	0  3        (  3  AV Block  E    gؤ{ 
    =*J/21DxEAG5cF#e S4xR 	*    g(g	0  3       (  3  AV Block I    gإ/ x  K'8o~|  
    %*J/Hat10
F8Ս`c_Ќi	*    g(g	0  3       (  3  AV Block H                           f H/NP   \FM   D    g(ߜ8 
    =*{/ƞ#*b<`6q0Lrأ`tV?Ч<(p 	-    g1g	0  3        (  2  AVB Type I   D    g) 
    =(W`t>4`fPG@c `Rؤ@tTwЮ\( 	,    g4_	0  3       (  2  AVB Type I 	,    g4	0  3       (  2  AVB Type I P                      ņ>/       ŒD~/   _׃   a    g"'~ 
    $ZW?"Fi;
f9̘І_FcFM=_]6?c=
%F?b"~Enu 	*    g(g	0  3        (  1  AV Block  D    g"'y8 
    =&?#*b<`6q0ƿ2%?_B@n@	*    g(g	0  3       (  1  AV Block 	*    g(g	0  3       (  1  AV Block  0    H 
    %%xzFF03	#/xR0XƮ9AW            _      _   J:c/T0  _      ;F/̀   j@ 	'    _{` 0            (  Asystole 	'    _{` 0  fff       (  Asystole 	'    _{` 0  fff       (  Asystole `         ߨca@      aU     $aY      褿c^   `  	#    _C` 0            (  VFib 	#    _C` 0  fff       (  VFib 	#    _C` 0  fff       (  VFib `         `ְ]_   솀  (]V  솀  ְ]a  솀  _W   m  	$    _[` 0            (  VTach 	$    _[` 0  fff       (  VTach 	$    _[` 0  fff       (  VTach `         wwh@     yߨuc@     yʹum      m$yZ    k  @ @ ?   
  loadText   90%  B *蠿 h    \dd   f =N?Gm,V|O ߜ\rf4QM =ލ.X*h@+P {-.TbA83C p (    `#x 	 f /   HcVA1z  [    \dd     f !=N?G9}*gK>k9/S7&2W.M 
6md-ldឺ-h#] (    `#x 	   /   HcVA1z  [    \dd     f !=N?F}*gK>9/S7g&2W.M 
6md-ldឺ-h#=  b    \dd     f !=iԮLԦVM\b2"/*q=w
m,*@y赲:'zdT J            ?     ?     ?     ?   f  	$    _m` 0 @         (  Start  $    _cH.   5lT)|KJe- 	$    _m` 0 @f        (  Start 	$    _m` 0 @f        (  Start 	$    _m` 0 @         (  Start Z         pɼ        ؀     ؀  pĽ  ؀   `    |7GGq <   %\RIux&qg- &h}b&jL8]Nsbi37H/
K@  <   %^VRIux&qg- &h}b&jL8]Nsbi37H/f
K@  <   %XgRIux&qg- &h}b&jL8]Nsbi37H/
]/  <   %|VgRIux&qg- &h}b&jL8]Nsbi37H,Fң-% <   %u/WgKFrfyyf/Za=Bfzʯθ.e:8]/N!3{*^K@  <   %ɗGKF'gwrtQ^^{֘OP2D˙v8N}CKӫAa pI|  <   %ΎKKF'gwrtQ^^{֘OP2D˙v8N}CKӫAa )-_ <   %ALRIux&qg- &h}b&jL8]Nsbi37H/X|
BK@  <   %ENgRIux&qg- &h}b&jL8]Nsbi37H/l
NK@  <   %жWKF'gwrtQ^^{֘OP2D˙v8N}CKӫAa jPI|  <   %ժ?KF'gwrtQ^^{֘OP2D˙v8N}CKӫAa -% <   %fu/WgKFrfyyf/Za=Bfzʯθ.e:8]/N!3{ʟ)-@  XT Z   Mg <   %`t ;ƗRcqp*
l;-t0=vPt{1YPz|\߸`[@M/gr\MƖÁa!qip0
H}h=j(`p+p-6Rp/p*`aGz-h<&RIux&qg- &h}b&jL8]Nsbi37H0q'֛/s&1{+JF7p-7l(T M`)`ip*o  <   & cԿhv^	w}/'EH	:_E籘i	*:0zN<k(gt::Lf,Zǵ@ <   % gRIux&qg- &h}b&jL8]Nsbi37H/&jDL  <   %u/WgKFrfyyf/Za=Bfzʯθ.e:8]/N!3{,190 <   %xRIux&qg- &h}b&jL8]Nsbi37H+bDL  <   & c9Կhv^	w}/'EH	:_E籘i	*:0zN<k(gt::Lf.u@ <   %򌁈gRIux&qg- &h}b&jL8]Nsbi37H/BDL  <   %άKF'gwrtQ^^{֘OP2D˙v8N}CKӫAa `0	0 <   %AzgRIux&qg- &h}b&jL8]Nsbi37H/XDL    O4J  Pw    B8 <   &eLཀ(&ӱ?
`L9:(Z@L//=L'LPUעq̻\'QC>%]k0o閿?'S~ ywrtQ^^{֘OP2D˙v8N}CK/)dOt;M4w @'miidEYҀ[n@S^7)_4	;?;󓢌/^zP	_p=z'\˵u3p^%:Z㋚[)_"qg- &h}b&jL8]Nsbh҂s= a?MH-@.g'0r2Vd7MSgKFrfyyf/Za=Bfzʯθ.e:8]/NE;YL	:;󓢌/^zP	_p=z'\˵u3p^HDN2'`	ly6hNw{]7:ť ܁ҧaRIux&qg- &h}b&jL8]Ns.=ȟO\`$eL'KFrfyyf/Za=Bfzʯθ.e:8]/N!'mo,s= O[?MH-@.'0}*USAb~wrtQ^^{֘OP2D˙v8N}CKӨN`--~N@9i3GK輼303T=BeW\^Ǘ2rpE.@_RG[A| *)37H/ 
{3a֛/
m&AU-(?W$8_N34tc1z	5C&U~u`ys.'	PϹt	ztPކkgdO.l0N&A9i3GK輼303T=BeW\^Ǘ2rpE.@Ws@_= 7Ic7p_lu_X>|V;՟ay2{"{    $ 	(    g(O00         (  Score (%) 	&    _~` 0         (  Correct 	'    g&?00         (  Attempts      \i0   3 rzCtK, 	6       :E  :{Љ  :r   @  @     SVp @ @  ?   
