ECG Recognition

ECG

Each small box is what vertically?

0.1 mV and 1 mm

Each small box is what horizontally?

0.04 seconds 1mm

How many small boxs in a big box?

5

Each large box is how many millivotls?

0.5 mV

Each large box is how many second long?

0.20 seconds

2 large boxs is what?

1 mV & 0.40 seconds

How many large boxs in a 6 second strip?

30

A p-wave should be how many second long?

less than 0.12 second

or

3 small boxs

The PRI should be how many seconds long?

between 0.12 & 0.20 seconds

or

3 to 5 small boxs

What is the aplitude of the p-wave in limb leads?

Less than 2.5 mm

or

Less than 2 ½ small boxs

What is the amplitude of a p-wave in the precordial leads?

Less than 1.5 mm

or

1½ small boxs

The p-wave represents the heart doing what?

Atrial Depolarization

The QRS represents the heart doing what?

Ventricular Depolarization

The t-wave represents the heart doing what?

Repolarization of ventricles

What is the duration of the QRS

0.04-0.12 seconds

A normal t-wave should have an amplitude of how many millimeters in limb leads?

Less than 5 mm

or

less than 5 small boxs

or

less than 0.5 mV

A normal t-wave should have an amplitude of how many mm in the precordial leads?

Less than 10 mm

or

10 small boxs

or

1 mV

From what points is the Absolute Refractory Period

From Q to Apex-T

From what points is the Relative Refractory Period

Apex-T to end of the T

What is the 6 second method?

Count the # of complexes in a 6-second interval Multiple number X 10

What is the R to R Interval Method?

-Accurate only if the heart rhythm is regular

-Measure the duration between the R waves in seconds then divide 60 by this number

-Example-22 small boxes X 0.04 = 0.88 seconds 60 / 0.88 = 68 beats per minute

or

Accurate only if the heart rhythm is regular Count the number of big boxes between the R waves then divide 300 by this number 300 / 4 = 75

or

Accurate only if the heart rhythm is regular Count the number of small boxes between the R waves then divide 1500 by this number 1500 / 22 = 68

What is the Triplicate Method?

Find a R wave located on a big line Count over the big boxes till the next R wave 300, 150, 100, 75, 60, 50, 43 and 38

ECG Interpretation 3rd Step

Are P waves present? –Are P waves regular?–Do all P waves look the same?– Are P waves upright or inverted?– Is there a P wave for each QRS complex?

What is the ECG-Systematic Approach

Name this rhythm

Name this rhythm

Name the rhythm

Name the rhythm

Name the rhythm

Name the rhythm

Name the rhythm

with a PVC

Name the rhythm

What leads are going to view the Septal Wall?

Which leads are going to view the Anterior Wall

What leads are going to view the Lateral Wall?

What leads are going to view the Lateral Wall?

What leads are going to view the Lateral Wall?

Which lead are going to see the Inferior Wall?

Name this rhythm

Name this rhythm

Name this rhythm

Name this rhythm

Name this rhythm

Name this rhythm

Name this rhythm

Name this rhythm

If the R is far from the P, then you have a FIRST DEGREE!

longer, longer, drop, then you have a WENCKEBACH!

If some Ps don’t get through, then you have a MOBITZ II!

If Ps and Qs don’t agree, then you have a THIRD DEGREE!

What medication is the preferred antiarrhythmic for the treatment of Torsades de Pointes (TdP)?

Magnesium Sulfate

What is the initial dose of Diltiazem for the control of Atrial Fibrillation with RVR

0.25 mg per kg max dose of 20 mg

What is the initial dose of Adenosine for the treatment of SVT?

6 mg rapid IV push with a 20 mL flush

A Ventricular tachycardia rhythm would present with a ventricular rate greater than ____ beats per minute.

Greater than 100 beats per minute.