ecg – review part 2
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what is oscilloscope
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results of the tracing they are usually on printed report. can be on this screen
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What speed does the paper run on an ECG?
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most common 25mm/ per second
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What should you do if you adjust speed on ECG
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you must indicate on ECG tracing
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What is gain pertaining to ECG
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regulates the output or height of the waveform can be doubled or reduced increases size of whole ECG
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What is an artifact filter used for
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used to reduce artifact It corrects only the printed output
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artifact filter normal setting
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40hz & 150 HZ
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What is a stylus
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On older machines are heated, and the paper is treated so when the heated stylus moves it generates a tracing
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What is a normal gain on an ECG
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10mm/ mv
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What is the input function of the ECG
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electrodes provide input
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What is the Signal processing function of the ECG
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occurs inside machine, it amplifies the electrical impulse and converts it into a mechanical action
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What is the Output display function of the ECG
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results of the tracing they are usually on a printed report. Can be on a screen known as an Oscilloscope
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The stylus goes up ____ small squares and remain there for ____small squares (when using standard amount of current)
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10 small squares and remain there for 2 small squares
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Measurements on ECG - Horizontal represents
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Measurements on ECG- represents time
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Measurements on ECG- Heavy lines are
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Measurements on ECG- are 5mm by 5mm
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Measurements on ECG- Smaller box represents
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Measurements on ECG- 0.04 seconds in time and 1mV in voltage
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Measurements on ECG- At normal speed, 1 sec. equals
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25mm or 5 heavy lines
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Measurements on ECG- Vertical represents
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Measurements on ECG- represents voltage
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ECG machines are calibrated so that
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1cm. =1 mV
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ECG graph paper - Provides _____ for measurement.
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ECG graph paper - increments
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ECG graph paper is ______ and _______ sensitive
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Pressure and heat sensitive
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what are the two types of ECG graph paper
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standard grid & dot matrix
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what will erase the tracings on ECG graph paper
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Alcohol, plastic, X-ray film and sunlight
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What is advantages and disadvantages of dot matrix
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Dot matrix more expensive but takes less ink easier to read photocopies sharper
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Electrodes used more commonly and why ?
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Disposable - Gel is already applied and also reduces the chance of cross contamination
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two types of Reusable Electrode
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plates and bulbs
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Reusable Electrode must use the same amount of what for each electrode? Why?
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conductive materials, or will get a poor reading
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Reusable Electrode what care is needed
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must be properly washed be checked regularly for corrosion
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_________refers to the action of making sure that the machine is working correctly & that it is done using a standard amount of current.
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Standardization
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New machines do this automatically. In older machines there is a button you can press to
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restandardize the machine
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place chest leads by
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counting down the correct number of intercostals spaces, -feel the clavicle next to the suprasternal notch count down
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What is Lead selector used for
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used to run each lead individually
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Location of chest leads & color for - V1
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4th ICS R of sternum- red
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Location of chest leads & color for - V2
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4th ICS L of sternum - yellow
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Location of chest leads & color for - V3
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midway between V2 and V4 -green
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Location of chest leads & color for - V4
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midclavicular line 5th ICS - blue
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Location of chest leads & color for - V5
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midway between V4 and V6 horizontal to V4 - orange
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Location of chest leads & color for - V6
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midaxillary line horizontal to V4 - purple
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What to remember when applying electrodes about skin ?
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Skin must be clean and dry. -Use alcohol to clean skin prn, -may have to shave small areas if hairy, allow to dry completely
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What to remember when applying electrodes about placement ?
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Place on non-bony areas
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What to remember when applying electrodes to legs
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above ankles tab facing upwards
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What to remember when applying electrodes to arms
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use fleshy parts tabs facing downwards
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Apply precordial leads tabs facing
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tabs facing downwards
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If using disposable leads remember to
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remove the paper backing and press firmly into position
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If you run an ECG machine @ 25mm/sec. in 1 minute it will create a strip with
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a strip with 300 large boxes
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How do you calculate heart rate
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Count the number of large boxes between 2 R waves divide by 300 Example: 5 large boxes between 2 R waves 300/5 = 60
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How do you calculate heart rate using the 6 second method
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Identify 6 second section of tracing (ECG tracing marked @ 3 second intervals) View 2 sections (30 boxes) Count the number of complete complexes (P,Q,R,S,T waves) Only count if fully complete Multiply by 10
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When is 6 second method most often used
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for irregular rhythms
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Location of Limb Leads color - RA
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right arm white (clouds) ***When all is right -clouds over grass ground*****
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Location of Limb Leads color - RL
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right leg - This is also grounded lead green (grass) (Ground ) ***When all is right- clouds over grass ground*****
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Location of Limb Leads color - LA
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Left Arm black (smoke) ******smoke over fire*****
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Location of Limb Leads color - LL
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Left Leg Red (fire) ******smoke over fire*****
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small box on ECG represents how many seconds
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.04 seconds
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large box on ECG represents how many seconds
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0.2 seconds
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PR Interval is how many seconds
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0.12 - 0.20 sec
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QRS Duration is how many Seconds
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0.08 -0.10 sec
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QT Interval is how many seconds
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0.4- 0.43 sec
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RR Interval is how many seconds
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0.6 - 1.0 sec
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Sequence Method also known as 300 method how does it work
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Find R wave closest to a line count each line after till next R wave - if next R wave not on line -go to first line after Each Line represents a number Sequence order: 300 150 100 75 60 50 look at the number of last line this is heart rate (you can estimate if R wave not on line.) ***does not work on irregular rhythms***
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1500 hundred method
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Count number of small boxes either Between P & P interval - for atrial rate or Between R & R interval - for ventricular rate ~ divide 1500 by number of small boxes = heart rate ** used for precise measurement / fast rhythms**
