What is important when idetifying an ECG?
Confirm the patients name and age along with the ECG date
What is the standardisation of an ECG?
- 1cm = 1mV
- Paper speed = 25mm/sec
How is the rate of an ECG calculated?
300 divided by the number of big squares per R-R interval
What ECG lead is used to calculate the rate?
What is normal rate?
What does an ECG record?
electrical impulses start and how they flow through the heart.
Where does the elctrical activity of the heart start?
"internal pacemaker" called the sinoatrial node
What is normal rhythm referred to as?
What is conduction?
The way electrical impulses floe through the heart
When should you take an ECG?
- Chest pain
- an episode of synocope (blackout)
- unexplained fall
What plane do the chest leads look at the heart from?
What plane do the 6 limb leads look at the heart from?
What is sinus rhythm?
- Normal P waves (2.5 boxes)
- Normal QRS complex (3 boxes)
- One P wave followed by one QRS complex
How do you check if rhythm is regular?
Mark position of 3 successive R waves.
Slide the mark forward and check that intervals are equal
Characteristics of Atrial Fibrillation
- No discernible P waves
- Irregular QRS complex
Charactertistics of Atrial Flutter
- P waves can be seen at a rate of 300bpm, giving a saw-toothed appearance
- 4 P waves per QRS complex
- Ventricular activation is regular
Characteristics of Nodal Rhythm
- Normal QRS complex
- P waves are absent
Another name for nodal rhythm
Characteristics of Ventricular Rhythm
- two sinus beats and the rate increases to 150bpm
- QRS complex becomes broad and T waves are difficult to identify
- Final beat shows a return to sinus rhythm
What does the P wave represent?
In what leads in the P wave upright?
In what conditions are P waves absent?
- Atrial fibrillation
- Nodal (junctional) rhythm
What is the maximum height of a P wave?
What occurs in abnormal P wave; P-Mitrale
2 P waves per QRS complex
What causes a bifid P wave?
left atrial hypertrophy
What occurs in abnormal P waves; P-Pulmonale
P wave is too tall
What causes a peaked P wave?
Right atrial hypertrophy
What is the P-R interval
Bgeining of P wave to the beginning of Q wave