OSCE Skills- ECG Flashcards
What is the purpose of an ECG?
To look at the patients heart activity.
What should you always tell the patient before you start?
What you are doing and that it shouldn’t hurt at all.
What should you do before anything else?
- Clean Hands
- Introduce yourself
- Check name and DOB
- Gain consent
How many leads are there?
10-
V1-V6
4 limb leads
What colours are the four limb leads?
- RED= right wrist
- Yellow = left wrist
- Green- left ankle
- Black= right ankle
Where do you place V1?
Right sternal edge, 4th intercostal space
V2?
4th intercostal space, left sternal edge
V4?
5th left intetcostal space in midclavicular line
V3?
in between V2 & V4
V5?
In same horizontal plane as V4 in anterior axillary line
V6?
Same horizontal plane- mid axillary line.
What should you do once all of the leads are attached?
Ask the patient to lie still.
What should you enter into the machine before pressing start?
Patient Name, DOB, CHI
How do you interpret an ECG?
300 squares = 1 minute
5 big squares= 1 second.
ARI BAR
A in ARI BAR?
Any electrical activity?
R?
Rate= 300 / number of large boxes in one PR interval.
I?
Irregular or regular? Rhythm?
B?
Broad or Narrow QRS complex?
A?
Any P waves?
R?
Relationship between P wave and QRS complex?
What heart condition is irregularly irregular?
Atrial Fibrillation
What condition causes an abnormal relationship between P and QRS?
Heart Block
Describe 1st degree heart block
Sometimes the QRS complex is late but it is always there. e.g. P-QRS-P–QRS-P—QRS-P-QRS–P
Describe 2nd degree heart block
Delay between P and QRS gets longer and longer until eventually there are no QRS.
Describe 3rd degree heart block
No relationship between the two- they are completely separate from each other.
What causes heart block?
AV node is blocked so the impulses are not being passed through to the ventricles.
