Scenario: The Figure below is a screen shot of a bedside monitor in the emergency department from an 85-year-old man who complained of dizziness, weakness, and a “fuzzy” memory. The nurse was challenged managing the numerous false asystole alarms generated, particularly because she could see indications of a QRS complex. The patient was alert and oriented, and his vital signs were within normal limits. Why is there an asystole alarm despite the obvious QRS complexes?

Sinus bradycardia at 54 beats/min, appears to have a first degree AV block (verify using printed ECG), with false positive asystole alarms

The American National Standard for cardiac monitors states that ECG devices should not label a QRS complex if the waveform is lower than 0.15 mV (1.5 mm) in amplitude to avoid mislabeling P waves or baseline noise as QRS complexes during critical arrhythmias such as...

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