  loadText   100%  C `B*`Aڪ`@*`>*`=`<*`:@ B5s    |Z"AB  <   %[Zݑ$"o>{yѩ8G?,j%	:N;󓢌jC0}AM~4&,PЕ&wZ<TD*:0zN<k(gt::LfP LAY@3Bbʥ	Rk'|D>QL8]Ns{l9339ip_*,_4	t_w}/'EHo;T8A]AVmD30}AM~4&,PЕ&wu`FQL8]Ns莹13_8_N3w-پA:4O`fhLYT*Md'PUעq̻\'QC>%z;?;0$$J!w
m6oNo/>YU(hJY;Ѹ
~a"u	_p=z'\˵u3p^mBg/`9ux&qg- 55Pdf3	AmZH!PS_	*4%I_@d0:ʯθ.e:8]/N5039ip_T<N}X JX}JI[Y|PJs3Bbʥ	Rk'| 3 U'S   |Bӿ0u <   %ɺuihSVhic\NNF¶F=gaaacao!b4zQb`I<0Z1sXHMCƹ$|ԇz.Ĺ XdWY`͉n+H)aaaOa[Q.
9Caa8ēWY`kIaaaOa[aaaa1Zh1Cb<d6ֿ. <<ԝt+z}"msz.~N؈	WaaaOa[aQB3Ӱk8%ݯඩ!۰ɦm=aYT9u.[`.%==mDzl(#A]e@5;v6$^K9`]_ J.it0]&Jw\t*#Uy/	OaaaOa[aaaa1Zh1Cb<h7d.替ȼJPo/	aaaOa[aQB3Ӱ؏1=FY1y0_p0_o<gf svΫӰѰaAh!u۰ɶ'",,騂qڍX`Kg[_)@݆Mτ  <   %Ɓ-4XzU'*UPTUٙF:'uuSpb^1$W	ˁ0ƫ C&&fY|  <   %A.4XzU'*UPTUٙF:'uuSpb^1$W	A1ƫ &9&fY|  <   %'t4XzU'*UPTUٙF:'uuSpb^1$W	*F  <   %tҠqcTT}AQWfeDCsgIOb9zfēI\w8$Ij0	ReIA <   %ֿҠqcƢAR083sr&pH.L%huU3|, <   %JIŎuJ
3('Dλ8.J}C0f$J GWX <   %z!t4XzU'*UPTUٙF:'uuSpb^1$W	{$F 	"eIA <   %H*':^I
GvfQN71vp]D#`I4sAcTj<[Nd <   %JIŎRzQE]aqg]Q%>!3M%qZƫ  2   !   }t(  <   %E@^}Q䭫:^KF]ӧ`*y@ahr]:5X5(	[;IAzH6{=ha5fds=|֦vHz,YS:i5ha;i4ʛ಺GRԕLItJiQM`S&}'c+0H	zTuopa'YRbF%9Mh8dZט,VfF\CDrSi.[wY mWUǩ!"B[#ޖ>_a0mV}}<cR-`kIL_YR[,a$9P:Z5փ\ק;ZҵxƕGz-/EvN^|ΰuSEtV`ր%n\%i"uIfG0ՙZ3)#TJYfL^Ѥ'%l*oKRU2a%Ң*)E7RL'Ɍ .S &Sռ"_bPj'SPxfJ4TR Ek#^cYh
bqiMmgLW9zr\}Wz'4Dt	oLz[C@}TyZNZaJ>Ф15cb2~eIlВKOkAdӝitiZZ cJ[WjtXΜ^|ΰuSEtV%@Qb.v4	:l$3#zJjzM쑪%S,YQ|u/hkTv6i7etT*0Q~ҢP)
^MOVa)MV/O1(5)<wTΌJr*)FE	pɢ1Y41R6'mgLW9zr\}Wz'4Dt	oLz[C@}TyZNZaJ>Ф15cb2~eIlВ@<hւ{Zs'^kKJ厁KEM[@~d4RSV.4}Tմ ( `Mܿ 7   |+>g  <   %IKKn	'
P(i9yz?ҕpAiS 	,.+cJ8N-nh-qѠ}I)
l.D`^Ю4`/Of( YhYi\VƕvbGtEp^-EnH2[tI=T"!@MȐT<`rzL,f
 IedFq[U(tX,nH2[tI=T"!@MȐORPˠ4jZVD`Zh]N'laAk,OtHP&au8r$(ڻ3ZT:FXP0 @*ȌM4;+Y
ܐdi`{ E
B69Ñ!G^JVy°YAiS 	,.+cJ8S.Y
ܐdi`{ E
B69Ñ!GQcJLL,f
 IedFq[UىbnH2[tI=T"!@MȐPɟYJC8VQYL,f
 IedFq[U2ql|h>$@APm6Ps"B0-tf5Kk3AiS 	,.+cJ1#".H,Y
ܐdi`{ E
B69Ñ!G)ĥj+ʞsAiS 	,.+cJ8S.Kn	'
P(i9ysb}	kQcJ֠4jZVD`Zh]\<z-.FZLU;j%0]V,uZ@Vh[ILU;vKn	'
P(i9y|AXҥL,f
 IedFq[Uى}4t m>$@APm6Ps"B0/kRPϾr20*`%UliWgŰ_e-}>4Z4I=T"!@MȐ.֢ƕ,+|eac5@TK- "0-4ҮHKn	'
P(i9ytXVy°]o9FXP0 @*ȌM4Q2.Y
ܐdi`{ E
B69Ñ!GQN4`.ߜL,f
 IedFq[Uىu"J`Yݠ_~-T՝`Yݠ ' O& e깉` e%l d 	)    g*
`0         (  Time Clock 	       l   @     p} 	       =8(3e&<@      @ 	       $ % ( + 3 4 7 L M O V W X Z \ q x                                      &'(23EFG	$    a;00          (  Ready G 	@    n_ǀ0        (  Dynamic Cardiac Rhythm Simulator F `	2    o 0 h        (  The Six Second ECG E { G    xB ]$/oh    P    %ϥ0!o1>ץ!xIE D @ @ @ @ ;<=>?@ABCDEFG?    d     W   pɼ        ؀     ؀  pĽ  ؀       ? DQ1@laT 	"    oۀ(          ( name >   IJNI9m	4    o׋ 0          (  Your name? Nickname? = ʎ	@    n_ǀ0        (  Dynamic Cardiac Rhythm Simulator < `	2    o 0 h        (  The Six Second ECG ; { 3    xdbHk ]g/oh     Fk|%KzWD :  @ @ @ @ @ 456789:;<=>?@ ?^    timePeriod   59 
  gameDone   2   /st_resetMask    @  1 #
 /contMask       @  1 #  	  rChosen   R   mode   L 
  attempts   0 
 /scoreBox       @  0 #   /timeClock       @  0 #    numCorrect   0   score   0  /grid       @  0 #  
 /infoBack       @  1 # 
   lStart    6    6'M[# st_resetMask 	'    g%	(0        ( gameTime     F1B*   6  C4Ԁ Clock 	    W^00         (  :   >p 	#    W{
1         ( score 0   P	(    W{
1         ( numCorrect 0   F	&    W{	Ѝ1         ( attempts 0   <   6  K scoreBox    6  ?$ timeClock    	"    _d` 0 f        ( HRtxt   ŞV=0	'    _\` 0 f        ( Leadtxt II   E:	#    _U` 0            (  Lead   }:	     W00            (  HR   S~     W   1b\3..  
