ECG MADE EASY.ppt

8/17/2019 ECG MADE EASY.ppt

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MAKING ECG’S EASYMAKING ECG’S EASY

APPLICATION FOR THEAPPLICATION FOR THE

ECGECG

EVALUATING THE ECGEVALUATING THE ECG


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Upon completion oneUpon completion one

will be able to:will be able to:• Describe wh! " ECG is#Describe wh! " ECG is#

• Describe !he $r%$er h%%&'($Describe !he $r%$er h%%&'($

$r%ce)(re *%r +,'Le) ECG$r%ce)(re *%r +,'Le) ECG

• I)e"!i*- bsic "%r./ ECGI)e"!i*- bsic "%r./ ECG

w0e*%r. .%r$h%/%1-#w0e*%r. .%r$h%/%1-#

• Dis!i"1(ish be!wee" bsic ECGDis!i"1(ish be!wee" bsic ECG

rrh-!h.i ") r!i*c!#rrh-!h.i ") r!i*c!#


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2UICK REVIE3 OF2UICK REVIE3 OF

HEARTHEART

P(r$%seP(r$%se

• P(.$s b/%%)P(.$s b/%%)

4sic A"!%.-4sic A"!%.-

•

5 ch.bers5 ch.bers• , si)es, si)es

• 5 0/0es5 0/0es


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THE CONDUCTINGY

HE CONDUCTINGY

SYSTE

YSTE

• SA N%)eSA N%)e

• I"!er'"%)/I"!er'"%)/

$!hw-$!hw-• AV N%)eAV N%)e

• 4(")/e %* HIS4(")/e %* HIS

• 4(")/e 4r"ches4(")/e 4r"ches• P(r&i"6e FibersP(r&i"6e Fibers


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RELATIONSHIPRELATIONSHIP


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CARDIAC CYCLESCARDIAC CYCLES


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+, LEAD ECG+, LEAD ECG

Ler"i"1 %b6ec!i0es7Ler"i"1 %b6ec!i0es7

Describe !he c%rrec!Describe !he c%rrec!

$/ce.e"! %* // e/ec!r%)es$/ce.e"! %* // e/ec!r%)es

Pr%$er S&i" $re$r!i%"Pr%$er S&i" $re$r!i%" Cre %* !he ECG .chi"e8 wiresCre %* !he ECG .chi"e8 wires

") e/ec!r%)es") e/ec!r%)es


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Pri"ci$/es %*Pri"ci$/es %*

E/ec!r%cr)i%1r$hE/ec!r%cr)i%1r$h

• E/ec!r%cr)i%1r$h 9 is !heE/ec!r%cr)i%1r$h 9 is !he

i"s!r(.e"! !h! rec%r)s !hei"s!r(.e"! !h! rec%r)s !he

e/ec!ric/ c!i0i!- %* !he her!e/ec!ric/ c!i0i!- %* !he her!

• E/ec!r%cr)i%1r. :ECG; is !heE/ec!r%cr)i%1r. :ECG; is !he

rec%r) %* !h! c!i0i!-rec%r) %* !h! c!i0i!-


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HOOKING UP THEHOOKING UP THE

+,'LEAD ECG+,'LEAD ECG

• Pr%$er s&i" $re$Pr%$er s&i" $re$

• P/ce.e"! %* !he /i.bP/ce.e"! %* !he /i.b

e/ec!r%)ese/ec!r%)es

•

P/ce.e"! %* !he ches!P/ce.e"! %* !he ches!e/ec!r%)ese/ec!r%)es


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SKIN PREPARATION

KIN PREPARATION

• REASON FOR SKINREASON FOR SKIN

PREPARATIONPREPARATION

• < STEP METHOD< STEP METHOD• , STEP METHOD, STEP METHOD


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ELECTRODEELECTRODE

PLACEMENTPLACEMENT

• LIM4 LEADSLIM4 LEADS

• CHEST LEADCHEST LEAD


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LIM4 LEADSLIM4 LEADS

• 4i$%/r /e)s4i$%/r /e)s

I II IIII II III

• A(1.e"! /e)sA(1.e"! /e)s

A0r A0/ A0* A0r A0/ A0*


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CHEST LEADSCHEST LEADS

• = UNIPOLAR= UNIPOLAR

LEADSLEADS

• V+V+• V,V,

• V>V>

• V5V5• V


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LETS REVIE3LETS REVIE3

• 3h! is " ECG3h! is " ECG

• 3h! re !he /i.b /e)s?3h! re !he /i.b /e)s?

• 3h! re !he ches! /e)s?3h! re !he ches! /e)s?

• 3h- )% s&i" $re$?3h- )% s&i" $re$?


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+,'LEAD ECG LAYOUT+,'LEAD ECG LAYOUT


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INFORMATION ON THEINFORMATION ON THE

ECGECG

• P!ie"!s )e.%1r$hicsP!ie"!s )e.%1r$hics

• Her! r!e ") .es(re.e"!sHer! r!e ") .es(re.e"!s

• S$ee) ECG is rec%r)e) !S$ee) ECG is rec%r)e) !

