EKG : Info from Test

Pulmonary vein

Only vein that carries OXYGENATED BLOOD

Pulmonary artery

only artery that carries DEOXYGENATED BLOOD

Coronary Arteries

Blood vessels that carry blood to heart muscles

Pulmonary Arteries

Blood vessels that carry blood away from heart to lungs

Capillaries

Smallest blood vessels, where gas exchange takes place (carries oxygenated and deoxy granted blood)

Superior and Inferior Vena Cava

Blood vessels that empty into the right atria:

SA node

• Primary pacemaker

• 60-100/minute

AV junctional tissue

• 40-60/minute

Purkinje fibers

• 20-40/minute

Depolarization

Makes the heart muscle contract and blood to empty the chambers

Repolarization

Is electrical “rest” and allows for refilling of the chambers

An EKG may be ordered for someone experiencing…

ANGINA (chest pain)

[ Pectoral Angina is chest pain ]

If patient has had a right sided mastectomy…

Blood pressures should be obtained from left arm

If patient has droplet precautions ordered….

 they should wear a surgical/simple mask in the hall when transporting

If a patient has airborne/aerosolized precautions (for example TB)

they should wear a N95/Hepa filter respirator type mask

If a patient has contact precautions…

MA would wear gloves and gown

If you are unable to obtain a radial pulse…

use the carotid artery

A patient with yellow skin has…

jaundice

If you can’t see respiration visually, where would you put your hands to feel it?

 UPPER CHEST

Eupnea

normal, healthy breathing at rest

3-lead: Telemetry

RA, LA and LL

5-lead: Holter monitor

4 limb leads plus V1

12-lead: Stress test

Standard 12 lead EKG

Precordial leads are…

unipolar

V1

fourth intercostal space to right of sternum

V2

fourth intercostal space to left of sternum

V3

between V2 and V4

V4

 fifth intercostal space midclavicular

V5

fifth intercostal spacebetween V4 and V6

V6

fifth intercostal space mid axillary line

If there is a need for V7, V8 and V9 they just wrap around the left posterior ending with…

• V9 closest to the paraspinous border

Right Limb lead

Clouds over Grass

Left Limb lead

Smoke over Fire

Leads I, II and III are created BETWEEN…

Limb leads. Because they require two electrodes they are bipolar 

Right arm

negative

Left leg

positive

Left arm ( Lead I )

positive

Right arm-

negative

Left arm ( lead III)

Negative

Augmented leads aVR, aVL, aVF are….

unipolar

aVL LEFT ARM

Augmented by right arm and left leg

aVR RIGHT ARM

Augmented by left arm and left leg…

aVF left FOOT

augmented by right arm and left arm

There are only 10 ELECTRODES for a….

12 LEAD EKG (6 precordial and 4 limb electrodes)

White Lead

RA: Right arm just below the right clavicle

Black Lead

LA: Left arm just below the left clavicle

Red Lead

LL: Left leg or on the left lower chest

A transtelephonic monitor is….

a 30-day looping event monitor

V_{1 Lead}

4^th intercostal space, right sternal border

V_{2 Lead}

4^th intercostal space, left sternal border

V_{3 Lead}

Midway between V₂ and V₄

V_{4 Lead}

5^th intercostal space, midclavicular line

V_{5 Lead}

5^th intercostal space, on the anterior axillary line

V_{6 Lead}

5^th intercostal space, left midaxillary line

Quivering of heart indicate ventricular fibrillation (vfib)….

ALERT PROVIDER

For pediatric patients V3 is placed on the right side…

for patients under 8 years old)

The patient walks on a treadmill at progressively…

increasing speeds and inclines (stages) every three minutes. 

Condition that is contraindicated for a stress testing is…

CHF (congestive heart failure)

Stop a stress test if the patient is…

dizzy or becomes hypotensive

Would expect HR to increase, BP to increase, sweat

If you see asystole on EKG call…

“Code Blue”

Maximum Heart Rate =

220 - AGE

Target Heart Rate

Maximum Heart x %

6 Second Method

Can be used for both REGULAR and IRREGULAR HR

Sequence Method

• REGULAR HR

• 300 / large boxes

1500 Method

• REGULAR HR

• 1500 / Small Boxes

Wandering Baseline

• Patient movement

• Loose electrodes

• Dry electrodes

• Patient’s labored breathing

• Improper skin preparation (leaving traces of lotion, oil, or gel on the skin

Speed is on the…

horizontal plane

Gain (mV) is on the

vertical plane

Standard gain is…

2 big boxes (5x2=10 small boxes)

Standard paper speed is…

25 mm/sec

P Wave

Atrial depolarization

PR Interval

Duration 0.12-0.20

PR Segment

Duration 0.05-0.12 seconds

QRS Complex

Ventricular depolarization is represented by the QRS complex

ST Segment depression indicates…

Myocardial Ischemia

ST Segment Elevation

Indicates Myocardial Infarction

Bruce Protocol:

heart rate and rating of perceived exertion are taken every minute and blood pressure is taken at the end of each stage (every three minutes).