R@/   0  
R@/   1  
R@  1b\3.2  
R@     /grid       @  40 #   ,Q     W   pɼ        ؀     ؀  pĽ  ؀      mode   G  S
  gameDone   1    -	  rChosen   R 
  gameDone   1    /grid       @  0 #    newRhythm   26 0	  rChosen   R   newRhythm !
  feedback     	  rChosen   /Clock   Start     
  attempts   1 
 /contMask       @  1 #   "  /grid       @  0 #   "  /grid       @  0 #     ,C 	<    h4 0          ( title Cardiac Rhythm Simulator   6@ iF    p(d 
   y3F!to or#zJ= 7ZB܌    X   `  (    zE    %(7]ȾzFN*    |     G      ?     ?     ?     ?    * http://www.skillstat.com/share.htm _blank     !    Xd] 	       S9e I    <   C!L  YaR  YaR  YaR       	'    _}?`} 0           (  No Limit     <   C!L  YaR  YaR  YaR      _level0:gameTime   unlimited time   _level0:timePeriod   59  	(    _}?`} 0            (  3 minutes     <   C!L  YaR  YaR  YaR      _level0:gameTime   ( 3 minutes )   _level0:timePeriod   3  	'   _}?`} 0            (  1 minute    <   C!L  YaR  YaR  YaR      _level0:gameTime   ( 1 minute )   _level0:timePeriod   1     
            	   ?    
   Hide   S@   q,g#@ @ @ @ @   ?    
   Show   d>GL  \Zp,7   eG'<	  \Z,%  eGBX \Zp(A@   PQ?K ) \Z
%  ɯ9 @ @ @ @ @ @    8  - \@ ]" y K e@ I    6w 5  contMask 	C   wI 0          ( InfoTxt_Header Explore. Review. Play. v #2@ 	  w10         ( INFOtxt The "Cardiac Rhythm Simulator" generates 26 of the most common cardiac rhythms for you to explore, review and play. Simply click on any rhythm name and the rhythm is diplayed. Click on "Freeze" to stop the rhythm and display a grid. Clicking the "Start" button resumes the rhythm once again. Later, choose 'Game' from the 'Option' menu to challenge yourself. u ɈG}N9   6s  +Ix]  infoBack    (   h@  h@  h@8         mode   G  	  rChosen   R 
  gameDone   0    /grid       @  0 #  
  feedback      /Clock   Reset     
  attempts   0   score   0   numCorrect   0 
 /contMask       @  1 #  
 /infoBack       @  1 #    mode   G   InfoTxt_Header   Try Out the CardiacSim Game! 	  INFOtxt  The "CardiacSim Game" , Game 1, begins by clicking on "Start". The objective is to correctly identify as many rhythms as possible within a certain timeframe. Clicking "Freeze" will stop the rhythm and provide a grid, but the clock continues. Click on "Reset" to restart the game.   title   The CardiacSim Challenge     q   p  A,  %   j    5B]AjE© o  n  eIOb  e_bR  	 ] 6   7  vd8  >
AҒ9  vd8  >
AҒ:  vd8  >
BRp;  	9      /contMask   7 "  0    newR 	  rChosen   newRhythm   26 0  newRhythm   0     newRhythm   1 	  rChosen   R   newRhythm !  newR 	  rChosen   	  rChosen   K   newRhythm   26 0	  rChosen   R   newRhythm !	  rChosen   /Clock   Start     
  attempts 
  attempts   1 

  feedback     
 /contMask       @  1 #      T 	ŀC9u  ?   
