NSR a tautology?

[Melclin]

Its semantics time. One of my lecturers hates the term NSR for normal sinus rhythm. He says its a tautology. Says its not wrong per se, but he hates it and if we use it he will take his bat and ball and go home. He prefers simply...Sinus Rhythm. His nomenclature for sinus rhythms is Sinus Rhythm, Sinus Brady, Sinus Tachy, Sinus Arrhythmia.

I disagree.

I say the term sinus rhythm describes a class of rhythms. It is implied that you mean a normal sinus rhythm if you say SR because the lack of adding a distinctive adjective implies that there isn't anything distinctive in situations when distinction is important and specific. Technically though, simply saying Sinus rhythm only describes a class of rhythms, Sinus bradycardia is still a sinus rhythm. Simply saying sinus rhythm doesn't tell a person if its a normal sinus rhythm of an abnormal one.

If you say normal sinus rhythm is distinguishes it from a brady sinus rhythm or tachy sinus rhythm.

It hardly matters, but things like this bug me.

What do you guys and gals think.

 

[MrBrown]

I say your lecturer is sort of kinda right in a round-about pedantic sort of a way mate as I have heard both terms used but use NSR myself like 99% of the time.

I looked in both my A&P textbook (Marieb, 7e) and around the web and I can't find a workable definition of "sinus" - i.e. sinus rhythm comes from the sinoatrial node. "Sinus" seems to be majorily defined as a hollow space inside a bone or organ which makes no real sesne to me at 2am but anyway ....

A "rhythm" implies a pattern obviously and broadly speaking in cardiology I was taught a "rhythm" is one which is "regular" (i.e. when I learnt ECG interpretation - OK I take that back heck I am STILL learning lol - we were taught to ask 'is this rhythm regular? (ie normal)' and 'is the rate regular?') so I personally would use the term "arrythmia" to describe any abnormal rhythm.

So all that said .... I would go with "sinus rhythm" to imply a normal rhythm that is originating from the SA node.

-Brownie

 

[Ridryder911]

I say your lecture is correct as well. Really, what is a "normal" sinus in compared to any other sinus rhythm with the correct rate and variables? The others you described such as Sinus bradycardia are arrhythmias. Kinda like vital signs "within normal limits"....

My other pet peeve is those to call rhythms such as "first degree AV block"; etc... What is the underlying rhythm and then tell me the arrhythmia or condition. I have seen other rhythms that can produce the same arrhythmias such as A-fib with third degree block, etc..

R/r 911

 

[Aidey]

When writing it down I tend to use the term Sinus Rhythm, or Regular Sinus Rhythm. Our charting software has a drop down list of options when charting rhythms anywhere but your narrative, and it too says "Sinus Rhythm".

Just to irritate rid though, the program doesn't offer an underlying rhythm option when charting 1st degree blocks or other such things.

 

[EMS49393]

I was taught "sinus rhythm." Actually, my instructor frowned on the use of "normal" with sinus rhythm, because normal is different for every patient.

Maybe it's my teachers fault, but I really do not like the word "normal." My normal is not your normal is not Bill's or Steve's or Jane's normal. A good example of that is the glucose level. "Normal" 70-120 mg/dL give or take 10 either direction depending on your service. My Grandmom lived in the low 300's mg/dL. She'd get to 150 and be exhibiting the signs and symptoms of a hypoglycemic. Her "normal" was not the "normal" normal. My normal blood pressure is 90/60, and it's even lower when I'm sleeping. I'm certainly not sick, but that finding can shake a paramedic up if they don't bother to ask the patient if they know what their normal blood pressure happens to be.

My other pet peeve is the saying "vital signs are within normal limits." Normal for whom? Brady? Mosby? Your patient? My vocabulary views the word normal as slang for "I'm too lazy to do it, to figure it out, and/or tell you."

 

[EMS49393]

I just reread Rid's post. Bob Page also taught us that there is no such thing as just an AV block. There is always an underlying rhythm. I chart "sinus rhythm with a first degree AV block," etc.

 

[Melclin]

I just reread Rid's post. Bob Page also taught us that there is no such thing as just an AV block. There is always an underlying rhythm. I chart "sinus rhythm with a first degree AV block," etc.

Exactly why having a term like normal sinus rhythm is a good idea. Differentiate between that and other sinus rhythms with ab-normalities.

Another word that bugs me. Arrythmia. This is an old one. It should be dysrythmia....surely the only arrythmia is asystole. I spose you could say that "without rhythm" could mean anything irregular. Still, irregular rhythms still have a rhythm to them, its just problem with it. Hence the dys- prefix.

My other pet peeve is those to call rhythms such as "first degree AV block

AH! I was sitting with someone looking at some ECGs the other day and I get asked what the rhythm is. I said,"sinus rhythm", and he replies with the answer, "no no its a first degree AV block". I raged for many moons that an AV block is not a rhythm per se.