basic ECG interpretation ppt

➢ Also called an ECG, it is an electrocardiogram
➢ Recording of the heart's electrical activity
➢ A series of "waves" that represent the electrical

impulses
➢ Can be used to monitor patients for extended periods

of time
➢ Can be used to test for heart conditions

The Sinoatrial (SA) node starts the electrical impulse, which travels down the heart.

One electrode is placed on each limb (but are frequently
placed on shoulder and hip areas)
The other electrodes are placed as follows:
• V1- 4th intercostal space, R of sternum
• V2- 4th intercostal space, L of sternum
• V3- 5th intercostal space, halfway between V2 and V4.
• V4- 5th intercostal space, Left midclavicular line.
• V5- 5th intercostal space, L anterior axillary line.
• V6- 5th intercostal space, L midaxillary line.



➢The electrical impulses cause

the heart muscles to contract
➢The electrical impulses cause

the heart muscles to contract.
➢The impulses are visible as

waves, and each wave can be

linked to when each part of

the heart contracts.











➢ The SA node "fires" (sends its impulse) about times per minute for the average adult
bmp is the normal adult heart rate.

➢ The heart rhythm will be regular and constant, meaning that the waves will occur at
regular intervals (versus being irregular, occuring at varying intervals)

➢ The height (voltage) and spacing of the waves will be "normal" (you will not need to
measure voltage or milliseconds for this lesson).

➢ Sinus Rhythm can look like any of the following

Sinus Bradycardia - Occurs when you have a regular rhythm and
normal waveforms, but the rate is slower than 60 bpm.

Sinus Bradycardia - Occurs when you have a regular rhythm and
normal waveforms, but the rate is slower than 60 bpm.

https://youtu.be/3vBg6hzCWbY

Sinus Tachycardia

https://youtu.be/jW4qIbWHa-Q

Sinus Tachycardia - Occurs when you have a regular rhythm and
normal waveforms, but the rate is greater than 100 bpm for adults.

This is a 6-second recording. Can you estimate the rate in bpm?

Sinus Arrhythmia - Occurs when the waveforms are normal, but the rhythm is
irregular. The heart rate may speed up and slow down.

https://youtu.be/hnCXtWsj0GA

Sinus Rhythm A

LABEL Sinus B
THE Bradycardia C
FOLLOWING
Sinus
Tachycardia

Sinus D
Arrhythmia

Atrial Fibriliation

- An arrhythmia in which the electrical current does not begin in the SA node, and
the electricity in the heart is disorganized.

- The atria do not contract normally, but instead, they fibrillate (quiver)

https://youtu.be/ezTEc6GwLNs • The rhythm is irregular, and there is not always a

distinct P Wave.
• A-fib can increase the risk for stroke due to clot

formation.
• Many patients with A-fib will be on anticlotting

medications.

Atrial Flutter

- occurs when the electrical signal in the atria travel in a circuit, causing the atria to
contract more than normal.

- On the EKG, you will see a "sawtooth" pattern of P Waves.
- The rhythm is more regular than that of A Fib.

https://youtu.be/pfx9mkl-0BY

Premature Ventricular Contractions

- PVC's, an occasional extra contraction of the ventricles.
- These do not pump blood out of the heart, since the atria have not had a chance to pump blood into the ventricles. Feels

like a "flip flop" feeling in the chest.

https://youtu.be/wBs4fowZmzs

Ventricular Tachycardia

• An area of the ventricle takes over as the pacemaker,
and creates a rapid contraction of the ventricles

• There will be no pulse, as blood will not be pumped
out of the heart.

• There will be no pulse, as blood will not be pumped
out of the heart.

• The patient may lose consciousness or die if this
condition is not treated.

• The condition can be treated with chest compressions
and defibrillation.

https://youtu.be/C1smdOKd4Ds

Ventricular Fibrillation

• vfib, chaotic irregular electrical activity within the
ventricles. No QRS complexes are seen. Basically,
the ventricles quiver.

• There will be no pulse, as blood will not be pumped
out of the heart.

• The patient may lose consciousness or die if this
condition is not treated.

• The condition can be treated with chest
compressions and defibrillation

https://youtu.be/BSf_YIyZzi8

Asystole

• There is no electrical activity in the
heart,and shows up as a "flat line" on
an EKG.

• It can happen suddenly or gradually.
• Chest compressions and injected

medications may treat asystole, but a
defibrillator will not work!

https://youtu.be/yAu-dlhZIo0

A "Code Blue" (aka, "code") is called

when a person enters cardiac arrest,
experiences pulseless electrical activity (vfib,
vtach, agonal, etc), or asystole and does NOT
have an "Allow Natural Death" order.

https://youtu.be/-67LDrSK8qQ