# Differentiating Heart Blocks (For Medic Students)



## crotchitymedic1986 (Jan 12, 2009)

Thought I would pass along an easy way to differentiate between the 4 heart blocks.  It is called the CICI's Pizza Method (for those who dont have them, CICI's is a pizza buffet restaurant chain). 

First you write down the heart blocks vertically in order on a piece of paper, then you write C I C I vertically:

1st                               *C*
2nd type I                     *I*
2nd type II                    *C*
3rd                               *I*

In this method CICI stands for CONSISTENT and INCONSITENT instead of CICI's pizza.

So now you look at the P-R interval for your rhythm and ask is it consistent or inconsistent ?

If *Consistent* the heart block can only be a 1st degree block or a 2nd degree Mobitz II.  If you have one p-wave with just a long interval then it is first degree.  If you have more than one "p" but the interval is consitent, it is 2nd degree type II.

If *Inconsistent*, the heart block can only be 2nd type I, or 3rd degree.  Obviously if the PR gets longer and longer until a QRS is dropped it is 2nd type I.  If you have more than one "p" and the PR interval is all over the place, then it is 3rd degree.

Using this method for a test knocks your choices down from 4 to 2, then it should be easy to pick the right one of the two.


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## daedalus (Jan 12, 2009)

Actually bud, I just keep this on my ipod and sing along on cardiac calls.

http://www.youtube.com/watch?v=GVxJJ2DBPiQ


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## mikeylikesit (Jan 12, 2009)

Good idea but I'm stuck in my ways already. i don't know how many mnemonics i use a day.


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## marineman (Jan 12, 2009)

I'm still in class and we've been taught so many mnemonics I can't remember which one goes with what so they do me no good.


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## VentMedic (Jan 12, 2009)

What has stuck in my brain for almost 30 years about heart blocks are the stories Dr. Nancy Caroline used in her Paramedic text book.


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