EKG Flowchart Mini II Version and Regular

8/19/2019 EKG Flowchart Mini II Version and Regular

http://slidepdf.com/reader/full/ekg-flowchart-mini-ii-version-and-regular 1/4

1. Is there a P wave for every QRS?2. Are all waves (P, QRS, T) present?

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# P0Rnterval? ( .2 se , or 4

s5all 6o7es)

2. ST0se!5entelevat on?

1st DEGREE(INCOMPLETE)HEART BLOCK

8PR0 nterval .2se

8SI'US R%-T%/86en !n, no 9r!ent

ntervent onre:9 re#.

ST SEGMENT ELEVATION =DIASTOLIC CURRENT OF

INJURY =TP SEGMENT an PR

SEGMENT DEPRESSION8#ea# ells 5a nta n onstant

ne!at ve har!e8the only t 5e the whole heart

s s9ppose# to 6e ne! s#9r n! ST se!5ent (ventr les

o5pletely #epolar ;e#)8th9s, ST se! stays where t<ss9ppose# to 6e, on soele trl ne, the rest of the se!5entsare #epresse# w th #ownwar#

#efle t on.8SI'US R%-T%/

8 ath la6 an#=or lyt s ( athpreferre#)

EKGInt!"#"!tat$%n

A&'%"$t($n*&+ $n'

M!an E&!*t"$*a&A,$s C an'!s)

( ,s $n &$' t -&+!=,s $n &$' t -&+!=s %*.a-&! "/t ss %*.a-&! "/t s 0 t!,t$n #$n. = %n t n!! t%

.n%2 3%" M$n$ II)

-es -es

3. ther P wavehan!es?

-es

GENERALATRIAL

HYPERTROPHY

>. QRS o5ple7han!es n net

ele tr al #ev at onfro5 l st ?

('et "ea#s I, II,av$, a ", 4, @'et 0 a R, 1)

4. /&A 0B C or 3 C?

-es to Any

MEAN ELECTRICAL A4ISDEVIATION

(see R for al 9lat on 5etho#s)**note, MEA deviations can be

present in pts with non-sinusrhythms, but they are notreproduced on the next page.

LEFT A4IS DEVIATION8patholo! a9ses n l9#e L

V!nt"$*+&a" H/#!"t"%# /0In3!"$%" MI0 E # /s! a0

S/st! $* HTN0 A%"t$*Va&5! St!ns%s$s

8phys olo! a9ses n l9#eathlet on# t on n!

RIGHT A4IS DEVIATION8patholo! a9ses n l9#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&&%t8phys olo! a9ses n l9#e tall, th na#9lt, an# h l#hoo#, h !h alt t9#e

1. /&A 03 C to 0B C?

2. /&A B C to 14 C?

H%2 t% Ca&*+&at! MEA6

S! $78+ant$tat$5! Est$ at!6

1."ooD for a lea# w th appro7. net ele tr al#ev at on .

2.+raw a l ne on the /&A # a!ra5 that sperpen# 9lar to the net lea#

3.'ow yo9 Dnow t has to 6e e ther thepos t ve or the ne!at ve port on of that

perpen# 9lar l ne .>. hoose any one of the other lea#s an#

#raw the 30se!5ent on ea h s #e ar , an#wh hever half of the perpen# 9lar l ne the

ar rosses, s yo9r /&A.

S! $78+ant$tat$5! L%n' V!"s$%n6

1.&sta6l sh the net ne!at v ty or pos t v ty ofea h lea# on the s 7 l 56 lea#s (I, II, II, a $,

a R, ")2. n the /&A # a!ra5, #raw a E30se!5ent

on ea h s #e E on e ther the pos t ve or thene!at ve port on of ea h lea#, a or# n! to

the &FG3.The /&A 59st l e w th n the we#!e wh hhas all s 7 ar s spann n! t. Th s ! ves yo9 a

ran!e of 3 C for yo9r a t9al /&A.

8+$*. an D$"t/6

1."ea#s I an# a $ are 6oth nor5al2."ea# I s H an# a $ s R !ht A7 s

+ev at on (RA+)3."ea# I s an# a $ s 0 "A+

8+ant$tat$5!8+ant$tat$5!(not #es . here 6= re:9 res r9ler)(not #es . here 6= re:9 res r9ler)




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 PAG& $ T%& %ART.)

' to '& or / R&

' '0SI'US R-T%/

1. +roppe# QRSo5ple7es?

VENTRICULARFIBRILLATION

8% !hly erratpattern

8fatal f not t7<#8' '0 SI'US

R%-T%/

9n DEGREE(INCOMPLETE)%&ART " FMOBIT: t/#! 1

a.a ;!n.!-a*" /t

8PR0 nterval .24 se8PR0 ntervals often !etpro!ress vely lon!er t llyo9 lose one, then t re0sets an# then they start

to !et lon!er a!a n8 A no#e s # sf tl

8' '0SI'USR%-T%/JJJ

1. Total A6sen eof any wavefor5

pattern?

