Download - ECG 101
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ECG 101
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The eyes may be the window to the soul
But the ECG is the window to the heart, lungs, toxicology, electrolytes, body temperature and sometimes even the brain
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Pattern recognition
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An ECG is put under your nose
Immediately
InterpretTime
Name stamp
Covers nurse/HCA’s arseMakes you read it
We know who to educate if it’s wrong
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Be systematic
One system
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Patient’s name
Presenting complaint
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ECG machine RR interval big squares: 300, 150, 100, 75, 60, 50
total number of complexes across the page x 6
Rate
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Rhythm
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Same patient after treatment for sepsis
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Frontal axis
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Why else do we care about axis?
CQC
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Incomplete trifascilar blockRBBB, LAD and 1˚HB
1 myocyte away from complete heart blockDon’t send this post syncope patient home
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Then proceed through the complexes
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p waves
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PR interval
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QRS complex
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QRS complex
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QRS complex
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Killer Qs
Pathological Qs
> 40 ms (1 mm) wide > 2 mm deep > 25% of depth of QRS complex Seen in leads V1-3
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ST segment
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ST segment
R
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ST segment
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ST segment
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Original Sgarbossa Criteria
Concordant ST-segment elevation ≥ 1 mm in any lead (5 points) Concordant ST-segment depression ≥ 1 mm in lead V1 – V3 (3 points)
Discordant ST-segment elevation ≥ 5 mm in any lead (2 points)
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ST segment
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T waves
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Repeat ECGs
13 minutes later, pain free:
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T waves
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T waves
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T waves
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QTc
Long QT syndrome (genetic)
Drugs incl amiodarone, digoxin, macrolides, antipsychotics, tricyclics, SSRIs, loratidine
HypothermiaHyperCaHypoK, hypoMag
Myocardial ischaemiaICH
+ others
> 440ms in men or > 460ms in women
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Methodical readRecord your interpretationTimeName stampFurther actions esp repeat ECGs q10min x 3 for CP
eg Trodat Printy 4910 http://www.selfinkingstamps.co.nz/shop/trodat-4910-26x9mm/
$20 delivered
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References and images
Most facts checked with and images obtained from
Life in The Fast Lanehttp://lifeinthefastlane.com/