• V%/!1e ECG is rec%r)e) !V%/!1e ECG is rec%r)e) !• 3h! !he *i/!er is se! %"3h! !he *i/!er is se! %"


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INFORMATION ON THEINFORMATION ON THE

+,'LEAD ECG+,'LEAD ECG


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3HAT YOU NEED TO3HAT YOU NEED TO

LOOK FORLOOK FOR

• Are !he /i.b /e)s h%%&e) ($Are !he /i.b /e)s h%%&e) ($

c%rrec!/-?c%rrec!/-?

• Are !he ches! /e)s h%%&e) ($Are !he ches! /e)s h%%&e) ($

c%rrec!/-?c%rrec!/-?

• Is !he ECG *ree %* r!i*c!#Is !he ECG *ree %* r!i*c!#

• Is !his ECG Cri!ic/ V/(eIs !his ECG Cri!ic/ V/(e


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IS !he ECG HOOKED UPIS !he ECG HOOKED UP

CORRECTLY?CORRECTLY?


N%r./ +,'/e)N%r./ +,'/e)

• AVR 9 /w-sAVR 9 /w-s"e1!i0e"e1!i0e

• Le) I 9 /w-sLe) I 9 /w-s$%si!i0e$%si!i0e

• Le) II8 III 9Le) II8 III 9$%si!i0e %r$%si!i0e %rbi$hsicbi$hsic


COLUMN IIICOLUMN III

•

R w0e $r%1ressi%"R w0e $r%1ressi%"• S.// !% T//S.// !% T//

COLUMN IVCOLUMN IV

• R w0e $r%1ressi%"R w0e $r%1ressi%"

• T// !% S.//T// !% S.//


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RULING OUT LIM4 LEADRULING OUT LIM4 LEAD

REVERSALREVERSAL

• A0r is /w-s "e1!i0eA0r is /w-s "e1!i0e

• Le) I is /w-s $%si!i0eLe) I is /w-s $%si!i0e

• Le) II ") III $%si!i0e *%r !he PLe) II ") III $%si!i0e *%r !he Pw0e ") (s(//- !he 2RS c%.$/e@w0e ") (s(//- !he 2RS c%.$/e@


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COLUMN IIICOLUMN III

•

R w0e $r%1ressi%"R w0e $r%1ressi%"• S.// !% T//S.// !% T//

COLUMN IVCOLUMN IV

• R w0e $r%1ressi%"R w0e $r%1ressi%"

• T// !% S.//T// !% S.//


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OTHER PRO4LEMSOTHER PRO4LEMS

3ITH THE ECG3ITH THE ECG

• Ar!i*c!Ar!i*c!

• E/ec!ric/ i"!er*ere"ceE/ec!ric/ i"!er*ere"ce

• S%.!ic !re.%r S%.!ic !re.%r

• 3")eri"1 bse/i"e3")eri"1 bse/i"e


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EINTHOVENS TRIANGLEEINTHOVENS TRIANGLE


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ARTIFACT ON THE ECGARTIFACT ON THE ECG


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FIND THE ARTEFACTFIND THE ARTEFACT


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3ANDERIN 4ASELINE3ANDERIN 4ASELINE


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SOMATIC TREMORSOMATIC TREMOR


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4ASIC CRITICAL4ASIC CRITICAL

VALUESVALUES

• 4r)-cr)i 9 HR4r)-cr)i 9 HR 5Bb$.5Bb$.

• Tch-cr)i HRTch-cr)i HR +,Bb$.+,Bb$.

• PVC’s ' 5 %r .%re i" r%wPVC’s ' 5 %r .%re i" r%w

•

ST E/e0!i%"ST E/e0!i%"


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LOOKING AT THELOOKING AT THE

RHYTHMRHYTHM

• E0/(!e !heE0/(!e !he

rh-!h. s!ri$ !rh-!h. s!ri$ !

!he b%!!%. %*!he b%!!%. %*!he +,'/e) *%r!he +,'/e) *%r

!he *%//%wi"1!he *%//%wi"1

• Is !he rh-!h.Is !he rh-!h.

re1(/r %rre1(/r %r

irre1(/r?irre1(/r?• Is !here PIs !here P

w0e be*%rew0e be*%re

e0er- 2RSe0er- 2RS

c%.$/e@c%.$/e@• Are !he- "-Are !he- "-

b"%r./ be!s#b"%r./ be!s#


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FINDING THE HEARTFINDING THE HEART

RATERATE

• > METHODS> METHODS

• RATE RULERRATE RULER

• COUNTINGCOUNTING

• 4O METHOD4O METHOD


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4O METHOD4O METHOD


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ECTOPIC 4EATSECTOPIC 4EATS


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ECTOPIC 4EATSECTOPIC 4EATS


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LETS SUMMARIELETS SUMMARIE

H%w )% we $r%)(ce " e@ce//e"!H%w )% we $r%)(ce " e@ce//e"!

+,'/e) ECG?+,'/e) ECG?

Pr%$er s&i" $re$Pr%$er s&i" $re$

C%rrec! e/ec!r%)e $/ce.e"!C%rrec! e/ec!r%)e $/ce.e"!

Rec%1"ie ") &"%w h%w !%Rec%1"ie ") &"%w h%w !%

c%rrec! $r%b/e.sc%rrec! $r%b/e.s

Rec%1"ie bsic cri!ic/ 0/(esRec%1"ie bsic cri!ic/ 0/(es

ECG MADE EASY.ppt

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