2. Prolon!e# PRInterval?


8PR0 nterval no K8s9##en, 9npre# ta6leloss of QRS o5ple7.8# sease of 69n#le of% s0p9rD nLe syste5

8*an -! 961 %" <61 (pwaveMQRS o5pl.)

8' '0SI'US R%-T%/8 an #e!ra#e to 3 r# #e!.

heart 6lo D

1. Separate P wave an#QRS o5ple7 rhyth5?

2. P waves

9n lear, errat6asel ne?

-

-

-es

'o-es

-es

'o

<" DEGREE (COMPLETE)HEART BLOCKa.a At"$%5!nt"$*+&a" D$ss%*$at$%n

8P wave has atr al rhyth5, QRS wave hasN9n t onal (A no#e)or entr 9lar (% s0

P9rD nLe or entr 9lar /yo ar# 95) rhyth58%all5arDM P wave an# R wave are sa # to 6e

E5ar h n! o9tO 5ean n! they follow sep.rhyth5s, 69t are st ll h !hly re!9lar (p0p an# r0r#o not han!e)

8%all5arDM P wave fo9n# 6t7 QRS an# T wave8so5et 5esM nverte# T waves.

8J+n*t$%na& R /t narrow QRS 3 s5all6o7es

8A**!&!"at! I $%5!nt"$*+&a" R /tw #ene# QRS

8t7 pa n!, transveno9s or trans 9taneo9s8' '0SI'US R-T%/

ATRIAL FIBRILLATION

8no lear P waves, st ll have QRS. no re!.%R

8atr a ontra t errat ally, a9ses rre!9lar6asel ne

8not # re tly fatal, 69t a9ses lots8P+& %na"/ E -%&$s thro569s for5e# n

atr a !oes to p9l5onary r an# l9n!s8C%"%na"/ %" C!"!-"a& E -%&$s

thro569s for5e# n atr 95 !oes to oronaryart. or 6ra n

8' '0SI'US R%-T%/

1. %as P*aves?

EKGInt!"#"!tat$%n

A&'%"$t(n%t $n*&+ $n'


( ,s $n &$' t -&+!=,s $n &$' t -&+!=s %*.a-&! " /t ss %*.a-&! " /t s )

-es

'o

1. * #e QRSo5ple7?

'o-es

VENTRICULARTACHYCARDIA

814 024 6p58fre:9ently #9e to a re0

entrant ventr 9larpathway a9se# 6y

s ar t ss9e fro5prev o9s /I, et .

SVTSUPRA VENTRICULAR

TACHYCARDIA

8 14 6p58fre:9ently #9e to a re0entrant pathway8or ! n of ele tr al 5p9lse s n the atr a

or the A no#e




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# P0Rnterval? ( .2 se , or 4

s5all 6o7es)

2. ST0se!5entelevat on?

1st DEGREE(INCOMPLETE)HEART BLOCK

8PR0 nterval .2se

8SI'US R%-T%/86en !n, no 9r!ent

ntervent onre:9 re#.

ST SEGMENT ELEVATION =DIASTOLIC CURRENT OF

INJURY =TP SEGMENT an PR

SEGMENT DEPRESSION8#ea# ells 5a nta n onstant

ne!at ve har!e8the only t 5e the whole heart

s s9ppose# to 6e ne! s#9r n! ST se!5ent (ventr les

o5pletely #epolar ;e#)8th9s, ST se! stays where t<ss9ppose# to 6e, on soele trl ne, the rest of the se!5entsare #epresse# w th #ownwar#

#efle t on.8SI'US R%-T%/

8 ath la6 an#=or lyt s ( athpreferre#)

EKGInt!"#"!tat$%n

A&'%"$t($n*&+ $n'


( ,s $n &$' t -&+!=s %*.a-&!)

-es -es

3. ther P wavehan!es?

-es

GENERALATRIAL

HYPERTROPHY

>. QRS o5ple7han!es n net

ele tr al #ev at onfro5 l st ?

('et "ea#s I, II,av$, a ", 4, @'et 0 a R, 1)

4. /&A 0B C or 3 C?

-es to Any

MEAN ELECTRICAL A4ISDEVIATION

(see R for al 9lat on 5etho#s)**note, MEA deviations can be

present in pts with non-sinusrhythms, but they are notreproduced on the next page.

LEFT A4IS DEVIATION8patholo! a9ses n l9#e L

V!nt"$*+&a" H/#!"t"%# /0In3!"$%" MI0 E # /s! a0

S/st! $* HTN0 A%"t$*Va&5! St!ns%s$s

8phys olo! a9ses n l9#eathlet on# t on n!

RIGHT A4IS DEVIATION8patholo! a9ses n l9#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&&%t8phys olo! a9ses n l9#e tall, th na#9lt, an# h l#hoo#, h !h alt t9#e

1. /&A 03 C to 0B C?