 Times New Roman   	+   oۀ0
h        ( feedback      S y o    E                     ő@Ed/Р      rNum   R25 
  bActions    P ` o    E                     f H/NP      rNum   R26 
  bActions    L F w    M                ņ>/       ŒD~/      rNum   R24 
  bActions    I Q܀ ~    T      _      _   J:c/T0  _      ;F/̀      rNum   R23 
  bActions    E Ѷ`     b     @{      @|    ʒ6/Yp}  DyI
I           rNum   R8 
  bActions    B '      ]   ߨca@      aU     $aY      褿c^      rNum   R22 
  bActions    ? ̪`     ]   `ְ]_   솀  (]V  솀  ְ]a  솀  _W      rNum   R21 
  bActions    < 8     ]   wwh@     yߨuc@     yʹum      m$yZ       rNum   R20 
  bActions    9 p     ]   5/YO     :)/WP     6/XQ     2M/      rNum   R19 
  bActions    6 X     ]   Ř|7/XPS     ş*:)/T     ş*6/U     ş*<h/      rNum   R18 
  bActions    3 xx     ]    褿YW     
񠿇UX      (\Y      񠿋V      rNum   R17 
  bActions    0 l     ]   H:)/ʠ[   I  ;I/I\   I  =/H0]   I  6/P      rNum   R16 
  bActions    - 2      ]   6/X_     9
/W `     9
/Wa     9
/W      rNum   R15 
  bActions    * F@     ]   Bոc     d     e     Kd      rNum   R13 
  bActions    '       Z   %rg     񠿉T@h     %ci     ô-_      rNum   R12 
  bActions    $ y      ]   7b\k     7b\l     8m     1      rNum   R14 
  bActions    ! :     ]   M\(}]o     HX$}Xp     M\}Uq     K (^@      rNum   R11 
  bActions     pw     ]   c9
/ s     c?/t     h?/Su     cV:)/V`      rNum   R10 
  bActions     eF@     ]   Ԙ;I/0w     <h/Ux     Ԙ=/y     Ԙ>/Ԑ      rNum   R9 
  bActions     _"     ]   `d      ̹x@     di     t      rNum   R7 
  bActions     Ȁ      ]   h5/X`     h4/X     h<h/Tp     h7/W      rNum   R6 
  bActions           ! ]   ;I/U  (  7/W  (  n9
/׀  (  6/X      rNum   R5 
  bActions     !x     " ]   v=/T@     v<h/U     j;I/U     \>/      rNum   R4 
  bActions     "I@    # ]   :uX  솀     솀   D  솀  Kd      rNum   R3 
  bActions    	 #    $ ]   !K8     8=/`          	Kd      rNum   R2 
  bActions     $#'    % ]   ň4,W  A@  ŋh=,Q  A@  Ŏx6,  A@  ŏ<h,R       rNum   R1 
  bActions     %'     6 > tx9Bp@ grid @ 
   gStart @ @ ?    HRtxt   140   mode   L  @  /infoBack    @  1 #  InfoTxt_Header   Sinus Tachycardia 	  INFOtxt   Sinus Tachycardia most often results from increased sympathetic stimulation (i.e. due to pain, fever, increased oxygen demand, and/or hypovolemia). It usually has a narrow QRS. The rate is often  limited to below 150 / minute.  k   InfoTxt_Header     	  INFOtxt       /infoBack    @  0 #  /st_resetMask    @  0 # ?    /grid       @  0 # 
   R3 n eNOb eG"R@ n e8Ob e<"R@ n e"Ob e1"R@ n eOb e&"R@ n eOb e"R@ n eOb e"R@ n eOb e"R@ n eOb e"R@ n eOb e"R@ n eOb e"R@ n erOb e"R@ n e\Ob e"R@ n eFOb e"R@ n e0Ob e"R@ n eOb e"R@ n eOb e"R@ n eOb e"R@ n eOb e"R@ n eOb e"R@ n eOb ev"R@ n eOb ek"R@ n eOb e`"R@ n ejOb eU"R@ n eTOb eJ"R@ n e>Ob e?"R@ n e(Ob e4"R@ n eOb e)"R@ n e<b e"R@ n eͥ<b e"R@ n eס<b e"R@ ?       n eu<b e"R@ b n @ ?S    HRtxt   56   mode   L    InfoTxt_Header   Sinus Bradycardia   /infoBack    @  1 #	  INFOtxt  Sinus Bradycardia with rates greater than 50/minute may be well tolerated by healthy adults. Athletes may routinely be in sinus bradycardia due to an optimal cardiac stroke volume that requires less HR to yield acceptable cardiac output. Sinus bradycardia may also be produced with  Vagal stimulation or due to Sick Sinus Syndrome. Expect a narrow QRS with upright P waves in Lead II.   J   InfoTxt_Header     	  INFOtxt       /infoBack    @  0 # ?    /grid       @  0 # 
   R2 [  JJd@ [ JJ	d@ [ JJ	d@ [ JJ	d@ [ JJpId@ [ JJUId@ [ JJ:d@ [ JJd@ [ JJd@ [ JJ	d@ [ JJ	d@ [ JJ	d@ ?    @  [ JJId@ [ ?U    HRtxt   52   mode   L    InfoTxt_Header   Sinus Exit Block   /infoBack    @  1 #	  INFOtxt  Sinus exit block (sinoatrial block) results from blocked sinus impulses - impulses not getting through to depolarize the atria. While the sinus is firing on schedule, the tissue around the SA node is not carrying the impulse. The seriousness of this dysrhythmia is related to the frequency and duration of the blocks. Note that each pause is equal to a multiple of previous P-P intervals.  J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R5 _  uٺdbF@ _ uٺWF@ _ uٺKF@ _ uٺ?G @ _ uٺ2G @ _ uٺ&"G @ _ uٺG @ _ uٺ"G @ _ uٺ G @ _ uٺBG@@ _ uٺG@@ _ uٺbG@@ _ uٺG@@ _ uٺG@@ _ uٺG@ _ uٺG@ _ uٺ"G@ _ uٺG@ _ uٺ"G@ _ uٺwG@ _ uٺkBG@ _ uٺ^G@ _ uٺRbG@ _ uٺEG@ _ uٺ9G@ _ uٺ-G@ _ uٺ H @ _ uٺ"H @ ?    M  _ uٺH @ ?E    HRtxt   44   mode   L    InfoTxt_Header   Sinus Arrest   /infoBack    @  1 #	  INFOtxt z Sinus Arrest (a.k.a. sinus pause) occurs when the SA node fails to fire. The resulting pause is often NOT equal to the multiple of P-P intervals seen in Sinus Exit Block. Instead, often an escape pacemaker such as the AV junction will assume control of the heart. Again, like Sinus Exit Block, treatment is related to the frequency and duration of the periods of sinus arrest.  J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R6 _ Cg$烉@ _ Cg$j@ _ Cg$Q@ _ Cg$8@ _ Cg$@ _ Cg$@ _ Cg$@ _ Cg$@ _ Cg$@ _ Cg$@ _ Cg$@ _ Cg$q	@ _ Cg$X	@ _ Cg$?	