![]() The rhythm strip is usually 25cm long (250mm i.e. If the rhythm is irregular (see next slide on rhythm to check whether your rhythm is regular or not) it may be better to estimate the rate using the rhythm strip at the bottom of the ECG (usually lead II) RR = 4 large squares 300/ 4 = 75 beats per minute It should be 10mm (10 small squares) tallĢ5 mm (25 small squares / 5 large squares) equals one secondĬount the number of large squares between R wavesĮ.g. Look for a reference pulse which should be the rectangular looking wave somewhere near the left of the paper. Is it part of a serial ECG sequence? In which case it may be numberedĬheck that your ECG is calibrated correctly “ chest pain ” or “ routine pre – op ” Any previous or subsequent ECGs V 1 to V 6 ‘ look ’ at the heart on the transverse plain V 1 and V 2 look at the anterior of the heart and R Limb leads look at the heart in the coronalĪVL, I and II = lateral II, III and aVF = inferiorĮach lead can be thought of as ‘ looking at ’ an area Lead I is formed using the right arm electrode (red) as the negative electrode and the left arm (yellow) electrode as the positiveĮlectrode (red) as the negative electrode and the left leg electrode as the positiveĮlectrode as the negative electrode and the left leg electrode as the positiveĪVL, aVF, and aVR are composite leads, computed using the information from the other leads If the impulse travels away from the positive electrode this results in a negative deflectionĮCG (I, II, III, aVL, aVF, aVR, V1 – 6) formed If the electrical impulse travels towards the positive electrode this results in a positive deflection The voltage change is sensed by measuring the current change across 2 electrodes – a positive electrode and a negative electrode Transmitted along interventricular septum in Bundle of Hisīundle splits in two (right and left branches)Įlectrical impulse (wave of depolarisation) picked up by placing electrodes on patient If the trace obtained is no good, check that all the dots are stuck down properly – they have a tendency to fall off. Any skeletal muscle activity will be picked up as interference. V6 at the same level as V4 and V5 but on the mid – axillary lineĭifferent ECG machines have different buttons that you have to press.Īsk one of the staff on the ward if it is a machine that you are unfamiliar with.Īsk the patient to relax completely. V5 at the same level as V4 but on the anterior axillary line V 4 over the apex (5 th ICS mid – clavicular line) Palpate inferiorly to find the 3 rd and then 4 th space ![]() (to find the 4 th space, palpate the manubriosternal angle (of Louis)ĭirectly adjacent is the 2 nd rib, with the 2 nd intercostal space directly below. V1 4 th intercostal space right sternal edge V2 4 th intercostal space left sternal edge The right leg electrode is a neutral or “ dummy ” ! The 10 leads on the ECG machine are then clipped onto the contacts of the ‘ dots ’ These have single electrical contacts on them Name, DoB, hospital number, date and time, reason for recordingġ0 electrodes in total are placed on the patientįirstly self – adhesive ‘ dots ’ are attached to the patient. Greet, rapport, introduce, identify, privacy, explain procedure, permission MI, AF, 1st 2 nd and 3 rd degree heart block, p pulmonale, p mitrale, Wolff – Parkinson – White syndrome, LBBB, RBBB, Left and Right axis deviation, LVH, pericarditis, Hyper – and hypokalaemia, prolonged QT. Interpret ECGs showing the following pathology: ![]() Recite the normal limits of the parameters of various parts of t he ECG List the steps involved in interpreting an ECG tracing in an ord erly way ![]() Perform an ECG on a patient, including explaining to the patient what is involvedĭraw a diagram of the conduction pathway of the heart Draw a simple labelled diagram of an ECG tracing Objectives for this tutorial What is an ECG?Įlectrocardiography on a patient Simple physiologyīy the end of this tutorial the student should be able to: Download The ECG Made Easy 9th Edition PDF ![]()
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