Presenting an ECG

Question 1

How do you present an ECG?

Answer 1

1. Demographics
2. Calibration
3. Axis
4. Rhythm
5. Rate
6. P waves
7. PR interval
8. QRS complex
9. ST segment
10. T waves
11. QT interval
12. Conclusion

Question 2

What do you include in the demographics?

Answer 2

Patient details

Date taken

Chest pain

Question 3

What is the correct calibration of an ECG?

Answer 3

25 mm/s

10 mm/V

Question 4

What rhythms can you comment on?

Answer 4

Sinus rhythm = p followed by QRS + QRS followed by p

Tachycardia/bradycardia

Regular/irregular

Question 5

How do you calculate the rate?

Answer 5

Regular = 300/big squares per R-R

Irregular = no. of QRS per strip x 6

Question 6

What can you say about p waves?

Answer 6

Normal

Tall = R atrial enlargement

Double peak = L atrial enlargement

Question 7

How is PR interval measured?

Answer 7

Start of P -> start of R

Question 8

What s the normal length of PR interval?

Answer 8

3-5 small squares

0.12-0.2 s

Question 9

What does a prolonged PR interval show?

Answer 9

First degree heartblock

Question 10

What does a short PR interval show?

Answer 10

No SA origin

- junctional rhythm

Question 11

How long should a QRS be?

Answer 11

> 0.12s

Question 12

What does a prolonged QRS show?

Answer 12

Bundle branch block

Question 13

What are you looking for in the ST segment?

Answer 13

Elevation

• 1mm limb leads
• 2mm chest leads

Depression

• 0.5mm limb leads
• 1mm chest leads

Question 14

What can you look for in T waves?

Answer 14

Tall waves
- hyperkalaemia

Inverted waves
- myocardial ischaemia

Pointed waves
- pericarditis

Question 15

How long should the QT interval be?

Answer 15

Should not be more than 1/2 R-R