@ _ Cg$&	@ _ Cg$	@ _ Cg$	@ _ Cg$	@ _ Cg$I@ _ Cg$I@ _ Cg$I@ _ Cg$wI@ _ Cg$^I@ _ Cg$EI@ _ Cg$,@ _ Cg$@ _ Cg$@ _ Cg$@ _ Cg$ȉ@ _ Cg$䯉@ _ Cg$䖉@ _ Cg$}@ _ Cg$d@ _ Cg$K@ ?    j  _ Cg$2@ _ ?    HRtxt   70   mode   L    InfoTxt_Header %  NSR with Premature Atrial Complexes   /infoBack    @  1 #	  INFOtxt < Premature Atrial Complexes or PAC result from irritability to the atria resulting in increased automaticity of atrial tissue. Since the atria initiate an impulse earlier than expected from the SA node, this is a premature complex.  Expect narrow QRS and flattenned, notched, peaked or biphasic P waves for the PAC.  J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R7 ] A ْK@ ] ْK@ ] ْK@ ] ْzbK@ ] ْn"K@ ] ْbK@ ] ْUK@ ] ْIK@ ] ْ=bK@ ] ْ1"K@ ] ْ%K@ ] ْK@ ] ْK@ ] ْ K@ ] ْ.@ ] ْI.@ ] ْ.@ ] ْ矉.@ ] ْ	.@ ] ْn.@ ] ْVI.@ ] ْ>	.@ ] ْ%.@ ] ْI.@ ] ْ.@ ] ْ܉.@ ] ْ	.@ ] ْ櫉.@ ] ْI.@ ] ْz.@ ] ْb.@ ] ْJI.@ ] ْ1.@ ] ْ.@ ] ْ	.@ ] ْ.@ ] ْI.@ ] ْ.@ ] ْ埉.@ ] ْ	.@ ?      ] ْn.@ ] ?k    HRtxt   230   mode   L    /infoBack    @  1 #  InfoTxt_Header   Atrial Tachycardia 	  INFOtxt  Atrial tachycardia is an ominous rhythm with rates often between 170-230 per minute. The telltale sign of atrial tachycardia is the narrow QRS which defines its supraventricular origin and its regular, rapid pattern. This rhythm is most likely not sinus tachycardia due to its typical very fast rate . For those who are at rest, narrow QRS tachycardias over 150 / minute are most often  atrial tachycardia.   J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R8 n  ~FI%b  ~G@ n ~.&b ~uH @ n ~	&b ~jH @ n ~&b ~^BH @ n ~&b ~RbH @ n ~I&b ~FH @ n ~三&b ~:H @ n ~&b ~.H @ n ~I&b ~#"H @ n ~q&b ~BH @ n ~Z	&b ~H @ n ~B&b ~ @ n ~*&b ~ @ n ~I&b ~I @ n ~$b ~縉 @ n ~$b ~	 @ n ~טb ~I @ n ~i$b ~q @ n ~:$b ~Z	 @ n ~$b ~B @ ?      n ~ۤb ~*@ b n ?3    HRtxt   90   mode   L    InfoTxt_Header   Atrial Fibrillation   /infoBack    @  1 #	  INFOtxt a Atrial fibrillation is a chaotic rhythm with recognizable QRS complexes. The chaotic rhythm pattern and the absence of P waves are the hallmarks of this dysrhythmia.The chaotic baseline - known as fibrillatory waves - is quickly seen. Note: 1) atrial kick is lost here; and 2) the risk of thrombus formation is particularly significant after 48 hours.  J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R9 Y  eBC@ Y ebC@ Y eC@ Y eC@ Y eC@ Y e"C@ Y eBC@ Y exC@ Y elC@ Y e`C@ Y eUC@ Y eI"C@ Y e=bC@ Y e1C@ Y e%C@ Y eC@ Y eC@ Y eBC@ Y e@ Y e	@ Y e罉@ Y e@ Y eI@ Y ev@ Y e^@ Y eGI@ Y e/@ Y e	@ Y e I@ Y e@ Y e	@ Y eI@ Y e@ Y e	@ Y erI@ Y eZ@ Y eC	@ Y e+I@ Y e@ Y e	@ Y e@ Y e@ Y e	@ Y e坉@ Y e@ Y enI@ Y eV@ Y e>@ Y e'I@ Y e@ Y e	@ ?      Y eI@ Y ?Z    HRtxt   75   mode   L    InfoTxt_Header   Atrial Flutter   /infoBack    @  1 #	  INFOtxt  Atrial flutter results from the development of a reentry circuit within the atria generating a loop that discharges impulses at a flutter rate of 250-350 / minute. Most often the AV junction passes every second (rate = 150, called a 2:1 response) or every fourth impulse(rate = 75, called a 4:1 response) through to the ventricles. Atrial flutter is readily identified by the sawtooth baseline.   J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R10 Z  U@@ Z }U@@ Z qU@@ Z eU @ Z YU @ Z MU @ Z AU @ Z 5T@ Z )T@ Z T@ Z T@ Z T@ Z 	R@ Z 	R@ Z IR@ Z IQ@ Z IQ@ Z |IQ@ Z dQ@ Z LP@ ?      Z 4P@ Z ?y    HRtxt   72   mode   L    InfoTxt_Header    Wolff-Parkinson-White Syndrome   /infoBack    @  1 #	  INFOtxt  Wolff-Parkinson-White syndrome is a pre-exitation occurance enabled by an accessory pathway (Bundle of Kent) that connects the atria to the ventricles .The sluring of the beginning of the QRS - called a Delta wave -results from part of the ventricles depolarizing early (preexcitation) before being met by the normal depolarization of ventricles (from the bundle branchs). A short PR interval is also expected.  J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R11 W  A@:X @ W A@.bX@@ W A@""X@ W A@X@ W A@	X@ W A@d@ W A@e@ W A@	e@ W A@簉f@ W A@	g@ W A@Ih@ W A@fh@ W A@N	i@ W A@5j@ W A@k@ W A@Ik@ W A@l@ W A@m@ W A@In@ W A@n@ ?     W A@	o@ W ?'    HRtxt   50   mode   L    InfoTxt_Header   Junctional Rhythm 	  INFOtxt W Junctional rhythm or junctional escape rhythm originates from the AV junction - AV node and Bundle of His.  The expected pacemaker rate of the AV junction is 40-60 / minute. In lead II, inverted or absent P waves are expected usually with a narrow QRS. Note: an absent P wave in junctional rhythm is also associated with loss of atrial kick.   /infoBack    @  1 # J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R13 \ N 5mpIp@ \ 5mpIp@ \ 5mpIo@ \ 5mpIo@ \ 5mpIo@ \ 5mpxIn@ \ 5mp`In@ \ 5mpHIn@ \ 5mp0n@ \ 5mpm@ \ 5mp m@ \ 5mpm@ \ 5mpЉl@ \ 5mp帉l@ \ 5mp堉l@ \ 5mp刉k@ ?    ) \ 5mppk@ \ @ ?    HRtxt   68   mode   L  [  InfoTxt_Header $  Premature Junctional Complex (PJC)   /infoBack    @  1 #	  INFOtxt   A PJC arises from an irritable focus within the AV junction. Characteristics of a PJC include: 1) an absent or inverted P wave in lead II; 2) a shortened PR interval - less than .12 seconds; and 3) the complex comes early or premature.   