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lectroCardioGraphyraphy ECG made extra easy
2 Overview Objectives for this tutorial What is an ECG? Overview of performing electrocardiography on a patient Simple physiology Interpreting the ECG
3 Objectives By the end of this tutorial the student should be able to: State a definition of electrocardiogram Perform an ECG on a patient, including explaining to the patient what is involved Draw a diagram of the conduction pathway of the heart Draw a simple labelled diagram of an ECG tracing List the steps involved in interpreting an ECG tracing in an orderly way Recite the normal limits of the parameters of various parts of the t ECG Interpret ECGs showing the following pathology: MI, AF, 1st 2 and 3 degree heart block, p pulmonale,, p mitrale,, Wolff- Parkinson-White syndrome, LBBB, RBBB, Left and Right axis deviation, LVH, pericarditis,, Hyper- and hypokalaemia,, prolonged QT.
4 What is an ECG? ECG = Electrocardiogram Tracing of heart s s electrical activity
5 Recording an ECG
6 Overview of procedure GRIP Greet, rapport, introduce, identify, privacy, explain procedure, permission Lay patient down Expose chest, wrists, ankles Clean electrode sites May need to shave Apply electrodes Attach wires correctly Turn on machine Calibrate to 10mm/mV Rate at 25mm/s Record and print Label the tracing Name, DoB,, hospital number, date and time, reason for recording Disconnect if adequate and remove electrodes
7 Electrode placement 10 electrodes in total are placed on the patient Firstly self-adhesive dots are attached to the patient. These have single electrical contacts on them The 10 leads on the ECG machine are then clipped onto the contacts of the dots
8 Electrode placement in 12 lead 6 are chest electrodes Called V1-6 6 or C1-6 4 are limb electrodes Right arm Left arm Left leg Right leg Ride Your Green Bike ECG Remember The right leg electrode is a neutral or dummy!
9 Electrode placement For the chest electrodes V1 4 th intercostal space right sternal edge V2 4 th intercostal space left sternal edge (to find the 4 th space, palpate the manubriosternal angle (of Louis) Directly adjacent is the 2 nd rib, with the 2 nd intercostal space directly below. Palpate inferiorly to find the 3 rd and then 4 th space V4 over the apex (5 th ICS mid-clavicular line) V3 halfway between V2 and V4 V5 at the same level as V4 but on the anterior axillary line V6 at the same level as V4 and V5 but on the mid-axillary line
10 Recording the trace Different ECG machines have different buttons that you have to press. Ask one of the staff on the ward if it is a machine that you are unfamiliar with. Ask the patient to relax completely. Any skeletal muscle activity will be picked up as interference. If the trace obtained is no good, check that all the dots are stuck down properly they have a tendency to fall off.
12 Electrophysiology Pacemaker = sinoatrial node Impulse travels across atria Reaches AV node Transmitted along interventricular septum in Bundle of His Bundle splits in two (right and left branches) Purkinje fibres
13 Overall direction of cardiac impulse
14 How does the ECG work? Electrical impulse (wave of depolarisation) picked up by placing electrodes on patient The voltage change is sensed by measuring the current change across 2 electrodes a positive electrode and a negative electrode If the electrical impulse travels towards the positive electrode this results in a positive deflection If the impulse travels away from the positive electrode this results in a negative deflection
15 Away from the electrode = negative deflection Towards the electrode = positive deflection Direction of impulse (axis)
16 Types of Leads Coronal plane (Limb Leads) 1. Bipolar leads 2. Unipolar leads Transverse plane V 1 V 6 (Chest Leads) l, l l, l l l avl, avr, avf
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For students of all the branches of medicine and surgery and health professionals that aspire to be greater and better at their procedures and medications. A renowned book by those who have read it and learnt from it. Many have already ordered it and is on the way to their home. Whether you work in the USA, Canada, UK or anywhere around the world. If you are working as a health professional then this is a must read.
The most reviewed ECG Made Extra Easy PDF 2022 Free Download on available for grabs now here on our website free. Whatever books, mainly textbooks we have in professional courses specially Medicine and surgery is a compendium in itself so understand one book you need to refer another 2-10 books. Beside this there are various other text material which needs to be mastered!! Only reference books are partially read but all other books have to be read, commanded and in fact read multiple times
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