Basic ECG Interpretationfor Nurses
Adel A. Hasanein, RN, BSN Academic Coordinator
NED‐KFMC
OutlineOutline
• Definition of the ECGDefinition of the ECG • Types of pathology can we identify and study
from ECGsfrom ECGs• Review of the conduction system• ECG waveforms and intervals• ECG waveforms and intervals• Determining heart rate
ECG h th b liti• ECG‐common rhythm abnormalities
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What is an ECG?What is an ECG?
An ElectrocardiogramAn Electrocardiogram (ECG or EKG) is:
A grafical representation of theA grafical representation of the electrical activity of the heart.y
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What types of pathology can we identify d d f ?and study from ECGs?
• Arrhythmias• Arrhythmias• Myocardial ischemia and infarctionP i diti• Pericarditis
• Chambers hypertrophy• Electrolyte disturbances (i.e. hyperkalemia, hypokalemia)
• Drug toxicity (i.e. digoxin and drugs which prolong the QT interval)
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Basic conduction mechanismsBasic conduction mechanisms
• Sinoatrial node (SA• Sinoatrial node (SA node)‐ primary pacemaker of thepacemaker of the heart
• Atrioventricular node (AV node)
• His Bundle• Bundle branches• Purkinje fibers
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ECG Waveforms & IntervalsECG Waveforms & Intervals
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ECG PaperECG Paper
•Vertically: each large square = 0.5 mv.
• Horizontally each large square = 0.2 sec.
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Determining Heart RateDetermining Heart Rate
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Quiz Question:Quiz Question:
What is the width of the normalQRS complex in little squares?
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Fundamentals of RhythmInterpretation
• P wave morphologyi l• PR interval
• QRS MorphologyQRS Morphology • Rate & Rhythm • Conduction ( P‐QRS Relation)
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Normal ‐ Sinus RhythmNormal Sinus Rhythm
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Supraventricular Tachycardia (SVT)Supraventricular Tachycardia (SVT)
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Premature Ventricular Contractions (PVC’s)
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Polymorphic Ventricular Tachycardia(Torsades de pointes)
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Polymorphous ventricular tachycardia (T d d i )(Torsade de pointes)
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Ventricular fibrillationVentricular fibrillation
Coarse VFCoarse VF
Fi VFFine VF
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