J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R12 ] @ TBO@@ ] T"O@@ ] T"O@@ ] TO@@ ] TO@@ ] TO@@ ] T~O@@ ] TqO@@ ] TdO@@ ] TWO@@ ] TJO@@ ] T=bO@@ ] T0BO@@ ] T#BO@@ ] T"O@@ ] T	"O@@ ] T	=@ ] T=@ ] T=@ ] T穉=@ ] TI=@ ] TuI=@ ] T[	=@ ] TA	=@ ] T&=@ ] T=@ ] T=@ ] TI=@ ] TI=@ ] T	=@ ] T=@ ] To=@ ] TU=@ ] T;I=@ ] T!I=@ ] T	=@ ] T	=@ ] T=@ ] T帉=@ ] T垉=@ ?    ; ] TI=@ ] @ ?    HRtxt   70   mode   L  j  InfoTxt_Header   Sinus Arrhythmia   /infoBack    @  1 #	  INFOtxt  Sinus Arrhythmia is most often a benign rhythm, common in children and less common with older adults. The irregular pattern of this rhythm fluctuates with inspiration (HR increases) and expiration (HR decreases). A narrow QRS and upright P waves in Lead II is expected.  J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R4 W  K]bU@ W K]V @ W K]V @ W K]BV@@ W K]vV@ W K]iV@ W K]]"V@ W K]PW @ W K]CW @ W K]7"W@@ W K]*bW@ W K]W@ W K]W@ W K]BX @ W K]I`@ W K]a@ W K]缉b@ W K]	b@ W K]c@ W K]pIc@ W K]Vd@ W K]=e@ W K]$	e@ W K]
f@ W K]Ig@ W K]	g@ W K]澉h@ W K]	i@ W K]i@ W K]rIj@ W K]Y	k@ W K]?k@ W K]&	l@ W K]m@ W K]Im@ W K]	n@ W K]o@ W K]Io@ ?    e W K]p@ W @ ?    HRtxt   86   mode   L    InfoTxt_Header   Accelerated Junctional   /infoBack    @  1 #	  INFOtxt A Accelerated junctional rhythm occurs as a result of enhanced automaticity, due to  increased sympathetic activity (catecholamines) and / or hypoxia. Key features of this rhythm include a rate between 60-100 / minute, inverted or absent P waves (in lead II) , shortened PR interval, and most often narrow QRS complexes.   J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R15 c  9peB_@@ c 9pYB_@@ c 9pMb_@@ c 9pAb_@@ c 9p5_@@ c 9p)_@@ c 9p_@@ c 9p_@@ c 9p_@@ c 9p}@ c 9pۉ}@ c 9p}@ c 9p}@ c 9p	}@ c 9p|	}@ c 9pdI}@ c 9pLI}@ c 9p4}@ ?     c 9p}@ ?	    HRtxt   118   mode   L    /infoBack    @  1 #  InfoTxt_Header   Junctional Tachycardia 	  INFOtxt 3 Junctional tachycardia occurs due to enhanced automaticity, possibly from increased sympathetic activity (catecholamines) and / or hypoxia. Key features of this rhythm include a rate  over 100 / minute, inverted or absent P waves (in lead II) , shortened PR interval, and most often narrow QRS complexes.   J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R16 c "ipZ	@ c "ip@	@ c "ip&	@ c "ip	@ c "ip	@ c "ipI@ c "ipI@ c "ipI@ c "ipI@ c "ippI@ c "ipVI@ c "ip<I@ c "ip"I@ c "ipI@ c "ip@ c "ipԉ@ c "ip庉@ c "ip堉@ ?     c "ip冉@ c ?:    HRtxt   60   mode   L    /infoBack    @  1 #  InfoTxt_Header   Wandering Pacemaker 	  INFOtxt h A Wandering Pacemaker rhythm results from a fluctuating site of impulse formation - usually between the SA node and the AV junction. This is a benign rhythm more commonly seen with narrow QRS rhythms with rates hovering around 60 / minute. The distinguishing characteristic is P wave changes that switch between upright P waves and absent / inverted P waves.  J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R14 `  }=]P @ ` }=Z8 @ ` }=W  @ ` }=T@ ` }=P@ ` }=MЗ@ ` }=J@ ` }=G@ ` }=D @ ` }=Ap @ ` }=>X @ ` }=;8 @ ` }=8 0@ ` }=50@ ` }=10@ ` }=.ؗ0@ ` }=+0@ ` }=(@@ ` }=%@@ ` }="p@@ ` }=X@@ ` }=@@@ ` }=(P@ ` }=P@ ` }=P@ ` }=ؗP@ ` }=P@ ` }=	`@ ` }=`@ ` }=x`@ ` }= ``@ ` }9]@ ` }9R]@ ` }9"]@ ` }9]@ ` }9]@ ` }9ے^ @ ` }9b^ @ ` }9"^ @ ` }9^ @ ` }9^ @ ` }9^@@ ` }9b^@@ ` }92^@@ ` }9^@@ ` }9^@@ ` }9^@ ` }9b^@ ?     ` }92^@ ` @ ?    HRtxt   78   mode   L  9  /infoBack    @  1 #  InfoTxt_Header   Premature Ventricular Complex 	  INFOtxt  Premature ventricular complexes (PVC) often represent increased ventricular automaticity and / or reentry phenonomen. The presence of PVC may be benign but can indicate irritable ventricles. The PVC arrives earlier than expected and is usually wide (.12 seconds or more) and bizarre. Note that the T wave will often point in an opposite direction from the QRS complex. A PVC every second complex is called ventricular bigeminy...every 3rd = ventricular trigeminy.  J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R17 a ? d-d,Io@ a d-d,o@ a d-d,	o@ a d-d,巉o@ a d-d,	p@ a d-d,Ip@ a d-d,mp@ a d-d,UIp@ a d-d,<p@ a d-d,$	p@ a d-d,p@ a d-d,q@ a d-d,Iq@ a d-d,q@ a d-d,	q@ a d-d,䐉q@ a d-d,x	q@ a d-d,_Iq@ a d-d,Fr@ a d-d,.Ir@ a d-d,r@ a d-d,%@ a d-d,%@ a d-d,ח@ a d-d,f@ a d-d,5@ a d-d,%@ a d-d,%@ a d-d,֢%@ a d-d,p@ a d-d,?@ a d-d,@ a d-d,%@ a d-d,լ%@ a d-d,{%@ a d-d,I@ ?     a d-d,@ a ?    HRtxt   40   mode   L  u  /infoBack    @  1 #  InfoTxt_Header   Idioventricular Rhythm (IVR) 	  INFOtxt  Idioventricular rhythm (IVR) occurs when the SA and AV nodes are  either NOT firing or firing slower than the ventricular pacemaker rate. A common ventricular pacemaker rate is 20-40 / minute, a rate that is often not sufficient to sustain an adequate cardiac output.   J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R18 W  ~r=;У @ W ~r=8У @ W ~r=5أ @ W ~r=2 @ W ~r=/ @ W ~r=, @ W ~r=) @ W ~r=& @ W ~r=# @ W ~r=  @ W ~r= @ W ~r=  @ W ~r=  @ W ~r= @ W ~r= @ W ~r= @ W ~r= @ W ~r=	 @ W ~r= @ W ~r=  @ ?    
