Post on 24-Jan-2016
description
ECG, EKG, ECG, EKG, ElectrocardiogramElectrocardiogram
The ECG is easy to understand
The abnormalities happen for a reason
CONSTANT VIGILANCE !!
!
The electricity of the The electricity of the heartheart
What to expect from What to expect from the ECGthe ECG
Essential monitor
Rate, rhythm, propagation of the excitation
wave, heart position, muscle hypertrophy,
regional ischemia
NO information about pump function
3-lead system3-lead system
Lead Selection• Lead II is the same as
standard lead two as
seen in a 12 lead ECG
.
• It is the most
common monitoring
lead.
• It is not the optimal
monitoring lead.
Lead Selection
• V5 = the best lead
to detect ST-T
change
• Move the LA lead
to V5 position
• Monitor lead I
The shape of the The shape of the ECGECG
PP T
QR S
QR S
Normal ECGNormal ECG
ECG interpretationECG interpretation
1. Rate
2. Rhythm
3. Intervals
4. QRS complexes
5. ST segments & T waves
Abnormal
Normal
ECG abnormalitiesECG abnormalities
Myocardial ischemia / infarction
arrhythmias
Myocardial ischemia / Myocardial ischemia / infarctioninfarction
ST depression
(0.1mv)
ST elevation
(0.2mv)
T wave inversion
Abnormal Q
Myocardial ischemia / Myocardial ischemia / infarctioninfarction
Condition associated with perioperative dysrhythmias
Electrolyte disturbances (hypokalemia, hypocalcemia, hypomagnesemia)
Hypothermia
Medications such as digitalis, theophylline, anesthetic agents
Metabolic alkalosis
Presence of indwelling central venous or pulmonary artery catheters
Sympathetic stimulation (hypoxia, hypercarbia, surgical or anesthetic stimulation)
Parasympathetic stimulation (distention of bladder or bowel)
BradyarrhythmiasBradyarrhythmias
Bradyarrhythmias Bradyarrhythmias
BradyarrhythmiasBradyarrhythmias
BradyarrhythmiasBradyarrhythmias : 2: 2ndnd degree AVBdegree AVB
BradyarrhythmiasBradyarrhythmias : 2: 2ndnd degree AVBdegree AVB
BradyarrhythmiasBradyarrhythmias : 3: 3rdrd degree AVBdegree AVB
TachyarrhythmiasTachyarrhythmias : : Premature complexesPremature complexes
TachyarrhythmiasTachyarrhythmias : : Premature complexesPremature complexes
TachyarrhythmiasTachyarrhythmias
TachyarrhythmiasTachyarrhythmias
TachyarrhythmiasTachyarrhythmias
TachyarrhythmiasTachyarrhythmias
TachyarrhythmiasTachyarrhythmias
TachyarrhythmiasTachyarrhythmias
AsystoleAsystole