EKG LECTURE.docx

**[Basic EKG Interpretation]** The terms ECG or EKG both stand for electrocardiogram. An electrocardiogram is a simple test that assesses the electrical conduction system of the heart. It can detect dysrhythmias and other cardiac issues. *Basic Blood Flow of the Heart:* Heart blood flow starts on...

**[Basic EKG Interpretation]** The terms ECG or EKG both stand for electrocardiogram. An electrocardiogram is a simple test that assesses the electrical conduction system of the heart. It can detect dysrhythmias and other cardiac issues. *Basic Blood Flow of the Heart:* Heart blood flow starts on the right side of the heart with deoxygenated blood entering the right atrium, flowing through the tricuspid valve, into the right ventricle, up through the pulmonic valve, into the pulmonary artery, then into the lungs for gas exchange (the blood now is oxygenated), it now enters into the left side of the heart via the left atrium, down through the mitral valve, into the left ventricle, up through the aortic valve, into the aorta, and lastly throughout the body. heart blood flow However, for your heart to pump the blood correctly it relies on the electrical conduction system. This system sends out jolts of electrical signals to the atria and ventricles causing them to contract and relax, which moves blood throughout the heart. This process is known as depolarization and repolarization of specific heart muscle cells that make up the atria and ventricles.  Heart Cells - - When these cells are resting, they're polarized. To get these cells to move (hence contract), they must become depolarized by an electrical stimulation. REPOLARIZED= RESTING AND RELAXATION "RE" DEPOLARIZED=CONTRACTING SA Node (sinoatrial node) - - - AV node (atrioventricular node): - - Bundle of His, Bundle of Branches, Purkinje Fibers - - - *\*\*If the electrical conduction system sends out electrical signals like it's supposed to (with the electrical signaling starting out in the SA node and traveling down throughout the system) it will create the rhythm known as Normal Sinus Rhythm on the ECG strip. However, if there are problems within this system, dysrhythmias can occur like atrial fibrillation, atrial flutter, v-tach, etc.\*\*\** *The ECG Waveform* - - - - small large square measurements on ekg ecg  **P wave:** this represents **atrial depolarization** (leads to the atria contraction), which is created by the SA node. The atria receive blood and they must push it down to the ventricles by contracting. In other words, the p-wave is showing you that the atria are contracting. **PR segment** (don't confuse this with the PR interval): this demonstrates the delay created by the AV node (remember it's the gatekeeper and gives the atria time to dump blood into the ventricles before they contract). It's a flat line after the p-wave. **PR interval**: this interval starts at the beginning of the p wave and extends to the beginning of the QRS complex. It demonstrates the amount of time it takes for the electrical signal to go from the atria to the AV node. This is a part that is measured on the ECG. **QRS complex**: this represents ventricle depolarization beginning which leads to the contraction of the ventricles and in this waveform is also atrial repolarization (relaxation of the atria), but it's overshadowed by the large ventricles, so you can't really see it. This is a part that is measured on the ECG. **ST segment:** this represents the completion of ventricular depolarization and beginning of ventricle repolarization. It starts at the end of the QRS and ends at the beginning of the t-wave. The segment should be flat. **T wave:** this represents the beginning of ventricular repolarization which leads to ventricle relaxation. The ventricles are so big that when they relax it creates the t wave. **QT interval:** starts at the beginning of the QRS complex and ends after the t wave. It demonstrates the time it takes for electrical signals to cause the ventricles to contract and then rest. This is a part that is measured on the ECG. pr interval measurement, ecg, ekg intepretation **QRS complex:** should be behind every p wave, should not be very wide or narrow, and measures no more than 0.12 seconds. measure, start of the q wave and end at the s wave. **P-**wave: think of the 3 R's (Regularity, Rate, Resemblance) 1. 2. 3. 1. Now the QRS: QRS complex: 3 R's (Regularity, Rate, Resemblance) 1. 2. 3. 1. Next, the T-wave T-wave: should come after the QRS complex and be round and in the upright position in most leads PQRST Extra: (intervals and segments) 1. 1. 2. 2. 3. **[EKG Steps]** 1. 2. 3. 4. 5. 6. 7. 8. **EXAMPLE**  1. 2. 3. 4. 5. 6. 7. 8. **[TYPES OF EKG STRIPS]** **[Normal Sinus Rhythm ]** **[Sinus Bradycardia]**  - - - - **[Sinus Tachycardia]** - - - - **[Atrial Fibrillation]** - - - - **[Atrial Flutter]** - - - - - **[Ventricular Tachycardia]** **MONOMORPHIC**  **POLYMORPHIC** - - - - - - - - - **[Ventricular Fibrillation]**  - - - - - - - - - **[Asystole (CARDIAC ARREST!!!!!!) ]** - - - **[Monitoring Equipment]** - - - **What is a Lead?** - - - - **[Lead Cable Electrode Placement ]**  **[EKG Skin Prep]** - - - - - -