 W ~r=   @ ?    HRtxt   54   mode   L    /infoBack    @  1 #  InfoTxt_Header +  Accelerated Idioventricular Rhythm (AIVR) 	  INFOtxt  Accelerated idioventricular rhythm (AIVR) is not yet a tachycardia but is occuring at a rate greater than what is expected of the ventricles. AIVR is found with a rate of 40-100 / minute. Enhanced automaticity - possibly due to hypoxia or abundant sympathetic stimulation - increases the ventricular firing. Note that this rhythm is not usually stable and can move quickly to either asystole or ventricular tachycardia (VT).  J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R19 W ɘV@@ W ɘI@@ W ɘ=b@@ W ɘ1"@@ W ɘ$@@ W ɘ@@ W ɘ"@@ W ɘ5@ W ɘJ5@ W ɘΊ5@ W ɘ
5@ W ɘJ5@ W ɘ5@ W ɘl
5@ W ɘS5@ W ɘ:5@ ?     W ɘ"J5@ ?e    HRtxt   180   mode   L    /infoBack    @  1 #  InfoTxt_Header   Ventricular Tachycardia 	  INFOtxt  Ventricular tachycardia (VT) is most often an ominous rhythm due to the low cardiac output that it produces (minimal filling time and no atrial kick) and to the rhythm that VT often succumbs to - ventricular fibrillation. Causes of VT include myocardial ischemia, a PVC landing on a T wave (R-on-T ), cardiac drug toxicity and electrolyte imbalance. Non-sustained VT is referred to as runs of VT.  J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R20 W  
TfI@ W 
TN@ W 
T7	@ W 
TI@ W 
Tɟ@ W 
T	@ W 
TI@ W 
Tɟ@ W 
T	@ W 
T呉@ W 
Tyɟ@ W 
TbI@ ?    0 W 
TJ@ ?B    HRtxt    - - -   mode   L    /infoBack    @  1 #  InfoTxt_Header   Ventricular Fibrillation 	  INFOtxt g Ventricular fibrillation (VFib) is a chaotic rhythm originating in the ventricles, resulting in no cardiac output. Coarse VFib is noted when the amplitude (height) of the rhythm is equal to or more than 3 mm. Fine VFib is less than 3 mm in height and signifies less electrical energy within the myocardium - less opportunity for a successful defibrillation.  J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R21 W  8hI2@ W 8h2@ W 8h瓉2@ W 8hz	1@ W 8h`1@ W 8hGI1@ W 8h-1@ W 8h1@ W 8h	1@ W 8h0@ W 8hI0@ W 8h0@ W 8h敉0@ W 8h|	0@ W 8hb/@ W 8hII/@ W 8h//@ W 8h/@ W 8h	/@ W 8h/@ W 8hI.@ W 8h.@ W 8h嗉.@ W 8h~	.@ W 8hd.@ W 8hKI.@ W 8h1-@ W 8h-@ ?    = W 8h	-@ ?    HRtxt   0   mode   L    /infoBack    @  1 #  InfoTxt_Header 
  Asystole 	  INFOtxt P Asystole is absence of cardiac electrical activity resulting in no cardiac output - no pulse. Asystole is most often an endstage rhythm. Occasionally, asystole is caused by excessive vagal tone and can be responsive to vagalytics (Atropine) and transcutaneous pacing (TCP). Always check pulse and lead placement to rule out leads off.  J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R22 W  }|'Bk@ W }|k@ W }|"k@ W }|	@ W }|ɮ@ W }|ɮ@ W }|竉@ W }|琉@ W }|uI@ W }|Z	@ W }|?	@ W }|#ɮ@ W }|@ W }|퉮@ W }|I@ W }|	@ W }|	@ W }|ɮ@ W }|eɮ@ W }|J@ W }|/I@ W }|I@ W }|	@ W }|ɮ@ W }|ɮ@ W }|姉@ W }|I@ W }|qI@ W }|V	@ W }|;	@ W }|ɮ@ W }|@ W }|鉮@ W }|I@ W }|	@ W }|	@ W }||ɮ@ W }|a@ W }|F@ W }|+I@ W }|I@ W }|&@ W }|׳@ W }|}@ W }|G&@ W }|@ W }|ڦ@ W }|֤&@ W }|m@ W }|7@ W }|&@ W }|&@ W }|Ք@ W }|^&@ W }|(&@ ?    Z W }|@ W ?C    HRtxt   65   mode   L    /infoBack    @  1 #  InfoTxt_Header    NSR with First Degree AV Block 	  INFOtxt f First degree AV block results from a prolonged transmission of an impulse through the junctional area (AV node and the Bundle of His). The significant finding of this rhythm is a prolonged PR interval of more than .20 seconds. The finding of first degree AV block describes only the PR interval. Mention of the underlying rhythm should be mentioned first.   J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R23 ] 4 ST@ ] GbT@ ] :T@ ] .bT@ ] !T@ ] bT@ ] T@ ] S@ ] S@ ] S@ ] S@ ] S@ ] {S@ ] bS@ ] IS@ ] 0S@ ] S@ ] S@ ] S@ ] S@ ] S@ ] S@ ?     ] S@ ] ?    