EKG ‘s Simplified: Understanding and Reading EKG Monitoring Strips : EKG ‘s Simplified: Understanding and Reading EKG Monitoring Strips By: Sherrie J. Bazin, BSN, RN
Outline of Course : Outline of Course Objectives of the course
Literature for review
Basic cardiac monitoring
Atrial arrhythmias
Junctional arrhythmias
Ventricular arrhythmias
Atrioventricular blocks
Pacemakers and electrolytes
Review and test
Objectives of the Course : Objectives of the Course Understand basic heart function.
Understand cardiac monitoring functions.
Recognize abnormal heart rhythms.
Understand basic causes of abnormal rhythms.
Obtain knowledge of treatment of abnormal rhythms.
Literature for Review : Literature for Review Read the following two articles. Links are available in the boxes above the whiteboard.
Article One- “Detecting Cardiac Injury with Telemetry”
Article Two- “Skilled Cardiac Monitoring at the Bedside: An Algorithm for Success”
Basic Cardiac Monitoring : Basic Cardiac Monitoring Electrocardiogram (EKG) records the heart’s electrical activity as a waveform.
The waveform simply depicts the depolarization or contraction repolarization or relaxation of the heart.
EKG’s/Cardiac Monitoring are used to diagnose, monitor and identify certain disorders or rhythm disorders.
Lead Placement : Lead Placement Remember lead placement is very important . An easy way to remember proper placement is the following poem:
Smoke over Fire
Clouds over Grass
Chocolate in the Center
Translates:
Black over Red
White over Green
Brown in the Center
Lead Placement : Lead Placement Always attach lead to electrode then the patient. You do not want to be pressing on the patient in order to ensure good contact.
Attach to clean skin-remove excess hair.
Brown electrode should be off to the center – this is important if you needed to do chest compressions.
Lead Placement : Lead Placement Lead II is the same as standard lead two as seen in a 12 lead EKG.
It is the most common monitoring lead.
It is not the optimal monitoring lead.
V1 lead is the best lead to view ventricular activity and differentiate between right and left bundle branch blocks.
Basic Anatomy of the Heart : Basic Anatomy of the Heart
Basic Anatomy of the Heart(Double-click on center of video to start if viewing from ppt)(Click content tab at top of window if viewing from WIZIQ lesson) : Basic Anatomy of the Heart(Double-click on center of video to start if viewing from ppt)(Click content tab at top of window if viewing from WIZIQ lesson)
The Cardiac Cycle : The Cardiac Cycle
The Cardiac Cycle(Double-click on center of video to start if viewing from ppt)(Click content tab at top of window if viewing from WIZIQ lesson) : The Cardiac Cycle(Double-click on center of video to start if viewing from ppt)(Click content tab at top of window if viewing from WIZIQ lesson)
Normal Sinus Rhythm : Normal Sinus Rhythm
Normal Sinus Rhythm : Normal Sinus Rhythm Rate is 60-100 bpm.
Atrial and Ventricular are regular
P waves are a normal rounded shape (upright in lead II) and one for every QRS complex.
T waves are a normal rounded shape (upright in lead II) following the QRS complex.
Normal Sinus Rhythm : Normal Sinus Rhythm Learn this pattern. This is the normal pattern. Analyze each pattern in comparison of the “Normal”.
Note the spacing of the complex.
Note the rate of the repeating complex.
Note the parts of the complex.
Normal Sinus Rhythm : Normal Sinus Rhythm Count large boxes between “R” waves. Divide 300 by that number, this result is your heart rate.
You should have a “P” wave just before each QRS segment.
Following the QRS segment is the “T” wave which is just a bit larger than the “P” wave.
Quiz Time : Quiz Time After reviewing this short lesson test your comprehension by taking the quiz. This will prepare you for the final exam at the end of the course.
Good Luck!
References : References Template by: www.presentationmagazine.com
Hamilton,P. (2010). Detecting Cardiac Injury with Telemetry, American Nurse Today
Evernson, L. & Farnsworth, M. (2010). Skilled Cardiac Monitoring at the Bedside: An Algorithm for Success. Critical Care Nurse
http://www.divitreemedia.com/ (Heart Video)
http://www.unm.edu
http://ems12lead.com
http://www.valuemd.com
http://www.dearnurses.com/ (excellent illustrations of problems)
http://www.rnceus.com (great resource for EKG practice)
http://www.emedu.org/ (excellent 12 lead EKG’s)