ekg made easy. all teh basics you need to quickly and correctly interpret and EKG

1. MAKING ECG’S EASY
EVALUATING THE ECG
Dr Nick Robinson
01206 504320
nickrobinson129@gmail.com

2. Don’t PANIC
• BASICS
• RELAX
• MAJOR POINTS ONLY
• PATTERN RECOGNITION
2

3. 3
You will be able to:
• Perform ECG correctly
• Describe ECG
• Understand main features
• Identify basic normal ECG
• Distinguish between ECG
arrhythmia and artefact

4. 4

5. 5

6. 6

7. 7

8. 8

9. 9

10. 10
LATERAL
LATERAL

11. 11
INFERIOR
INFERIOR INFERIOR

12. 12
RIGHT SIDE

13. 13

14. 14
ANT & RV
ANT & RV
Antero-Septal
Antero-Septal
Lateral
Lateral

15. 15

16. 16

17. 17
RELATIONSHIP

18. 18

19. 19

20. 20
INFORMATION ON THE
12-LEAD ECG

21. 21
WHAT YOU NEED TO
LOOK FOR
• Are the limb leads set up
correctly?
• Are the chest leads set up
correctly?
• Is the ECG free of artifact.

22. 22
IS the ECG SET UP
CORRECTLY?
LIMB LEADS
• AVR – always
negative
• Lead I – always
positive
CHEST LEADS
• R wave progression
• Small to Tall

23. 23

24. 24
OTHER PROBLEMS
WITH THE ECG
• Artifact
• Electrical interference
• Muscle tremor
• Wandering baseline

25. 25
FIND THE ARTEFACT

26. 26
MUSCLE TREMOR

27. 27
ELECTRICAL
INTERFERANCE

28. 28
BASIC OBSERVATIONS
• Heart Rate
• Rhythm: regular? sinus?
• Intervals: PR, QRS
• ST segment

29. 29

30. 30
BOX METHOD

31. 31

32. 32

33. 33

34. 34
ECTOPIC BEATS

35. 35

36. 36

37. 40 y/o with chest pain & palpitations
short PR/delta wave (WPW)

38. 38

39. 39

40. 40

41. 41

42. 42

43. 43

44. 44

45. 45

46. 46

47. 47

48. 48

49. 49

50. 50

51. 51

52. 52

53. 53

54. 54

55. 55

56. Atrial Flutter
Saw tooth baseline
Atrial rate 300 bpm
56

57. 57

58. 58

59. 59

60. 60

61. Rhythm
Sinus Not sinus
Ventricular
Supraventricular
Morphology

62. The Normal ECG

63. The Normal ECG
Sinus rhythm (P before QRS)
Rate 50 – 100 bpm
Axis +90o to –30o
Intervals: PR .12-.20 sec
QRS <.12 sec

64. 64
SUMMARY
Correct electrode placement
? Regular ? Sinus/ ’p’ wave
Rate
Recognize basic values

65. Dr Nick Robinson
07973 437009