Ecg Made Easy
-
Upload
sailesh-bond -
Category
Documents
-
view
17 -
download
0
description
Transcript of Ecg Made Easy
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 1/45
MAKING ECG’S EASYMAKING ECG’S EASY
APPLICATION FOR THEAPPLICATION FOR THEECGECGEVALUATING THE ECGEVALUATING THE ECG
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 2/45
2
Upon completion oneUpon completion one
will be able to:will be able to:• Describe wh ! " ECG is#Describe wh ! " ECG is#• Describe !he $r%$er h%%&'($Describe !he $r%$er h%%&'($
$r%ce)(re *%r +,'Le ) ECG$r%ce)(re *%r +,'Le ) ECG• I)e"!i*- b sic "%r. / ECGI)e"!i*- b sic "%r. / ECG
w 0e*%r. .%r$h%/%1-#w 0e*%r. .%r$h%/%1-#• Dis!i"1(ish be!wee" b sic ECGDis!i"1(ish be!wee" b sic ECG
rrh-!h.i ") r!i* c!#rrh-!h.i ") r!i* c!#
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 3/45
3
2UICK REVIE3 OF2UICK REVIE3 OFHEARTHEART
P(r$%seP(r$%se• P(.$s b/%%)P(.$s b/%%) 4 sic A" !%.-4 sic A" !%.-•
5 ch .bers5 ch .bers• , si)es, si)es• 5 0 /0es5 0 /0es
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 4/45
4
THE CONDUCTINGYHE CONDUCTINGY
SYSTEYSTE
• SA N%)eSA N%)e• I"!er'"%) /I"!er'"%) /
$ !hw -$ !hw -• AV N%)eAV N%)e• 4(")/e %* HIS4(")/e %* HIS
• 4(")/e 4r "ches4(")/e 4r "ches• P(r&i"6e FibersP(r&i"6e Fibers
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 5/45
5
RELATIONSHIPRELATIONSHIP
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 6/45
6
CARDIAC CYCLESCARDIAC CYCLES
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 7/45
7
+, LEAD ECG+, LEAD ECG
Le r"i"1 %b6ec!i0es7Le r"i"1 %b6ec!i0es7
Describe !he c%rrec!Describe !he c%rrec!$/ ce.e"! %* // e/ec!r%)es$/ ce.e"! %* // e/ec!r%)es
Pr%$er S&i" $re$ r !i%"Pr%$er S&i" $re$ r !i%" C re %* !he ECG . chi"e8 wiresC re %* !he ECG . chi"e8 wires
") e/ec!r%)es") e/ec!r%)es
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 8/45
8
Pri"ci$/es %*Pri"ci$/es %*E/ec!r%c r)i%1r $hE/ec!r%c r)i%1r $h
• E/ec!r%c r)i%1r $h 9 is !heE/ec!r%c r)i%1r $h 9 is !hei"s!r(.e"! !h ! rec%r)s !hei"s!r(.e"! !h ! rec%r)s !hee/ec!ric / c!i0i!- %* !he he r!e/ec!ric / c!i0i!- %* !he he r!
• E/ec!r%c r)i%1r . :ECG; is !heE/ec!r%c r)i%1r . :ECG; is !herec%r) %* !h ! c!i0i!-rec%r) %* !h ! c!i0i!-
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 9/45
9
HOOKING UP THEHOOKING UP THE+,'LEAD ECG+,'LEAD ECG
• Pr%$er s&i" $re$Pr%$er s&i" $re$• P/ ce.e"! %* !he /i.bP/ ce.e"! %* !he /i.b
e/ec!r%)ese/ec!r%)es•
P/ ce.e"! %* !he ches!P/ ce.e"! %* !he ches!e/ec!r%)ese/ec!r%)es
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 10/45
10
SKIN PREPARATIONKIN PREPARATION
• REASON FOR SKINREASON FOR SKINPREPARATIONPREPARATION
• < STEP METHOD< STEP METHOD• , STEP METHOD, STEP METHOD
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 11/45
11
ELECTRODEELECTRODEPLACEMENTPLACEMENT
• LIM4 LEADSLIM4 LEADS
• CHEST LEADCHEST LEAD
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 12/45
12
LIM4 LEADSLIM4 LEADS
• 4i$%/ r /e )s4i$%/ r /e )s
I II IIII II III
• A(1.e"! /e )sA(1.e"! /e )s
A0r A0/ A0* A0r A0/ A0*
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 13/45
13
CHEST LEADSCHEST LEADS
• = UNIPOLAR= UNIPOLARLEADSLEADS
• V+V+• V,V,• V>V>
• V5V5• V<V<• V=V=
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 14/45
14
LETS REVIE3LETS REVIE3
• 3h ! is " ECG3h ! is " ECG• 3h ! re !he /i.b /e )s?3h ! re !he /i.b /e )s?• 3h ! re !he ches! /e )s?3h ! re !he ches! /e )s?
• 3h- )% s&i" $re$?3h- )% s&i" $re$?
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 15/45
15
+,'LEAD ECG LAYOUT+,'LEAD ECG LAYOUT
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 16/45
16
INFORMATION ON THEINFORMATION ON THEECGECG
• P !ie"!s )e.%1r $hicsP !ie"!s )e.%1r $hics• He r! r !e ") .e s(re.e"!sHe r! r !e ") .e s(re.e"!s• S$ee) ECG is rec%r)e) !S$ee) ECG is rec%r)e) !
