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Ekg powerpoint

  1. 1. Electrocardiograms and You Basic Cardiac Anatomy and Physiology and Overview of EKG use and Strip Reading SPC Hauffe, Ian A.K., EMT-P, LPN
  2. 2. Willem Einthoven
  3. 3. Einthoven’s Triangle
  4. 4. Simply: EKGs measure the direction of electrical flow through the heart.
  5. 5. A Little Physiology <ul><li>Action Potential </li></ul><ul><ul><li>In neurophysiology, the action potential is a self-regenerating wave of electrochemical activity that allows nerve cells to carry a signal over a distance. </li></ul></ul><ul><ul><li>These which end at muscles cause the muscle to contract in a similar fashion. </li></ul></ul><ul><li>Ions (-) vs Cations (+) </li></ul><ul><ul><li>Na+, K+, Ca++ </li></ul></ul><ul><ul><li>Cl- </li></ul></ul>
  6. 6. Why a little physiology is good for you. <ul><li>(7) 5 H’s </li></ul><ul><li>HYPOVOLEMIA </li></ul><ul><li>HYPOXIA </li></ul><ul><li>HYDROGEN IONS </li></ul><ul><li>HYPOKALEMIA </li></ul><ul><li>HYPERKALEMIA </li></ul><ul><li>HYPOGLYCEMIA </li></ul><ul><li>HYPOTHERMIA </li></ul><ul><li>(6) 5 T’s </li></ul><ul><li>TOXINS & TABLETS </li></ul><ul><li>TAMPONADE, CARDIAC </li></ul><ul><li>TENSION PNEUMOTHORAX </li></ul><ul><li>THROMBOSIS, CORONARY </li></ul><ul><li>THROMBOSIS, PULMONARY </li></ul><ul><li>TRAUMA </li></ul>
  7. 7. Reading Rhythms 101 Rule 1: Live and conscious people don’t enjoy 200 Joules
  8. 8. The Leads <ul><li>12 – lead </li></ul><ul><li>3 or 4 – lead </li></ul><ul><li>Defibrillation Pads </li></ul><ul><li>Emergency Paddles </li></ul>
  9. 9. 12 - lead
  10. 10. 3 or 4 - lead RA LA RL LL
  11. 11. Defiblrillation Pads
  12. 12. Emergency Paddles
  13. 13. The Paper
  14. 14. Anatomy
  15. 15. The Breakdown 5 keys to unlock any rhythm <ul><li>Rate </li></ul><ul><ul><li>60 – 100 bpm </li></ul></ul><ul><li>Rhythm </li></ul><ul><ul><li>Reg. / Reg. </li></ul></ul><ul><li>PR interval </li></ul><ul><ul><li>.12 -.20 sec. </li></ul></ul><ul><ul><li>1:1 ratio </li></ul></ul><ul><li>QRS Complex </li></ul><ul><ul><li>.08 - .10 sec. </li></ul></ul><ul><li>ST Segment </li></ul><ul><ul><li>.12 - .20 sec. </li></ul></ul><ul><ul><li>Elev. / Dep. </li></ul></ul>
  16. 16. 4 Origins <ul><li>SA Node </li></ul><ul><ul><li>60-100 bpm </li></ul></ul><ul><li>Atria </li></ul><ul><ul><li>60-100 bpm </li></ul></ul><ul><li>AV Junction </li></ul><ul><ul><li>40-60 bpm </li></ul></ul><ul><li>Ventricles </li></ul><ul><ul><li>20-40 bpm </li></ul></ul>
  17. 17. Waves and Segments <ul><li>Rate </li></ul><ul><ul><li>60 – 100 bpm </li></ul></ul><ul><li>Rhythm </li></ul><ul><ul><li>Reg. / Reg. </li></ul></ul><ul><li>PR interval </li></ul><ul><ul><li>.12 -.20 sec. </li></ul></ul><ul><ul><li>1:1 ratio </li></ul></ul><ul><li>QRS Complex </li></ul><ul><ul><li>.08 - .10 sec. </li></ul></ul><ul><li>ST Segment </li></ul><ul><ul><li>.12 - .20 sec. </li></ul></ul><ul><ul><li>Elev. / Dep. </li></ul></ul>
