ECG Interpretation & Monitoring Flashcards
Proper ECG lead placement
Electrical impulses in heart
It starts in the Sinoatrial node (SA node), which is in the atria.
The Atrioventricular node (AV node), which is located in between the atria and ventricles (hence the name)
Bundle of His, which is located in the septum of the heart
Bundle Branches, which is where the Bundle of His branches off farther down in the septum
And the end of the line is the Purkinje Fibers, which go up the sides of the ventricles.
EKG interpretation
- Ensure the picture is clear (no artifact)
- See if the heart rate is regular: by finding each R wave (the very peak of the QRS complex) and see if the space in between each R wave is the same.
- Check out your P wave: The first P wave related question is to check if there is one! Ideally, there is a P wave before every single QRS complex and that distance between the two is the same for all of the complexes on the strip. The P waves should all look the same and be regular
- Measure your PR interval: It should be between 0.12-0.2 seconds.
- Check out your QRS: The QRS complex represents the spread of the electrical impulse through the ventricles. So, we want to see consistency in shape, size, and timing.
- A normal QRS complex is 0.08-0.1, and is measured from the beginning of the Q wave to the end of the S wave. - Check in on the T and S waves:
* Note if there is elevation between the S and T which is indicative of a myocardial infarction.
PR interval
The PR interval is the conduction up through the AV node.
PR interval: It should be between 0.12-0.2 seconds.
QRS interval
Represents ventricular depolarization as the electrical signal passes down from the AV node
A normal QRS complex: 0.08-0.1
QT interval
The time between the onset of ventricular depolarization and the end of ventricular repolarization.
- QT prolongation can predispose to a potentially fatal ventricular arrhythmia known as torsades de pointes
RR interval
Can be described as the HR
