OSCE Skills- ECG

Question 1

What is the purpose of an ECG?

Answer 1

To look at the patients heart activity.

Question 2

What should you always tell the patient before you start?

Answer 2

What you are doing and that it shouldn’t hurt at all.

Question 3

What should you do before anything else?

Answer 3

• Clean Hands
• Introduce yourself
• Check name and DOB
• Gain consent

Question 4

How many leads are there?

Answer 4

10-
V1-V6
4 limb leads

Question 5

What colours are the four limb leads?

Answer 5

• RED= right wrist
• Yellow = left wrist
• Green- left ankle
• Black= right ankle

Question 6

Where do you place V1?

Answer 6

Right sternal edge, 4th intercostal space

Question 7

V2?

Answer 7

4th intercostal space, left sternal edge

Question 8

V4?

Answer 8

5th left intetcostal space in midclavicular line

Question 9

V3?

Answer 9

in between V2 & V4

Question 10

V5?

Answer 10

In same horizontal plane as V4 in anterior axillary line

Question 11

V6?

Answer 11

Same horizontal plane- mid axillary line.

Question 12

What should you do once all of the leads are attached?

Answer 12

Ask the patient to lie still.

Question 13

What should you enter into the machine before pressing start?

Answer 13

Patient Name, DOB, CHI

Question 14

How do you interpret an ECG?

Answer 14

300 squares = 1 minute
5 big squares= 1 second.
ARI BAR

Question 15

A in ARI BAR?

Answer 15

Any electrical activity?

Question 16

R?

Answer 16

Rate= 300 / number of large boxes in one PR interval.

Question 17

I?

Answer 17

Irregular or regular? Rhythm?

Question 18

B?

Answer 18

Broad or Narrow QRS complex?

Question 19

A?

Answer 19

Any P waves?

Question 20

R?

Answer 20

Relationship between P wave and QRS complex?

Question 21

What heart condition is irregularly irregular?

Answer 21

Atrial Fibrillation

Question 22

What condition causes an abnormal relationship between P and QRS?

Answer 22

Heart Block

Question 23

Describe 1st degree heart block

Answer 23

Sometimes the QRS complex is late but it is always there. e.g. P-QRS-P–QRS-P—QRS-P-QRS–P

Question 24

Describe 2nd degree heart block

Answer 24

Delay between P and QRS gets longer and longer until eventually there are no QRS.

Question 25

Describe 3rd degree heart block

Answer 25

No relationship between the two- they are completely separate from each other.

Question 26

What causes heart block?

Answer 26

AV node is blocked so the impulses are not being passed through to the ventricles.