HRtxt   70   mode   L    /infoBack    @  1 #  InfoTxt_Header   Second Degree AV Block Type I 	  INFOtxt  Second degree AV block type I (Wenkebach or Mobitz Type I) occurs due to progressive slowing at the AV node. This results in a lengthening PR interval followed by a dropped QRS - a P wave not partnered with a QRS. The ventricular rhythm then is irregular. Second degree AV block type I may be caused by enhanced vagal tone, myocardial ischemia or the effects of drugs such as calcium-channel blockers, digitalis and beta-blockers.  J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R24 _  	vI@ _ 	[Ʉ@ _ 	A@ _ 	'	@ _ 	Ʉ@ _ 	I@ _ 		@ _ 	潉@ _ 	I@ _ 	Ʉ@ _ 	nI@ _ 	T	@ _ 	9@ _ 	I@ _ 	Ʉ@ _ 	ꉄ@ _ 		@ _ 	Ʉ@ _ 	I@ _ 	Ʉ@ _ 	f@ _ 	L	@ _ 	1Ʉ@ _ 	I@ _ 		@ _ 	≄@ _ 	I@ _ 	Ʉ@ _ 	I@ _ 	y	@ _ 	^@ _ 	DI@ _ 	)Ʉ@ _ 	@ _ 	&@ _ 	׵@ ?     _ 	׀@ _ ?_    HRtxt   58   mode   L    /infoBack    @  1 #  InfoTxt_Header    Second Degree AV Block Type II 	  INFOtxt  Second Degree AV Block Type II occurs usually below the AV node at the bundle branches or less commonly at the Bundle of His.  Note that one or more QRS complexes are dropped with PR intervals remaining equal. This irregular rhythm requires close monitoring: 1) low cardiac output is likely with multiple dropped QRS complexes; and 2) this rhythm can progress to complete heart block.  J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R25 [   `~=M@ [  `~=J @ [  `~=F @ [  `~=Cؗ @ [  `~=@ȗ @ [  `~== @ [  `~=:0@ [  `~=70@ [  `~=4p0@ [  `~=1X@@ [  `~=.H@@ [  `~=+0@@ [  `~=(@@ [  `~=%P@ [  `~=!P@ [  `~=ؗP@ [  `~=ȗ`@ [  `~=`@ [  `~=`@ [  `~=`@ [  `~=pp@ [  `~=`p@ [  `~=	Hp@ [  `~=0@ [  `~= @ [  `~= @ [  `~9^@@ [  `~9^@@ [  `~9^@@ [  `~9r^@@ [  `~9B^@ [  `~9^@ [  `~9^@ [  `~9^@ [  `~9Ȓ^@ [  `~9r^@ [  `~9B^@ [  `~9"_ @ [  `~9_ @ [  `~9_ @ [  `~9_@@ [  `~9r_@@ [  `~9B_@@ [  `~9"_@@ [  `~9_@ [  `~9_@ [  `~9~_@ [  `~9xr_@ [  `~9rR_@ [  `~9l"_@ [  `~9e_@ [  `~9_` @ ?     [  `~9Y` @ [ ?V    HRtxt   44   mode   L    /infoBack    @  1 #  InfoTxt_Header   Third Degree AV Block 	  INFOtxt  Third degree AV block (complete heart block) is an ominous rhythm requiring close monitoring for low cardiac output and progression to asystole or other fatal dysrhythmias. The significant characteristics of this rhythm are: 1) regular R-R intervals; and 2) chaotic PR intervals. A narrow QRS denotes a higher block while a wide QRS points more towards a block in the bundle branches.  J   /infoBack    @  0 #  InfoTxt_Header     	  INFOtxt      ?    /grid       @  0 # 
   R26 W   Ⓚ@ W @ W 肓@ W b@ W B@ W @ W Ⓚ@ W @ W @ W b@ W "@ W {@ W nⓀ@ W b@ W V@ W Jb@ W >"@ W 2@ W %@ W @ W @ W B@ W JN@ W 
N@ W 繊N@ W JN@ W 
N@ W pN@ W XJN@ W ?N@ W 'N@ W JN@ W N@ W ފN@ W JN@ W N@ W 敊N@ W }JN@ W dN@ W LN@ W 4
N@ W N@ W N@ W 
N@ W N@ W 床N@ W 
N@ W N@ W qJN@ W Y
N@ W @N@ W (JN@ W 
N@ W N@ W JN@ W 
N@ W N@ W JN@ W ~
N@ W eN@ W MJN@ W 5
N@ W N@ W JN@ W )8@ W ק)8@ W v8@ W F)8@ W )8@ W 8@ W ֳ8@ W փ)8@ W R8@ W !8@ ?     W )8@ W @ ?    HRtxt   80   mode   L  7  InfoTxt_Header   Regular Sinus Rhythm   /infoBack    @  1 #	  INFOtxt   Sinus rhythm - also known as regular sinus rhythm (RSR) or normal sinus rhythm (NSR) - is the most common adult rhythm with rates between 60-100/minute. The QRS is most often narrow with upright P waves in Lead II.  J   InfoTxt_Header       /infoBack    @  0 #	  INFOtxt      ?    /grid       @  0 # 
   R1 b  Z}Y0,"W@ b Z}Y0 BW@ b Z}Y0bW@ b Z}Y0X @ b Z}Y0I`@ b Z}Y0a@ b Z}Y0a@ b Z}Y0	b@ b Z}Y0Ib@ ?    O b Z}Y0炉c@ b @ @ @ o p q s u v w y    @    	        ! $ ' * - 0 3 6 9 < ? B E I L P S T          @ @           @ ?   /grid       @  0 #    mode   L     rNum   
  feedback 
  Correct! 	  rChosen   R  l	  rChosen   rNum    /Clock  Stop   
 /contMask       @  0 #    numCorrect   numCorrect   1 

  feedback 
  Correct!   score   numCorrect 
  attempts   100   	  rChosen   rNum  x 
  feedback   Try Again 
  attempts 
  attempts   1 
  score   numCorrect 
  attempts   100     
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