  18. 18. Sinus Rhythms (SA Node) <ul><li>Normal Sinus Rhythm </li></ul><ul><li>Sinus Bradycardia </li></ul><ul><li>Sinus Tachycardia </li></ul><ul><li>Sinus Arrythmia </li></ul>
  19. 19. Normal Sinus Rhythm
  20. 20. Sinus Bradycardia
  21. 21. Sinus Tachycardia
  22. 22. Sinus Arrhythmia
  23. 23. Atrial Rythms <ul><li>Atrial Flutter </li></ul><ul><li>Atrial Fibrillation </li></ul><ul><li>Premature Atrial Complex(PACs) </li></ul>
  24. 24. Atrial Flutter
  25. 25. Atrial Fibrillation
  26. 26. Premature Atrial Complex(PAC)
  27. 27. Junctional Rhythms (AV Junction) <ul><li>Junctional Escape Rhythm (Bradycardia) </li></ul><ul><li>Accelerated Junctional Rhythm </li></ul><ul><li>Junctional Tachycardia </li></ul><ul><li>Premature Junctional Complex </li></ul>
  28. 28. Junctional Escape Rhythm
  29. 29. Accelerated Junctional Rhythm
  30. 30. Junctional Tachycardia
  31. 31. Premature Junctional Complex
  32. 32. Ventricular Arrhythmias (Ventricle) <ul><li>Premature Ventricular Complex (PVCs) </li></ul><ul><li>Ventricular Tachycardia </li></ul><ul><ul><li>Monomorphic vs Polymorphic </li></ul></ul><ul><ul><li>Torsades de pontes </li></ul></ul><ul><li>Ventricular Fibrillation </li></ul><ul><ul><li>Coarse vs Fine </li></ul></ul>
  33. 33. Premature Ventricular Complex (PVCs)
  34. 34. Monomorphic Ventricular Tachycardia (V-tach)
  35. 35. Polymorphic Ventricular Tachycardia (V-tach)
  36. 36. Torsades de Pontes
  37. 37. Coarse Ventricular Fibrillation (V-fib)
  38. 38. Fine Ventricular Fibrillation (V-fib)
  39. 39. Other Rhythms <ul><li>Atrioventricular Blocks </li></ul><ul><ul><li>1 st Degree </li></ul></ul><ul><ul><li>2 nd Degree </li></ul></ul><ul><ul><ul><li>type 1 </li></ul></ul></ul><ul><ul><ul><li>type 2 </li></ul></ul></ul><ul><ul><li>3 rd Degree </li></ul></ul><ul><li>Agonal Rhythm </li></ul><ul><li>Asystole </li></ul><ul><li>Pulseless Electrical Activity </li></ul>
  40. 40. 1 st Degree AV Block
  41. 41. 2 nd Degree AV Block type 1 (Mobitz I / Wenkebock)
  42. 42. 2 nd Degree AV Block type 2 (Mobitz II / Hay)
  43. 43. 3 rd Degree AV Block (AV Dissociation)
  44. 44. Agonal Rhythm (Near Death or Swirling the Drain)
  45. 45. Asystole (Death)
  46. 46. Pulseless Electrical Activity (PEA)
  47. 47. Quick Tips <ul><li>Know your 5 H’s and 5 </li></ul><ul><li>Memorize the 5 keys to breaking down any rhythm. </li></ul><ul><li>Know your general Anatomy </li></ul><ul><li>Remember these numbers- </li></ul><ul><li>300-150-100-75-60-50 </li></ul><ul><li>But most important: </li></ul><ul><li>ABC’s, BLS, Check Your Equipment and Teamwork!! </li></ul>
  48. 49. Questions?

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