This document provides an overview of EKG interpretation for nursing students. It covers the basics of EKG including normal sinus rhythm, intervals, blocks, axis, hypertrophy, ischemia, and various arrhythmias. Examples of various rhythms and conditions are presented to help students learn to systematically interpret EKGs by evaluating rate, rhythm, intervals, axis, hypertrophy, and evidence of ischemia. The document is intended as a guide for nursing students to develop skills in EKG interpretation and recognition.
crème de la crème basics to understand electrocardiographic analysis in an easy & simple way with some specifications to its use in Emergency medicine/clinical toxicology practice.
crème de la crème basics to understand electrocardiographic analysis in an easy & simple way with some specifications to its use in Emergency medicine/clinical toxicology practice.
Brief explanation of Junctional arrhythmia and Ventricular Arrhythmia. Slide 15, 16 and 18 are animations but cannot be viewed through the slide. Mail me if you need the animation or visit the website on the reference (number 7) and choose the animation according to your preference.
Brief explanation of Junctional arrhythmia and Ventricular Arrhythmia. Slide 15, 16 and 18 are animations but cannot be viewed through the slide. Mail me if you need the animation or visit the website on the reference (number 7) and choose the animation according to your preference.
The PR interval is the time from the onset of the P wave to the start of the QRS complex.
It reflects conduction through the AV node.
The normal PR interval is between 120 – 200 ms (0.12-0.20s) in duration (three to five small squares).
If the PR interval is > 200 ms, first degree heart block is said to be present.
PR interval < 120 ms suggests pre-excitation (the presence of an accessory pathway between the atria and ventricles) or AV nodal (junctional) rhythm.
commonly used for medical students, and helpful to use this ppt to study for them, and also a common man can understand very easily what is coarctation of aorta.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
7. EKG Distributions
Anteroseptal: V1, V2, V3,
V4
Anterior: V1–V4
Anterolateral: V4–V6, I,
aVL
Lateral: I and aVL
Inferior: II, III, and aVF
Inferolateral: II, III, aVF,
and V5 and V6
JERIN.T.S, 3RD YEAR BSC NURSING,
KRSMCON MANGALORE. PH:
+919496743672
9. Interpretation
Develop a systematic approach to reading EKGs
and use it every time
The system we will practice is:
Rate
Rhythm (including intervals and blocks)
Axis
Hypertrophy
Ischemia
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
10. Rate
Rule of 300- Divide 300 by the number of boxes
between each QRS = rate
Number of
big boxes
Rate
1 300
2 150
3 100
4 75
5 60
6 50
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
11. Rate
HR of 60-100 per minute is normal
HR > 100 = tachycardia
HR < 60 = bradycardia
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
12. Differential Diagnosis of
Tachycardia
Tachycardia Narrow Complex Wide Complex
Regular ST
SVT
Atrial flutter
ST w/ aberrancy
SVT w/ aberrancy
VT
Irregular A-fib
A-flutter w/ variable
conduction
MAT
A-fib w/ aberrancy
A-fib w/ WPW
VT
JERIN.T.S, 3RD YEAR BSC NURSING,
KRSMCON MANGALORE. PH:
+919496743672
13. What is the heart rate?
(300 / 6) = 50 bpm
www.uptodate.com
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
14. Rhythm
Sinus
Originating from
SA node
P wave before
every QRS
P wave in same
direction as QRS
JERIN.T.S, 3RD YEAR BSC NURSING,
KRSMCON MANGALORE. PH:
+919496743672
15. What is this rhythm?
Normal sinus rhythm
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
16. Normal Intervals
PR
0.20 sec (less than one
large box)
QRS
0.08 – 0.10 sec (1-2 small
boxes)
QT
450 ms in men, 460 ms in
women
Based on sex / heart rate
Half the R-R interval with
normal HR
JERIN.T.S, 3RD YEAR BSC NURSING,
KRSMCON MANGALORE. PH:
+919496743672
17. Prolonged QT
Normal
Men 450ms
Women 460ms
Corrected QT (QTc)
QTm/√(R-R)
Causes
Drugs (Na channel blockers)
Hypocalcemia, hypomagnesemia, hypokalemia
Hypothermia
AMI
Congenital
Increased ICP
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
18. Blocks
AV blocks
First degree block
PR interval fixed and > 0.2 sec
Second degree block, Mobitz type 1
PR gradually lengthened, then drop QRS
Second degree block, Mobitz type 2
PR fixed, but drop QRS randomly
Type 3 block
PR and QRS dissociated
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
19. What is this rhythm?
First degree AV block PR is fixed and
longer than 0.2 sec
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
20. What is this rhythm?
Type 1 second degree block (Wenckebach)
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
21. What is this rhythm?
Type 2 second degree AV block Dropped QRS
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
22. What is this rhythm?
3rd
degree heart block (complete)
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
23. The QRS Axis
Represents the overall direction of the heart’s activity
Axis of –30 to +90 degrees is normal
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
24. The Quadrant Approach
QRS up in I and up in aVF = Normal
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
25. What is the axis?
Normal- QRS up in I and aVF
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
26. Hypertrophy
Add the larger S wave of V1 or V2 in mm, to the
larger R wave of V5 or V6.
Sum is > 35mm = LVH
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
27. Ischemia
Usually indicated by ST changes
Elevation = Acute infarction
Depression = Ischemia
Can manifest as T wave changes
Remote ischemia shown by q waves
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
28. What is the diagnosis?
Acute inferior MI with ST elevation in leads II, III, aVF
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
29. What do you see in this EKG?
ST depression II, III, aVF, V3-V6 = ischemia
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
30. Let’s Practice
The sample EKGs were obtained from the following
text:
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
36. Wellen’s Sign
ST elevation and biphasic T wave in V2 and V3
Sign of large proximal LAD lesionJERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
37. Brugada Syndrome
RBBB or incomplete RBBB in V1-V3 with convex ST elevation
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
38. Brugada Syndrome
Autosomal dominant genetic mutation of sodium
channels
Causes syncope, v-fib, self terminating VT, and
sudden cardiac death
Can be intermittent on EKG
Most common in middle-aged males
Can be induced in EP lab
Need ICD
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
44. Inferolateral MI
ST elevation II, III, aVF
ST depression in aVL, V1-V3 are reciprocal changesJERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
46. Left Bundle Branch Block
Monophasic R wave in I and V6, QRS > 0.12 sec
Loss of R wave in precordial leads
QRS T wave discordance I, V1, V6
Consider cardiac ischemia if a new finding
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
47. Right Bundle Branch Block
V1: RSR prime pattern with inverted T wave
V6: Wide deep slurred S wave
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
48. First Degree Heart Block, Mobitz Type I
(Wenckebach)
PR progressively lengthens until QRS dropsJERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
50. Right Ventricular Myocardial
Infarction
Found in 1/3 of patients with inferior MI
Increased morbidity and mortality
ST elevation in V4-V6 of Right-sided EKG
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
52. Prolonged QT
QT > 450 ms
Inferior and anterolateral ischemia
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
53. Second Degree Heart Block, Mobitz Type II
PR interval fixed, QRS dropped intermittentlyJERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
54. Acute Pulmonary Embolism
SIQIIITIII in 10-15%
T-wave inversions, especially occurring in
inferior and anteroseptal simultaneously
RAD
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
55. Wolff-Parkinson-White
Syndrome
Short PR interval <0.12 sec
Prolonged QRS >0.10 sec
Delta wave
Can simulate ventricular hypertrophy, BBB and previous MI
JERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
56. Hypokalemia
U waves
Can also see PVCs, ST depression, small T wavesJERIN.T.S, 3RD YEAR BSC NURSING, KRSMCON
MANGALORE. PH:+919496743672
