Objectives. Lead Placement. Hexaxial System. ECG Paper. Systematic Approach to Reading an ECG. Page 3. Lead Placement. Page 4. Hexaxial System. P wave = atrial depolarisation. PR Interval = impulse from atria to ventricles to ventricles. QRS complex = ventricular depolarisation. ST segment = isoelectric -. Library of Congress Cataloging-in- Publication Data. ECG interpretation made incredibly easy!. —. 5th ed. p. ; cm. Includes bibliographical references and index .
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Discuss a systematic approach to rhythm interpretation. Review common cardiac arrhythmias. Describe the process for interpretation of a 12 lead ECG. To get the most out of the Basic ECG Interpretation Study Day please read this In this section of the course, we'll cover the basics of how an ECG works. Basic Principles of ECG. Interpretation. ♥Place electrodes correctly (??) ♥Be Careful to Get Correct Data. ♥Consider Clinical Context/Setting. ♥Chest pain?.
Abstract The use of dynamic electrocardiogram ECG monitoring is regarded as a standard of care during general anesthesia and is strongly encouraged when providing deep sedation. Although significant cardiovascular changes rarely if ever can be attributed to mild or moderate sedation techniques, the American Dental Association recommends ECG monitoring for patients with significant cardiovascular disease.
The purpose of this continuing education article is to review basic principals of ECG monitoring and interpretation.
Keywords: Electrocardiography, Patient monitoring, Continuing education Dynamic electrocardiographic ECG monitoring is a standard of practice when providing general anesthesia, but opinions are mixed regarding its use during moderate conscious and deep sedation. The American Dental Society of Anesthesiology included pulse oximetry for patient monitoring in its guidelines published in The American Dental Association recently revised its monitoring guidelines to include ECG monitoring for all deeply-sedated patients and for consciously-sedated patients with compromised cardiovascular function.
Despite this controversy, a growing number of state dental boards are requiring ECG monitoring for general anesthesia and all levels of intravenous sedation. Count the number of large squares present within one R-R interval Divide by this number to calculate the heart rate e.
Step 2 — Heart rhythm The heart rhythm can be regular or irregular. Irregular rhythms can be either: Regularly irregular i. Normal Cardiac Axis.
Right axis deviation 2. Left axis deviation 2. P-waves 1. First degree heart block. Delta wave 5. Various components of an ECG. Poor R-wave progression 7. ST elevation in the anterior leads.
ST depression. Tall tented T-waves 8. Inverted T-wave. Biphasic t-wave 9. Flattened T-wave 9.
U-wave Previous How the Gonadal Axis Works. The horizontal axis represents time and the vertical axis represents voltage.
The "large" box is represented by a heavier line weight than the small boxes. Not all aspects of an ECG rely on precise recordings or having a known scaling of amplitude or time. For example, determining if the tracing is a sinus rhythm only requires feature recognition and matching, and not measurement of amplitudes or times i.
An example to the contrary, the voltage requirements of left ventricular hypertrophy require knowing the grid scale. Rate and rhythm[ edit ] In a normal heart, the heart rate is the rate in which the sinoatrial node depolarizes as it is the source of depolarization of the heart. Heart rate, like other vital signs like blood pressure and respiratory rate, change with age.
In adults, a normal heart rate is between 60 and bpm normocardic where in children it is higher. A complication of this is when the atria and ventricles are not in synchrony and the "heart rate" must be specified as atrial or ventricular e.
In normal resting hearts, the physiologic rhythm of the heart is normal sinus rhythm NSR. Generally, deviation from normal sinus rhythm is considered a cardiac arrhythmia. Thus, the first question in interpreting an ECG is whether or not there is a sinus rhythm.
Once sinus rhythm is established, or not, the second question is the rate. For a sinus rhythm this is either the rate of P waves or QRS complexes since they are 1-to If the rate is too fast then it is sinus tachycardia and if it is too slow then it is sinus bradycardia.