Intro to EKG: Interpreting EKGs

0.2

One large box, at normal paper speed, is equivalent to _._ seconds and is made up of 5 small boxes

300, 1500

Determining Heart Rate with a Normal Rhythm

-# of large boxes between RR cycles: ____/# of large boxes between R waves

-# of small boxes between RR cycles: ____/# of small boxes between R waves

R, 6, 10

Determining Heart Rate with an Irregular Rhythm

-Count the number of _ waves in a _-second strip (30 large boxes) and multiply by __

60-100

The normal range for heart rate is __-___ bpm

sinus, upright, II, 3

Atrial Sinus

-Produces normal/abnormal _______ rhythms, showing if the SA node is firing regularly

-You can determine if the rhythm is sinus by seeing if the P wave is ________ in lead __ and if there is regularity in the beats with less than _ small boxes difference

rate, axis, morphology

Reading EKGs: Order of Operations

1. Determine _____

2. Examine rhythm

3. Note the _____

4. Intervals

5. Hypertrophy

6. __________

90, -30

If the average vector is between __ and ___, then it is normal

-30, -90

If the average vector is between ___ and ___, then there is left axis deviation

90, 180

If the average vector is between __ and ___, then there is right axis deviation

-90, 180

If the average vector is between ___ and ± ____, then it is an indeterminate/northwest axis deviation

positive, positive

Normal QRS Axis

-The QRS complex is _______ in Lead I and _______ in aVWF

negative, positive

Right Axis Deviation

-The QRS complex is ________ in Lead I and _______ in aVF

positive, negative

Left Axis Deviation

-The QRS complex is ________ in Lead I and ________ in aVF

negative, negative

Northwest/Indeterminate Deviation

-The QRS complex is ________ in lead I and _________ in lead aVF

.12, .2, .12, .42

Normal Rates and Reference Ranges

-HR = 60-100 bpm

-P wave = < .__ seconds

-PRI = .12-._ seconds

-QRS complex = < .__ seconds

-QT interval = .__ seconds

-T wave = more concerned with morphology

depolarization, 3

P Wave

-Represents atrial ____________

-Count from beginning of wave to end of wave

-Should be < 0.12 sec (<_ small boxes), can also count half boxes

P, QRS, atrial, ventricular

P-R Interval

-Measure from the beginning of the _ wave to beginning of ___ complex

-Represents the time to travel through _______ muscle to _________ muscle

-Normal is .2 seconds

ventricular, .12

QRS Complex

-Represents ___________ depolarization

-Normal value is < .__ seconds

-Measure from start of Q wave to the end of S wave (aka J point)

repolarization, flat

ST Segment

-Represents early ___________

-Usually ____, AKA isoelectric

-Important in exercise testing, for it indicates oxygenation

repolarization, resting

T Wave

-Ventricular ____________, which is the return of stimulated muscle to _______ state

-Before the next cardiac cycle can begin

normal, 60-100

Normal Sinus Rhythm

-Rate, rhythm, intervals, and morphology are _______

-Rate = __-___ BPM

-Rhythm = regular

-Intervals = less than 3 small boxes

normal, less

Sinus Bradycardia

-Rhythm, intervals, and morphology are _______

-The heart rate is _____ than 60 bpm

normal, 100, separate

Sinus Tachycardia

-Rhythm, intervals, and morphology are ______

-Rate is greater than ___ bpm

-P and T wave must be __________ to be considered sinus tachy

irregular, intervals, 3

Sinus Arrhythmia/Dysrhythmia

-Rate, intervals, and morphology are normal

-Rhythm is _________

-R-R ________ vary by _ or more intervals, switching between longer and shorter periods of time