Quick Clinical Analysisasda.net.au/.../2020/01/ECG-INTERPRETATION-HANDS-ON...Quick Clinical Analysis...
Transcript of Quick Clinical Analysisasda.net.au/.../2020/01/ECG-INTERPRETATION-HANDS-ON...Quick Clinical Analysis...
Quick Clinical Analysis ECG INTERPRETATION
We will learn to quickly identify 18 rhythms.
We will focus only on identification not causes ,
pathophysiology or treatment. See examples in your handout
OVERVIEW
1) P-waves and T-waves are upright
2) P-waves precede all QRS complexes
3) QRS complexes are narrow less than 0.12 milliseconds
4) P-R intervals are less than 0.20 milliseconds
5) The J-Point is isoelectric
6) The heart rate is between 60-100 beats per minute
1-NORMAL SINUS RHYTHM
1) All the features of NSR except rate is less than 60 beats per minute
2-SINUS BRADYCARDIA
1) Same as NSR except rate over 100 beats per minute
3) SINUS TACHYCARDIA/SUPERVENTRICULAR TACHCARDIA
1) No P-waves
2) Irregularly irregular pattern of QRS complexes
3) multiple undulations between normal width QRS complexes ( less than 0.12 ms)
4-ATRIAL FIBRILLATION
1) Identifiable saw-tooth pattern between regular QRS complexes( less than 0.12 ms)
5-ATRIAL FLUTTER
1-fixed prolonged P-R interval( over 0.20 ms /5 small boxes)
6-1ST DEGREE AV BLOCK
1) Progressive prolongation of the P-R interval until a beat/QRS is dropped/missed and the the cycle repeats.
7-2ND DEGREE AV BLOCK TYPE 1
Fixed prolonged P-R interval with dropped beats/QRS complexes
8-2ND DEGREE AV BLOCK TYPE 2
1) p-waves are regularly spaced but have no relationship to the QRS complexes
2) QRS Complexes are wide ( over 0.12 ms)
3) The P-waves seem to be marching through the QRS complexes
9-THIRD DEGREE AV BLOCK
1)-there are no P-waves
2)-can look like sinus rhythm but P-wave is absent
3) Can be wide QRS complexes without P-waves
10-JUNCTIONAL RHYTHMS
1)-regular wide QRS complexes with a rate over 100 beats per minute
2) No P-waves are seen
11-VENTRICULAR TACHYCARDIA
1) No P-waves or QRS complexes seen but there is electrical activity
12-VENTRICULAR FIBRILLATION
1) No electrical activity is seen even though baseline often wanders
13-ASYSTOLE
1) No P-waves or QRS complexes are seen but electrical activity is present and so is a form of ventricular fibrillation.
2) There is a characteristic sine wave pattern
14-TORSADES DE POINTS( TWISTING POINTS)
The J-point is elevated
15-ST ELEVATION
1) The J-point is depressed
16-ST DEPRESSION
1) Wide QRS complexes that occur before the next QRS complex is due
17-PVC’S ( PREMATURE VENTRICULAR CONTRACTIONS)
1) You see a new P, QRS and T-wave prior to when the next is expected
2) often get a compensatory pause in the cycle after the PAC and the regular rhythm resumes.
3) However there may be no pause.
18- PAC ( PREMATURE ATRIAL CONTRACTIONS)