EKG and ACLS/BLS extras

Question 1

What is the proper positioning of a patient while recording an EKG? Why is this important?

Answer 1

Laying supine (flat on their back).
Body habitus more likely to produce artifact in semi-fowlers/fowlers position.

Question 2

Hyperkalemia and its effect on EKG tracings:

Answer 2

• flattened p-wave d/t slow conductance
  -wide QRS
• peaked T waves

Question 3

Hypokalemia and its effect on EKG tracings:

Answer 3

• ST depression
• Flattening of T wave
• U wave

Question 4

What are some physical symptoms of hypokalemia?

Answer 4

-Muscle cramps
-N/V/D

Question 5

Hypercalcemia and its effect on EKG tracings:

Answer 5

• low R waves
  -broad, tall T waves
• disappearance of P waves

Question 6

Hypocalcemia and its effect on EKG tracings:

Answer 6

• flattened, inverted T waves
• U waves
• Prolonged QT interval

Question 7

What is the Osborne “J” wave?

Answer 7

a positive deflection seen at the J point. Indicative of hypothermia

Question 8

What are delta waves?

Answer 8

Slurred upstroke of the QRS complex, commonly associated with pre-excitation arrhythmias such as Wolff-Parkinson White syndrome

Question 9

What constitutes a normal axis?
Leads 1, 2, and 3: + or - deflections?

Answer 9

0- +90 degrees

Question 10

What constitutes a physiologic left axis?
Leads 1, 2, and 3: + or - deflections?
Block involved?

Answer 10

0 - -40 degrees
No block involved

Question 11

What constitutes a pathologic left axis?
Leads 1, 2, and 3: + or - deflections?
Block involved?

Answer 11

-40 - -90 degrees
Left anterior hemiblock

Question 12

What constitutes a right axis deviation?
Leads 1, 2, and 3: + or - deflections?
Block involved?

Answer 12

90 - 180 degrees
Posterior hemiblock