ECGs Flashcards
procedure before beginning ECG
check patient ID alongside their wristband
lie at 30-40 degrees
tracing problems
AC interference
baseline wander
muscle tremor
junctional rhythm
occurs at AV node
markers of ischaemia
Q waves
ST depression/ elevation
T wave changes
criteria for thrombolysis
ST elevation >1mm in 2 contiguous limb leads and >2mm in two contiguous chest leads, posterior MI or LBBB
other causes of ST elevation
high take off benign early repolarisation LBBB LVH ventricular aneurysm coronary vasospasm pericarditis Brugada syndrome SAH
criteria for STEMI with LBBB
Sgarbossa criteria
Sgarbossa criteria
Concordant ST elevation > 1mm in leads with a positive QRS complex (score 5)
Concordant ST depression > 1 mm in V1-V3 (score 3)
Excessively discordant ST elevation > 5 mm in leads with a -ve QRS complex (score 2)
how long does it take Q waves to develop?
2-24 hours (myocardial necrosis)
pathological if in leads V1-3
amputee
move limb leads on both limbs not just one
where should you apply the electrodes of limb leads?
over bone to avoid muscle interference
what does Einthoven’s triangle demonstrate?
orientation of the bipolar leads (RA, LA, LL, RL) to form the augmented leads I, II and III
normal axis
lead I +ve and aVF +ve
-30 to +90 degrees
left axis deviation
lead I +ve and aVF -ve
-30 to -180 degrees
right axis deviation
lead I -ve and aVF +ve
+90 to 180 degrees
