Electrocardiogram
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a portable version of an EKG that is worn under the close by the patient for 24 to 48 hour.
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Holter monitor
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on a Holter monitor chest electrodes are connected to the monitor and cardiac TV is continually monitored when?
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while the patient goes about his usual daily activities.
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a Holter monitor is worn by a patient for how long?
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24 to 48 hours as instructed by a physician.
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the recording is scanned by an electro cardio scanner and?
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a hard copy of the ECG is produced for review by the physician
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Aholt about your is used to detect ECG abnormalities that may occur over?
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unexpanded. The time
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besides ECG abnormalities what Cao Holter monitor evaluate?
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the effectiveness of any anti-arrhythmic drugs and to associate the occurrence of chest pain with stress or physical activity
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what are the two types of Holter monitors?
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looping and non-looping
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what does a looping Holter monitor do?
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it loops the activity so when the patient pushes the button to record it can record a few seconds before they push the button to a few seconds after
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what does a non-looping Holter monitor do?
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it only begins to record when the patient pushes the button.
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the electrical impulses generated by the?
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SA node
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another name for the SA node?
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pacemaker
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the waves of depolarization move through the atria causing contraction
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P-wave
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the impulse is received by the AV node where is delayed for a short time
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PR interval
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the stimulus is then sent to the bundle of HIS and the left and right bundle branches to the Purkinje fibers. This produces the ventricle depolarization and contractions
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QRS complex
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a short delay after the QRS complex
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ST segment
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the heart re-polarizes
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T wave
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how long does one small horizontal square and EKG paper represent
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.04 seconds
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how long does one large horizontal square EKG paper represent
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.20 seconds
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how much voltage does 10 vertical small blocks or two vertical large blocks represent EKG paper?
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1 mV
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one small block of EKG paper equals what size?
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1 mm
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one large block of ECG paper equals what size?
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5 mm
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how many and where are the limb lead placed?
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there are four limb leads one placed on each limb
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how many chest leads are there?
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six
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what is the electrode?
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an object place in the skin to to conduct electrical current from the body to a monitoring or measured device
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what is a lead?
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a positive and negative electrode that allows electrical current to flow
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what adjust which electrode will be positive and which will be negative
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the ECG machine
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what happens when the impulse of the heart moves towards the positive electrode
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an upward deflection is made on the ECG paper
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what would cause a downward deflection made on the ECG paper?
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the impulse of the heart moving towards the negative electrode
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how many leads are used?
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12
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how many limb leads & precordial are there?
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six each
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how many electrodes are used?
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10, six and the chest and one on each limb
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lead 1 is?
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left arm positive, right arm negative
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lead 2 is?
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left leg positive, right arm negative
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lead 3 is?
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left leg positive, left arm negative
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AVR is?
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right arm positive, everything else negative
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AVL is?
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left arm positive, everything else negative
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AVF is?
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left leg (foot) positive, everything else negative
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are the chest leads positive or negative?
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all chest leads or positive
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where is V1 placed
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fourth intercostal space, right side of the sternum
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where is V2 placed
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fourth intercostal space, left of the sternum
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what part of the heart does V1 and V2 look at
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right side
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where is V3 placed
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between V2 and V4 on the left side
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where is V4 placed
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fifth intercostal space, left mid-clavicle line
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what part of the heart does V3 and V4 look at
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ventricular septum
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where is V5 placed
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between V4 in V6 on the left side
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where is V6 placed
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fifth intercostal space, left mid auxiliary line
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what part of the heart does V5 and V6 look at
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left heart
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what are the rates of; bradycardia, tachycardia, flutter, fib, and normal heartbeats
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100 tachycardia, >200 flutter, fib is too fast account, 60 to 100 normal heart rate
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what you waves to use to estimate the rate of in EKG
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the R waves
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if there are 3 to 5 large box between R waves, what is the rate
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60 - 100
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if the R waves are closer than three large box then what is the rate
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>100 tachycardia
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if the R waves are wider than five large blocks than what is the rate
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<60 bradycardia
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heart rate equals 300 divided by what?
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large blocks between R waves
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heart rate equals 1500 divided by what?
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small blocks between R waves
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if the P-wave goes up on the paper that means
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it's a positive sinus
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the treatment for normal sinus rhythm
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nothing
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the treatment for sinus tachycardia
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oxygen
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the treatment for sinus bradycardia
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atropine, oxygen
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the treatment for PVCs
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oxygen, lidocaine
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the treatment for V Tach
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defibrillate if no pulse, lidocaine and cardiovert if pulses present
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treatment for V fib
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defibrillate
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treatment for multifocal PVCs
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oxygen, lidocaine
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treatment for Asystole
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confirm 2 leads, Epinephrine, atropine
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treatment for her first-degree AV block
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atropine
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treatment for second-degree AV block
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atropine, electrical pacemaker
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treatment for third-degree AV block
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electrical pacemaker
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what rhythm has a rate of 60 - 100 with no skips were no extra beats
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NSR or normal sinus rhythm
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sinus rhythm with the rate >100
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sinus tachycardia
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sinus rhythm with the rate <60
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sinus bradycardia
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sinus rhythm with premature ventricular contractions
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PVC
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ventricular rhythm with the rate >100
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V tach
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ventricular rhythm that is completely irregular
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V fib
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rhythm that shows no activity
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Asystole
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PR interval >.20
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first-degree AV block
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irregular rhythm, normal P waves but the QRV complexes missing
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second-degree AV block
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atrial rate >60, ventricular rate <40, PR intervals cannot be determined, QRS complex will be widened
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third-degree AV block
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what does the axis of the ECG measure
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the direction of all electricity to the heart during contraction
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normally what corner does the electrical impulse of the heart begin at
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upper right-hand corner at the SA node in the right atrium
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what direction does the electrical impulse travel in the heart
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down and across the heart to the left
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normal axis direction
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down into the left
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what are the two factors that affect direction
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hyper trophy, and infarction
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what is ischemia
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reduce blood flow in the tissue
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what is injury
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acute damage to tissue, often from ischemia
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what is infarction
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necrosis or death of the tissue may be recent ( acute) or old
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on a ECG what represents ischemia
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a depressed or inverted T wave
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on a ECG what represents injury
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an elevated ST segment
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Anna ECG what represents infarction
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significant Q waves, half the height of R wave or one small square wide
