1. Is t here a P wave for eve ry QRS? 2. Are all wav es ( P, QRS, T) p res ent ? 3. Is the P wave Upr!ht n "ea#s I, II, an# III? (I$ T%& A'S T&&' '& $ T%&S& IS ', T%&' $""* T%& no SI+& $ T%& %ART.) -&S to A"" SI'US R%-T%/ 1. Prolon!e# P0R nterval? (.2se, or 4 s5all 6o7es) 2. ST0se!5ent elevaton? 1 st DEGREE (INCOMPLETE) HEART BLOCK 8PR0nterval .2se8SI'US R%-T%/ 86en!n, no 9r!ent nterventon re:9re#. ST SEGMENT ELEVATION = DIASTOLIC CURRENT OF INJURY = TP SEGMENT anPR SEGMENT DEPRESSION 8#ea# ells 5antan onstant ne!atve har!e 8the only t5e the whole heart s s9ppose# to 6e ne! s #9rn! ST se!5ent (ventrles o5pletely #epolar;e#) 8th9s, ST se! stays where t<s s9ppose# to 6e, on soeletrlne, the rest of the se!5ents are #epresse# wth #ownwar# #efleton. 8SI'US R%-T%/ 8ath la6 an#=or lyts (ath preferre#) EKG Int!"#"!tat$%n A&'%"$t($n*&+$n' M!an E&!*t"$*a& A,$s Can'!s) (,s $n &$'t -&+!= ,s $n &$'t -&+!= s%*.a-&! "/ts s%*.a-&! "/ts0 t!,t $n #$n. = %nt n!!t% .n%2 3%" M$n$ II) -es -es 3. ther P wave han!es? -es GENERAL ATRIAL HYPERTROPHY >. QRS o5ple7 han!es n net eletral #evaton fro5 lst ? ('et "ea#s I, II, av$, a", 4, @ 'et 0 aR, 1) 4. /&A 0BC or 3C? -es to Any MEAN ELECTRICAL A4IS DEVIATION (see R for al9laton 5etho#s) **note, MEA deviations can be present in pts with non-sinus rhythms, but they are not reproduced on the next page. LEFT A4IS DEVIATION 8patholo!a9ses nl9#e L V!nt"$*+&a" H/#!"t"%#/0 In3!"$%" MI0 E#/s!a0 S/st!$* HTN0 A%"t$* Va&5! St!ns%s$s 8physolo!a9ses nl9#e athleton#tonn! RIGHT A4IS DEVIATION 8patholo!a9ses nl9#e R V!nt"$*+&a" H/#!"t"%#/0 Lat!"a& MI0 P+&%na"/ HTN0 P+&%na"/ Va&5! St!n%s$s0 VSD0 T!t"%&%'/ %3 Fa&&%t 8physolo!a9ses nl9#e tall, thn a#9lt, an# hl#hoo#, h!h altt9#e 1. /&A 03C to 0BC? 2. /&A BC to 14C? H%2 t% Ca&*+&at! MEA6 S!$78+ant$tat$5! Est$at!6 1."ooD for a lea# wth appro7. net eletral #evaton . 2.+raw a lne on the /&A #a!ra5 that s perpen#9lar to the net lea# 3.'ow yo9 Dnow t has to 6e ether the postve or the ne!atve porton of that perpen#9lar lne . >.hoose any one of the other lea#s an# #raw the 30se!5ent on eah s#e ar, an# whhever half of the perpen#9lar lne the arrosses, s yo9r /&A. S!$78+ant$tat$5! L%n' V!"s$%n6 1.&sta6lsh the net ne!atvty or postvty of eah lea# on the s7 l56 lea#s (I, II, II, a$, aR, ") 2.n the /&A #a!ra5, #raw a E30se!5ent on eah s#e E on ether the postve or the ne!atve porton of eah lea#, aor#n! to the &FG 3.The /&A 59st le wthn the we#!e whh has all s7 ars spannn! t. Ths !ves yo9 a ran!e of 3C for yo9r at9al /&A. 8+$*. anD$"t/6 1."ea#s I an# a$ are 6oth nor5al 2."ea# I s H an# a$ s R!ht A7s +evaton (RA+) 3."ea# I s an# a$ s 0 "A+ 8+ant$tat$5! 8+ant$tat$5! (not #es. here 6=re:9res r9ler) (not #es. here 6=re:9res r9ler)
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8/19/2019 EKG Flowchart Mini II Version and Regular