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Introduction to ECGs

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1 small box = 1 mm = 0.04 sec. Every 5 lines (boxes) are bolded ... Moving muscle. Limb best but more artifact. Components of the ECG Complex ... – PowerPoint PPT presentation

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Title: Introduction to ECGs


1
Introduction to ECGs
  • EMS Technology
  • Temple College

2
Discussion Topics
  • Standardized Methods Devices
  • Components Measurements of the ECG Complex
  • Component Associations
  • Rhythm Assessment Format

3
Standardized Methods Devices
  • ECG Paper
  • Device Paper Speed
  • Device Calibration
  • Electrode Placement
  • Variations Do Exist!

4
Standardized Methods Devices
  • ECG Graph Paper
  • Vertical axis- voltage1 small box 1 mm
  • Horizontal axis - time1 small box 1 mm 0.04
    sec.
  • Every 5 lines (boxes) are bolded
  • Horizontal axis - 1 and 3 sec marks

5
Standardized Methods Devices
  • ECG Paper Examples
  • Vertical Axis
  • No. of mm in 10 small boxes?
  • No. of small boxes in 2 mm?
  • Horizontal Axis
  • No. of seconds in 5 small boxes?
  • No. of small boxes in 0.2 second?
  • No. of small boxes in 1 second?

6
Standardized Methods Devices
  • Paper Speed Calibration
  • Paper Speed - 25 mm/sec standard
  • Calibration of Voltage is Automatic
  • Both Speed and voltage calibration can be changed
    on most devices

7
Standardized Methods Devices
  • Electrode Placement
  • Standardization improves accuracy of comparison
    ECGs
  • 3 Lead and 12 Lead Placement are most common
  • Avoid
  • Bone
  • Moving muscle
  • Limb best but more artifact

8
Components of the ECG Complex
  • Components Their Representation
  • P, Q , R, S, T Waves
  • PR Interval
  • QRS Interval
  • ST Segment

9
Components of the ECG Complex
  • Normal Values
  • PRI 0.12 - 0.20 seconds
  • QRS Interval lt 0.12 seconds
  • Ventricular rate 60-100 (adult)

10
Component Association
  • Specific associations found with normal ECG
  • Normal P wave before each complex (Indicative
    of?)
  • Relationship of P wave to QRS complex is 11
    (Indicative of?)
  • ST segment visible
  • Distinct isoelectric line, waves intervals

11
ECG Rhythm Assessment Format (3 Lead)
  • Rate (3 methods)
  • Regularity (RR interval)
  • Components Relationships
  • Waves (Present? Alike?)
  • Intervals
  • PRI QRS duration
  • PQRS relationship
  • Consistent?
  • Extras? Other Info?

12
ECG Rhythm Assessment Format (3 Lead)
  • Clues
  • Normal vs. Abnormal rate
  • AV association vs. dissociation
  • PQRS
  • R-R
  • Pacemaker site
  • QRS Duration
  • PQRS relationship and PRI
  • Premature complexes

13
Practice
  • Textbook, PP. 38-39, 40-44, 61-66
  • Identifying Components
  • Determining Rates using various methods
  • Determining Regularity the degree of
    Irregularity
  • Measuring intervals and durations

14
Lab
  • Device Familiarization (LifePak 10, Codemaster
    100, Zoll )
  • Power (Batteries, Warnings)
  • Electrical Rate vs. Mechanical (common error with
    counting QRS)
  • Printing
  • Failures
  • Electrode Placement
  • Causes of Artifact
  • Examples
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