ECG Tips

Question 1

What’s the velocity?

Answer 1

10mm= 1mV
Recording rate: 25mm/sec , 1mm=0.04 sec
1 large square = 0.2 sec

Question 2

4 day hx of V+ D followed by miscle W + cramps –> ??

Answer 2

Hypokalaemia–> U waves

2o to severe GI K loss.

Question 3

Missing a dialysis session and Tented T waves? What do they mean?

Answer 3

Pts in hemodialysis usually in ESRF
Hemodialysis used to remove metabolic stuff: urea, K from blood. + ultrafiltration (if pt is overload hemodialysis helps) .

Accumul of K –> palpitations
Hyperkalaemia ECG: Tall tented T waves, P wave flattening, PR prolongation (more time of hyperfypolatisation)
Widened QRS complex , arrythmias VT ot VFib.

Question 4

Sinus tacchycardia- clinical sign

Of what?

Answer 4

PE: SOB, pleuritic chest pain(worse on exertion/inspiration)haemoptysis.
Most common ECg finding: Sinus tacchycardia, RBBB + R axis deviation.

Question 5

What are J waves? Any possible causes?

Answer 5

Upward deflection following R wave of the QRs

Hypothermia eg to 2o environmental exposure –> severe can lead to
Coagulopathy , bradycardia, HF, arrythmia and death.
Severe: rewarmed slowly 0.5^/hr

Rapid warming : vasodilation, hypotension, and circulatory collapse.

1. Removal of wet clothes
2. Warm humidified O2,
3. Warm saline Iv slowly

Cardiac ward !

Question 6

RTA , no obvious injuries, whats up?

Answer 6

Siunus tacchycardia

In A+E they wil be highly anxious, maybe pain.