2. /&A B C to 14 C?

H%2 t% Ca&*+&at! MEA6

S! $78+ant$tat$5! Est$ at!6

1."ooD for a lea# w th appro7. net ele tr al#ev at on .

2.+raw a l ne on the /&A # a!ra5 that sperpen# 9lar to the net lea#

3.'ow yo9 Dnow t has to 6e e ther the

pos t ve or the ne!at ve port on of thatperpen# 9lar l ne .

>. hoose any one of the other lea#s an##raw the 30se!5ent on ea h s #e ar , an#wh hever half of the perpen# 9lar l ne the

ar rosses, s yo9r /&A.

S! $78+ant$tat$5! L%n' V!"s$%n6

1.&sta6l sh the net ne!at v ty or pos t v ty ofea h lea# on the s 7 l 56 lea#s (I, II, II, a $,

a R, ")2. n the /&A # a!ra5, #raw a E30se!5ent

on ea h s #e E on e ther the pos t ve or thene!at ve port on of ea h lea#, a or# n! tothe &FG

3.The /&A 59st l e w th n the we#!e wh hhas all s 7 ar s spann n! t. Th s ! ves yo9 a

ran!e of 3 C for yo9r a t9al /&A.

8+$*. an D$"t/6

1."ea#s I an# a $ are 6oth nor5al2."ea# I s H an# a $ s R !ht A7 s

+ev at on (RA+)3."ea# I s an# a $ s 0 "A+

8+ant$tat$5!(not #es . here 6= re:9 res r9ler)




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 PAG& $ T%& %ART.)

' to '& or / R&

' '0SI'US R-T%/

1. +roppe# QRSo5ple7es?

VENTRICULARFIBRILLATION

8% !hly erratpattern

8fatal f not t7<#8' '0 SI'US

R%-T%/


a.a ;!n.!-a*" /t

8PR0 nterval .24 se8PR0 ntervals often !etpro!ress vely lon!er t llyo9 lose one, then t re0sets an# then they start

to !et lon!er a!a n8 A no#e s # sf tl

8' '0SI'USR%-T%/JJJ

1. Total A6sen eof any wavefor5

pattern?

2. Prolon!e# PRInterval?


8PR0 nterval no K8s9##en, 9npre# ta6leloss of QRS o5ple7.8# sease of 69n#le of% s0p9rD nLe syste5

8*an -! 961 %" <61 (pwaveMQRS o5pl.)

8' '0SI'US R%-T%/8 an #e!ra#e to 3 r# #e!.

heart 6lo D

1. Separate P wave an#QRS o5ple7 rhyth5?

2. P waves

9n lear, errat6asel ne?

-

-

-es

'o-es

-es

'o

<" DEGREE (COMPLETE)HEART BLOCKa.a At"$%5!nt"$*+&a" D$ss%*$at$%n

8P wave has atr al rhyth5, QRS wave hasN9n t onal (A no#e)or entr 9lar (% s0

P9rD nLe or entr 9lar /yo ar# 95) rhyth58%all5arDM P wave an# R wave are sa # to 6e

E5ar h n! o9tO 5ean n! they follow sep.rhyth5s, 69t are st ll h !hly re!9lar (p0p an# r0r#o not han!e)

8%all5arDM P wave fo9n# 6t7 QRS an# T wave8so5et 5esM nverte# T waves.

8J+n*t$%na& R /t narrow QRS 3 s5all6o7es

8A**!&!"at! I $%5!nt"$*+&a" R /tw #ene# QRS

8t7 pa n!, transveno9s or trans 9taneo9s8' '0SI'US R-T%/

ATRIAL FIBRILLATION

8no lear P waves, st ll have QRS. no re!.%R

8atr a ontra t errat ally, a9ses rre!9lar6asel ne

8not # re tly fatal, 69t a9ses lots8P+& %na"/ E -%&$s thro569s for5e# n

atr a !oes to p9l5onary r an# l9n!s8C%"%na"/ %" C!"!-"a& E -%&$s

thro569s for5e# n atr 95 !oes to oronaryart. or 6ra n8' '0SI'US R%-T%/

1. %as P*aves?

EKGInt!"#"!tat$%n

A&'%"$t(n%t $n*&+ $n'


( ,s $n &$' t -&+!=s %*.a-&! " /t s)

-es

'o

1. * #e QRSo5ple7?

'o-es

VENTRICULARTACHYCARDIA

814 024 6p58fre:9ently #9e to a re0

entrant ventr 9larpathway a9se# 6y

s ar t ss9e fro5prev o9s /I, et .

SVTSUPRA VENTRICULAR

TACHYCARDIA

8 14 6p58fre:9ently #9e to a re0entrant pathway8or ! n of ele tr al 5p9lse s n the atr a

or the A no#e

EKG Flowchart Mini II Version and Regular

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Transcript of EKG Flowchart Mini II Version and Regular