midterm Flashcards
(34 cards)
What is an ECG
A test that records the electrical activity of the heart through electrodes attached to the skin and limbs
What are the 5 types of ECG
Resting (monitors heart at rest)
Exercise (stress test)
Signal-averaged (multiple ECG in 15-30 minutes)
Holter monitor (portable ECG)
Event/loop recording (for weeks or months)
Why do a 12 lead ECG
To find cause of unexplained chest pain
Find cause of symptoms of heart disease
Check how well meds are working
Check how well mechanical devices are working
Why do you print 2 copies of the ECG
One goes to the nurse or doctor which is written “copy” on it
Second stays with ECG machine to go to cardiologist
Where does V1 go
4th intercostal space to right of sternum
Where does V2 go
4th intercostal space to left of sternum
Where does V3 go
Between V2 and V4
Where does V4 go
5th intercostal space at left midclavicular line
Where does V5 go
5th intercostal space at left anterior axillary line
Where does V6 go
5th intercostal space at left mid axillary line
How much time is represented by a large 5X5mm box on the ECG
0.2 seconds
How much time does one 1X1mm block represent on an ECG
40 millisecond
Why do we do a right sided ECG
For patients with inferior myocardial infarct, or when right ventricular infarct is suspected
Patients with dextrocardia of situs inversus
Explain the lead placement for a right sided ECG
V1, V2 stay same
V3R on a line midway between electrodes V1 and V4R
V4R in 5th right intercostal space mid clavicular
V5R level with V4R at right anterior axillary line
V6R level with V4R and V5R in right mid axillary line
What must you do on the ECG paper when doing a right sided ECG
Write in header that it is a right sided ECG and put the letter “R” after V3-V6 to clarify it is a right sided ECG
Why do we do a 15 lead ECG
When there is a possibility of an inferior STEMI (ST-elevated MI)
If the 12 lead is non diagnostic
If the issue is inferior or posterior
Why do we do a 15 lead ECG
If the patient has an inferior STEMI (ST-elevated MI)
If the issue is inferior or posterior
If the ST is depressed in V1-V3 it’s a symptom of acute coronary syndrome
How do you do a 15 lead ECG
Run a normal 12 lead ECG
V4 gets switched to V4R
V5 gets moved to the 5th intercostal space mid scapular line (is now V8)
V6 gets moved to between V8 and the spine (is now V9)
*make sure to label as a 15 lead and reliable V8 and V9)
Why do we use Holter monitors
To evaluate symptoms suggesting arrhythmia or myocardial is ischemia
Evaluation of patients with ST segment changes
Evaluate patients response after going back to normal after MI or cardiac surgery
Monitor medication effectiveness
Evaluate pacemaker
Further investigate abnormal ECG
Why do you place the electrodes over bones for Holter monitors
To minimize artifacts from muscular activity
Where is the lead placement for a Holter monitor
Red: at top of sternum
Green: 8th rib at right mid clavicular line
Brown: 5th rib at left anterior axillary line
White: below right clavicle, lateral to mid clavicular line
Black: 8th rib left mid clavicular line
What is a stress loop
It’s used to reinforce electrodes to skin by taping over each electrode and wire
What must you do when installing a Holter monitor
Put new batteries
Impure patient and operator data
Make sure it works properly
Show patient the “event” button
Instruct patient to maintain normal daily activity
What to avoid when wearing a Holter monitor
Absolutely no baths or showers
Electric blankets
Magnets
Electric razors and toothbrushes
Metal detectors
Microwave ovens
High voltage areas
Try not to get monitor close to cellphones
