introduction to ecg for nursing

8/4/2019 Introduction to ECG for Nursing

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Introduction toECG

Dr. Rashed J. Al-Hamdan M.D. FRCP( C )


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Introduction to ECG

ECG is short for ElectroCardioGram.

The idea of ECG is to measure a surface

electrical potential of the electrical activitiesoccurring in the heart.

This entails fitting leads to look at the

currents from every possible angle. This emphasizes the need for standardizing

the leads positions to be able to compare

different ECGs.


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An old ECG Machine


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Conduction System


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Normal ECG


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Action Potential and ECG


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Basic ECG Leads


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Basic ECG Leads


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Chest Leads

V1: 4th space, Rt para-

sternal line.

V2: 4th space Lt para-

sternal line. V3: Between V2 and V3.

V4: 5th Space Mid-

clavicular line.

V5: 5th space Anterior

axillary line.

V6: 5th space Midaxillary

line.


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Electro-Mechanical Coupling


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Standard Limb Leads


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Standard Limb Leads


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Waves and Intervals


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Axis Determination

The depolarization wave spreads in different

directions through the ventricle.

The term axis usually refers to the meandirection of the QRS wave in the frontal

plane unless otherwise specified.

This means that we are examining the QRSaxis only in the standard limb leads.


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Axis Determination The way to determine the electrical axis is made easy

by remembering few rules in ECG.


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Axis Determination


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Axis Determination


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Axis Determination


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Common Mistakes

One of the commonest mistakes to be done

by nurses and doctors is leads

misplacement.

The most common ones are

1- Right ArmLeft Arm leads misplacement.

2- Arm

Leg leads misplacement.3- Reversal of 2 leads of the anterior chest

leads V1V3.


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Common Mistakes: Rt - Lt Arm

Leads Misplacement


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Common Mistakes: Rt - Lt Arm

Leads Misplacement


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Common Mistakes: Leg - Arm

Leads Misplacement


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Common Mistakes: V1V2

Leads Misplacement


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Spot The Differences


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What is that ???


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What is that ???


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Atrial and Ventricular Tachycardia


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Atrial Flutter


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Atrial Flutter


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Atrial Flutter


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Atrial Flutter


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Flutter With High AV Block


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Atrial Fibrillation


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Fine Atrial Fibrillation


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P S V T


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A V N R T - Sinus Rhythm


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A V N R T - Attack


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Ventricular Tachycardia


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Ventricular Tachycardia


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W P W


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Orthodromic WPW


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Antidromic WPW


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WPW with AFib


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WPW with AFib


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Atrio-Ventricular Block


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1st Degree AV Block


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Mobitz Type I


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Mobitz Type II


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3rd Degree AV Block


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Bundle Branch Blocks


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Right B B B


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Left B B B


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Torsade de Pointes


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Torsade de Pointes


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Hyperkalemia


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Hyperkalemia


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Hypokalemia


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Hypokalemia


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S T E M I


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S T E M I


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S T E M I


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S T E M I


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S T E M I


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S T E M I


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STEMI with LBBB


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Single Chamber Pacemaker


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Dual Chamber Pacemaker


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I C D


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Dangerous Patterns


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Dangerous Patterns


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Dangerous Patterns


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Dangerous Patterns


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Dangerous Patterns

D P


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Dangerous Patterns

introduction to ecg for nursing

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