• V%/! 1e ECG is rec%r)e) !V%/! 1e ECG is rec%r)e) !• 3h ! !he *i/!er is se! %"3h ! !he *i/!er is se! %"
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 17/45
17
INFORMATION ON THEINFORMATION ON THE+,'LEAD ECG+,'LEAD ECG
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 18/45
18
3HAT YOU NEED TO3HAT YOU NEED TOLOOK FORLOOK FOR
• Are !he /i.b /e )s h%%&e) ($Are !he /i.b /e )s h%%&e) ($c%rrec!/-?c%rrec!/-?
• Are !he ches! /e )s h%%&e) ($Are !he ches! /e )s h%%&e) ($c%rrec!/-?c%rrec!/-?
• Is !he ECG *ree %* r!i* c!#Is !he ECG *ree %* r!i* c!#• Is !his ECG Cri!ic / V /(eIs !his ECG Cri!ic / V /(e
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 19/45
19
IS !he ECG HOOKED UPIS !he ECG HOOKED UPCORRECTLY?CORRECTLY?
LIM4 LEADSLIM4 LEADSN%r. / +,'/e )N%r. / +,'/e )
• AVR 9 /w -sAVR 9 /w -s"e1 !i0e"e1 !i0e
• Le ) I 9 /w -sLe ) I 9 /w -s$%si!i0e$%si!i0e
• Le ) II8 III 9Le ) II8 III 9$%si!i0e %r$%si!i0e %rbi$h sicbi$h sic
CHEST LEADSCHEST LEADSCOLUMN IIICOLUMN III•
R w 0e $r%1ressi%"R w 0e $r%1ressi%"• S. // !% T //S. // !% T //
COLUMN IVCOLUMN IV• R w 0e $r%1ressi%"R w 0e $r%1ressi%"• T // !% S. //T // !% S. //
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 20/45
20
RULING OUT LIM4 LEADRULING OUT LIM4 LEADREVERSALREVERSAL
• A0r is /w -s "e1 !i0eA0r is /w -s "e1 !i0e
• Le ) I is /w -s $%si!i0eLe ) I is /w -s $%si!i0e
• Le ) II ") III $%si!i0e *%r !he PLe ) II ") III $%si!i0e *%r !he Pw 0e ") (s( //- !he 2RS c%.$/e@w 0e ") (s( //- !he 2RS c%.$/e@
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 21/45
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 22/45
22
LIM4 LEADSLIM4 LEADS
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 23/45
23
CHEST LEADSCHEST LEADS
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 24/45
24
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 25/45
25
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 26/45
26
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 27/45
27
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 28/45
28
OTHER PRO4LEMSOTHER PRO4LEMS3ITH THE ECG3ITH THE ECG
• Ar!i* c!Ar!i* c!• E/ec!ric / i"!er*ere"ceE/ec!ric / i"!er*ere"ce• S%. !ic !re.%r S%. !ic !re.%r
• 3 ")eri"1 b se/i"e3 ")eri"1 b se/i"e
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 29/45
29
EINTHOVENS TRIANGLEEINTHOVENS TRIANGLE
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 30/45
30
ARTIFACT ON THE ECGARTIFACT ON THE ECG
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 31/45
31
FIND THE ARTEFACTFIND THE ARTEFACT
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 32/45
32
3ANDERIN 4ASELINE3ANDERIN 4ASELINE
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 33/45
33
SOMATIC TREMORSOMATIC TREMOR
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 34/45
34
ELECTRICALELECTRICALINTERFERANCEINTERFERANCE
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 35/45
35
4ASIC CRITICAL4ASIC CRITICALVALUESVALUES
• 4r )-c r)i 9 HR4r )-c r)i 9 HR 5Bb$.5Bb$.• T ch-c r)i HRT ch-c r)i HR +,Bb$.+,Bb$.• PVC’s ' 5 %r .%re i" r%wPVC’s ' 5 %r .%re i" r%w•
ST E/e0 !i%"ST E/e0 !i%"
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 36/45
36
LOOKING AT THELOOKING AT THERHYTHMRHYTHM
• E0 /( !e !heE0 /( !e !herh-!h. s!ri$ !rh-!h. s!ri$ !
!he b%!!%. %*!he b%!!%. %*!he +,'/e ) *%r!he +,'/e ) *%r!he *%//%wi"1!he *%//%wi"1
• Is !he rh-!h.Is !he rh-!h.re1(/ r %rre1(/ r %r
irre1(/ r?irre1(/ r?• Is !here PIs !here Pw 0e be*%rew 0e be*%ree0er- 2RSe0er- 2RS
c%.$/e@c%.$/e@• Are !he- "-Are !he- "-
b"%r. / be !s#b"%r. / be !s#
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 37/45
37
FINDING THE HEARTFINDING THE HEARTRATERATE
• > METHODS> METHODS
• RATE RULERRATE RULER• COUNTINGCOUNTING
• 4O METHOD4O METHOD
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 38/45
38
4O METHOD4O METHOD
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 39/45
39
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 40/45
40
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 41/45
41
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 42/45
42
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 43/45
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 44/45
44
ECTOPIC 4EATSECTOPIC 4EATS
7/21/2019 Ecg Made Easy
http://slidepdf.com/reader/full/ecg-made-easy-56e16970d06b2 45/45
LETS SUMMARI ELETS SUMMARI E
H%w )% we $r%)(ce " e@ce//e"!H%w )% we $r%)(ce " e@ce//e"!+,'/e ) ECG?+,'/e ) ECG?
Pr%$er s&i" $re$Pr%$er s&i" $re$ C%rrec! e/ec!r%)e $/ ce.e"!C%rrec! e/ec!r%)e $/ ce.e"! Rec%1"i e ") &"%w h%w !%Rec%1"i e ") &"%w h%w !%
c%rrec! $r%b/e.sc%rrec! $r%b/e.sRec%1"i e b sic cri!ic / 0 /(esRec%1"i e b sic cri!ic / 0 /(es