Scribd
Upload
314 views52 pages

Introd To ECG Code Blue Champs March 2019

The document discusses the basics of ECG interpretation including: 1. Identifying different types of cardiac rhythms on an ECG such as sinus bradycardia, first degree heart block, and ventricular fibrillation. 2. Calculating heart rate using different methods such as counting QRS complexes in a 6 second strip or measuring the distance between R waves. 3. Understanding the components of a normal ECG including the P wave, QRS complex, T wave, and their intervals like the PR interval and QT interval.

Uploaded by

james rukenya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
314 views52 pages

Introd To ECG Code Blue Champs March 2019

The document discusses the basics of ECG interpretation including: 1. Identifying different types of cardiac rhythms on an ECG such as sinus bradycardia, first degree heart block, and ventricular fibrillation. 2. Calculating heart rate using different methods such as counting QRS complexes in a 6 second strip or measuring the distance between R waves. 3. Understanding the components of a normal ECG including the P wave, QRS complex, T wave, and their intervals like the PR interval and QT interval.

Uploaded by

james rukenya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 52

1

LEARNING OBJECTIVES
1. Describe the basic approach to ECG
interpretation

2. Outline calculation heart rate given a 6 second


ECG strip

3. Identify different types of ECG rhythms of


interest to ACLS

4. Brief introduction to the 12 Lead ECG


Pacemakers of the Heart

SA Node - Dominant


pacemaker with an intrinsic
rate of 60 -100
beats/minute.

AV Node - Back-up


pacemaker with an intrinsic
rate of 40 - 60
beats/minute.

Ventricular cells - Back-up


pacemaker
4 with an intrinsic
rate of 20 - 45 bpm.
.

5
.

6
The Electrocardiogram

Defines the graphic representation of the


cardiac electrical activity

The printed record of the electrical activity


of the heart is called a rhythm strip or an
ECG strip.

It is an important diagnostic tool.


7
ECG PAPER

8
ECG PAPER
Amplitude in MV

Time in seconds
ECG AND ELECTRICAL ACTIVITY

The normal electrocardiogram consists of a P


wave, QRS complex, and T wave.
A U wave sometimes may be seen after the T
wave.
Other key parts of the ECG include ; the P-R
interval, ST segment, and Q-T interval.
The combination of these waves represents a
single heartbeat,or one complete cardiac
cycle
10
Determining the heart rate

1. 6-Second Method: Have a six second strip, count


the QRS complexes and multiple by 10.

11
Determining the heart rate

2. Using Triplicate Method

Accurate only under two circumstances: when the


rhythm is regular and the heart rate is greater
than 50 beats/minute.

To use this method, memorize two sets of numbers:


300-150-100 and 75-60-50.
12
Determining the heart rate-RR
method

Method 3. Count the large squares between the peaks of


two consecutive R waves. Divide this number into 300 to
obtain the heart rate

13
Determining the heart rate-RR
method
Method 4. Count the small squares between the peaks of
two consecutive R waves. Divide this number into 1500 to
obtain the heart rate

14
Steps in Rhythm Analysis

Step 1:Assess P wave.


Step 2: Determine Rhythm
Step 3: Calculate rate.
Step 4: Determine fast or slow
Step 5: Determine PR interval.
Step 6: Determine QRS duration.
THEN INTERPRETATION
15
Step 1: Assess the P waves

Are there P waves?


Do the P waves occur at a regular rate?
Is there one P wave before each QRS?

16
Step 2:Determine Rhythm;

Regular or irregular

Measure ventricular rhythm by measuring the


interval between R to-R waves and atrial rhythm
by measuring the P to-P waves.

Heart rhythm are classified as regular or


irregular.
17
Step 3 and 4:Determine Rate, fast or slow

The normal adult heart rate is 60 to 99 beats/minute.

A ventricular rate less than 60 beats/minute is considered


bradycardia.

a rate equal to or greater than 100 beats/minute -


tachycardia.

18
Step 5: Determine PR interval

Normal: 0.12 - 0.20 seconds.


(3 - 5 boxes)

Interpretation? 0.12 seconds

19
Step 6:Determine QRS duration

1. Wide QRS complexes greater than 0.12 secs (3


small boxes) is of ventricular in origin.

2. Narrow QRS complexes less than 0.04 seconds (1


small box) is supraventricular in origin.

3. Are QRS complexes similar in appearance across


the ECG strip?
20
Rhythm Practice

Rate ?
Fast or slow ?
Rhythm/Regularity ?
P waves ?
PR interval ?
QRS duration ?
21
Interpretation?
Rh

22
Sinus Bradycardia

23
First degree heart block
• PR Interval is prolonged
• Heart Rate may be low or normal
Second degree heart block
– Type 1: Also called Mobitz 1 or Wenckebach
– Progressive prolongation of the PR interval till
there is a dropped beat
Second degree heart block
– Type 2: Also called Mobitz 2 or Non-Wenckebach
– Constant PR interval till there is a dropped beat
– Normal or prolonged PR interval
Third degree heart block
– Also called Complete heart block

– Regular P-P interval and R-R interval

– No relationship between P waves and QRS complexes

– More P’s are present than QRS complexes


Sinus Tachycardia
• Rate above 100
• Regular rhythm
• P before each QRS

28
Supraventricular tachycardia

• Narrow complex QRS


• Regular rhythm
•

29
Atrial Fibrillation:
• Narrow complex QRS rhythm
• Irregular

30
31
32
Monomorphic Ventricular
Tachycardia

Fast and wide QRS


33
Polymorphic Ventricular Tachycardia

Fast and wide QRS; Special “winding”


pattern called Torsades de pointes
34
Ventricular Fibrillation

Fast and wide; chaotic shapes in irregular


pattern
35
Pulseless Electrical Activity (PEA)

The presence of an organised rhythm

without a palpable pulse

(excluding VT and VF) on cardiac monitor.

There is some electrical function that does

not
36 culminate to a ventricular contraction
12 Lead ECG

• Presents the electrical heart activity

• Uses 10 electrodes to generate 12 different


views

37
Coronary circulation

38
Lead placement in 12 lead ECG

41
Lead placement in 12 lead ECG

• .

42
12 lead ECG strip

43
Inferior Leads; 11, 111, AVF

aVR aVL

0° I
v1 v2
v3
v4
v5 v6

III aVF
II
Septal Leads – v1, v2
Anterior Leads – v3, v4

aVR aVL
Anterior/Septal Leads

0°I
v1 v2
v3
v4
v5 v6

III aVF II
Anterior Surface
 The front of the heart viewing the left ventricle and the
septum
 Leads V1, V2, V3 and V4 look towards this surface
 Mostly fed by the Left Anterior Descending branch of the
Left artery
49
Lateral Leads

aVR aVL

0°I
v1 v2
v3
v4
v5 v6

III aVF II
Lateral Surface
 The left sided wall of the left ventricle
 Leads V5 and V6, I and avL look at this surface
 Mostly fed by the Circumflex branch of the left artery

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy