ECG Workshop Flashcards

1
Q

Where do you place the electrode for V1 in a 12 lead ECG?

A

Fourth intercostal space at the right sternal border

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2
Q

Where do you place the electrode for V2 in a 12 lead ECG?

A

Fourth intercostal space at the left sternal border

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3
Q

Where do you place the electrode for V3 in a 12 lead ECG?

A

Halfway between leads V2 and V4

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4
Q

Where do you place the electrode for V4 in a 12 lead ECG?

A

Fifth intercostal space in the midclavicular line

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5
Q

Where do you place the electrode for V5 in a 12 lead ECG?

A

Fifth intercostal space left anterior axillary

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6
Q

Where do you place the electrode for V6 in a 12 lead ECG?

A

Fifth intercostal space left midaxillary line

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7
Q

Which limbs do you put the limb leads on in a 12 lead ECG

A
  • Right arm (inner wrist)
  • Left arm (inner wrist)
  • Left leg (inner ankle)
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8
Q

How wide should the QRS complex be?

A

< 0.10 sec / less than 3 small squares

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9
Q

How long should the PR interval be?

A

3-5 small squares / 0.12 – 0.20 sec

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10
Q

How long should the QT segment be?

A

0.35 to 0.46 seconds / 8-11 small squares

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11
Q

How many seconds are represented by a small box on an ECG

A

0.04 second

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12
Q

When would a QT interval be considered prolonged?

A

> 440ms in men or > 460ms in women

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13
Q

How many seconds are represented by a large box on an ECG

A

0.2

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14
Q

How do you calculate a regular heart rate?

A

300/number of large squares between R-R interval

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15
Q

How do you calculate an irregular heart rate?

A

Count the number of QRS complexes in 30 large squares and multiply by 10

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16
Q

What is the process of reading an ECG?

A
  • Verify patient details
  • Check date and time
  • Check the calibration of the paper
  • Is electrical activity present?
  • Is the rhythm regular or irregular?
  • What is the heart rate?
  • P-waves present?
  • What is the PR interval?
  • Is each P-Wave followed by a QRS complex?
  • Is the QRS duration normal?
  • Look at individual leads for voltage criteria changes OR any ST or T-wave changes
17
Q

What does the P wave represent?

A

Atrial depolarization

18
Q

What does the PR interval represent?

A

AV node delay

19
Q

What does the QRS complex represent?

A

Ventricular depolarization

20
Q

What does the T wave represent?

A

Ventricular repolarization

21
Q

What are the 2 types of irregular heart rhythm?

A

Regularly irregular and irregularly irregular

22
Q

What indicates left axis deviation?

A

Lead I is +ve and lead II is -ve

23
Q

What indicates right axis deviation?

A

Lead I is -ve and lead II is +ve

24
Q

What indicates a normal axis?

A

Lead I and II are +ve

25
Q

What commonly causes left axis deviation?

A

Heart conduction defects eg left anterior fascicular block and inferior MI

26
Q

What commonly causes right axis deviation?

A

Right ventricular hypertrophy

27
Q

What does a saw tooth baseline indicate?

A

Atrial flutter

28
Q

What does a broad QRS with a delta wave indicate?

A

Wolff-Parkinson-White syndrome

29
Q

What do tall tented T waves indicate?

A

Hyperkalaemia

30
Q

What does absent P waves indicate?

A

AF

31
Q

What can cause a prolonged PR interval?

A

AV block (heart block)

32
Q

What ECG changes do you see in first degree heart block

A

A fixed prolonged PR interval

33
Q

What ECG changes do you see in second degree heart block (Mobitz type 1)

A

The PR interval slowly increases then there is a dropped QRS complex

34
Q

What ECG changes do you see in second degree heart block (Mobitz type 2)

A

The PR interval is fixed but there are dropped beats

35
Q

What ECG changes do you see in third degree heart block

A

The P waves and QRS complexes are completely unrelated

36
Q

What does a delta wave look like?

A

Slurred upstroke on the QRS complex