If the heart rhythm is irregular, then you will not be able to use the aforementioned method. Instead, a different method will need to be used, The second part explains the theory underpinning the recording of an ECG to begin a basic interpretation of the 12 leads. If pulseless: start CPR, follow ACLS protocol for defibrillation, ET intubation, and administration f epinephrine or vasopressin, lidocaine, or amiodarone; ineffective consider magnesium sulfate. EKG/ECG proficiency is required for many nursing jobs. Telemetry, cardiac, and stepdown units all require some level of proficiency. Nurses interested in working in the intensive care unit or cardiac care unit are required to be proficient in reading EKGs. These jobs are also in high demand.

The atrial impulse is getting to the ventricle by a faster shortcut instead of conducting slowly across the atrial wall. This accessory pathway can be associated with a delta wave (see below). If P waves are absent and there is an irregular rhythm, it may suggest a diagnosis of atrial fibrillation. Ever wonder how nurses and doctors can read ECG papers with ease?How do they differentiate atrial tachycardia from atrial fibrillation, or how even to know what atrial fibrillation or tachycardia is?High take-off (or benign early repolarisation) is a normal variant that causes a lot of angst and confusion as it LOOKS like ST elevation. Each lead’s ECG recording is slightly different in shape. This is because each lead is recording the heart’s electrical activity from a different direction (a.k.a viewpoint). ECG is the abbreviated term for an electrocardiogram. It is used to record the electrical activity of the heart from different angles to both identify and locate pathology. Electrodes are placed on different parts of a patient’s limbs and chest to record the electrical activity. One of the most useful and commonly used diagnostic tools is electrocardiography (EKG) which measures the heart’s electrical activity as waveforms. An EKG uses electrodes attached to the skin to detect electric currents moving through the heart. These signals are transmitted to produce a record of cardiac activity. Arrhythmiaordysrhythmiaare disturbances in the normal cardiac rhythm of the heart which occur as a result of alterations within the conduction of electrical impulses. These impulses stimulate and coordinate atrial and ventricular myocardial contractions that provide cardiac output. Table of Contents

Amjid Rehman has created an innovative, interactive online application to assist in honing and refining your ECG interpretation skills.A pathological Q wave is > 25% the size of the R wave that follows it or > 2mm in height and > 40ms in width. For over fifty years The ECG Made Easy book has been regarded as the best fundamental guide to ECG learning, with sales of over a million prints as well as being translated into more than one language. Recognized by the British Medical Journal as a “medical classic”, it has remained a favorite of ages of medical and health care workers who want fair, basic information about the ECG. Observe the distribution of the T wave inversion (e.g. anterior/lateral/posterior leads). You must take this ECG finding and apply it in the clinical context of your patient. Inverted T wave Biphasic T waves

A narrow QRS complex occurs when the impulse is conducted down the bundle of His and the Purkinje fibre to the ventricles. This results in well organised synchronised ventricular depolarisation. Narrow-complex escape rhythms (QRS complexes of <0.12 seconds duration) originate above the bifurcation of the bundle of His. PR interval: Represents the time taken for excitation to spread from the sino-atrial (SA) node across the atrium and down to the ventricular muscle via the bundle of His. Trust your gut; nurses have great intuition skills—don’t be afraid to ask questions and seek more information when you feel something isn’t right. Carry This Card On Your Badge For Help This is not always easy for busy physicians. This article outlines a few pitfalls for the non-specialist ECG interpreter.

Examinations

The more familiar you are with different rhythms, the easier interpretation becomes. Don’t forget your colleagues are great resources as well; let them know you are working on your 12 lead EKG interpretation skills and ask them to save interesting tracings for your review. Now you are a whizz at placing the leads where they should be, do you know what you are looking for? Let’s start with the basics; every ECG consists of a P wave, QRS complex and a T wave. This is known as the cardiac cycle or in easier terms the period between the start of one heart beat and the beginning of the next, this should last 0.8 seconds.