electrophysiology & ecg basics - 3m...

3M™ Learning Connection 6/7/2013

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3M Infection Prevention SolutionsLearning Connection

June 11, 2013Gayle Anderson , RN, BSN

Electrophysiology & ECG Basics

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Disclosure

Gayle Anderson is a consultant for 3M

• September 18 - Anatomy and Physiology of the Heart

• November 11 - Congestive Heart Failure and Pulmonary Edema


Gayle Anderson RN, BSN


www.clinicaladvisor.com© 3M 2013. All Rights Reserved


Learning Objectives

• Discuss the Cardiac Conduction System Anatomy.

• Describe proper placement of 5-and 12- lead ECG electrodes.

• Define Electrocardiography and Cardiac Conduction.

• Discuss the ‘Sequence’ of a rhythm strip and correlation of heart conduction system to ECG rhythm strip.

• Recognize various cardiac rhythms.


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Cardiac Conduction System Anatomy

www.pharmacology2000.com


5 Lead ECG Placement

www.the-ekg-site.com


12 Lead ECG Placement

wg11.sc29.org


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Normal Intervals

www.medicalopedia.com


Algorithm for Rhythm Analysis

• Is the overall rhythm regular or irregular?

• What are the atrial and ventricular heart rates?

• What is the appearance of the P wave

• Are the PR’s of normal duration and fixed?

• What is the relationship of the P’s to QRS’s?

• What is the appearance of the QRS’s


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Normal Sinus Rhythm

http://www.proprofs.com/flashcards/story.php?title=emtcardiology


Sinus Bradycardia

http://www.cardiachealth.org/bradycardia


Sinus Tachycardia

http://www.usi.edu/science/biology/mkhopper/ap_labs/2402/EKG/EKGMain.htm


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Supraventricular Tachycardia

• Regular rhythm with rate at 150-250 bpm

• P wave usually not discernible especially at high rate; if

seen Atrial P waves differ from Sinus P waves.

• PR Usually not discernible; if seen 0.12-.20

• QRS complexes are Narrow <0.10 sec


Atrial Fibrillation

http://wardwiki.com/w/Supraventricular_Arrhythmias


Atrial Flutter

http://www.hxbenefit.com/atrial-flutter.html


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Ventricular Tachycardia

http://www.doctortipster.com/3748-ventricular-tachycardia-causes-diagnosis-and-treatment.html


Torsades de Pointe

http://www.ceufast.com/courses/viewcourse.asp?id=239


Wolff-Parkinson-White Syndrome - (WPW)

www.frca.co.uk


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Ventricular Fibrillation

http://www.medvarsity.com/content/DEM/Module1/1_3_6.aspx


Pulseless Electrical Activity (PEA)



Asystole



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1st Degree AV Heart Block

www.meducation.net/resources/21755-First-degree-AV-block---marquette


2nd Degree AV Heart Block Type I

http://farhahsyakirah2011.blogspot.com/2012/04/heart-block-is-like-marriage-life.html


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2nd Degree AV Heart Block Type II

http://farhahsyakirah2011.blogspot.com/2012/04/heart-block-is-like-marriage-life.html


3rd Degree AV Heart Block

http://www.studyblue.com/notes/note/n/ekgs/deck/6647012


Wandering Atrial Pacemaker (WAP)

http://quizlet.com/19622022/ecg-rhythm-strip-flash-cards/


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Junctional Rhythm

http://www.frca.co.uk/article.aspx?articleid=100687


Accelerated Junctional Rhythm

http://www.frca.co.uk/article.aspx?articleid=100687


Junctional Tachycardia

• Rate > 100 bpm

• Rhythm Regular

• P wave Inverted, may be on ST or hidden in QRS

• PR interval Regular

• QRS, R to R regular

http://nurse-station.ir/images/newspost_images/Electrocardiogram%20Education/5-6.jpg


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Idioventricular Rhythm

www.meducation.net/resources/21594-Idioventricular-escape-rhythm


Accelerated Idioventricular Rhythm

https://www.meducation.net/encyclopedia/Dissociative_Disorders


Catchy Phrase

“When in doubt, print it out!!”

http://www.checkoutthefuture.com/faq.html


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Questions before we get started on some practice strips??

funny-tshirts.feedio.net

GOT RHYTHM????


Practice Strip 1

www.flashcardmachine.com


Practice Strip 2



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Practice Strip 3



Practice Strip 4



Practice Strip 5



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Practice Strip 6



Practice Strip 7



Practice Strip 8



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Practice Strip 9



Practice Strip 10



Practice Strip 11



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Practice Strip 12



Practice Strip 13



Practice Strip 14



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Practice Strip 15



Questions????


Referenceswww.answers.com

www.cardiachealth.org/bradycardia

www.cartoonstock.com

www.ceufast.com/courses/viewcourse.asp?id=239

www.checkoutthefuture.com/faq.html

www.clinicaladvisor.com

www.dobrador.com

www.doctortipster.com/3748-ventricular-tachycardia-causes-diagnosis-and-treatment.html

www.frca.co.uk/article.aspx?articleid=100687


www.funny-tshirts.feedio.net

www.hxbenefit.com/atrial-flutter.html

www.meducation.net/resources/21594-Idioventricular-escape-rhythm

www.meducation.net/encyclopedia/Dissociative_Disorders


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References (cont.)

www.medicalopedia.com

www.medvarsity.com/content/DEM/Module1/1_3_6.aspx

www.nurse-station.ir/images/newspost_images/Electrocardiogram%20Education/5-6.jpg

www.pharmacology2000.com

www.proprofs.com/flashcards/story.php?title=emtcardiology

www.quizlet.com/19622022/ecg-rhythm-strip-flash-cards

www.studyblue.com/notes/note/n/ekgs/deck/6647012

www.the-ekg-site.com

www.usi.edu/science/biology/mkhopper/ap_labs/2402/EKG/EKGMain.htm

http://wardwiki.com/w/Supraventricular_Arrhythmias

wg11.sc29.org


Thanks!!

Thank you for attending this 3M webinar on


Have a wonderful day!! ☺

&

Remember…….

“When in doubt, Print it out!!”

• September 18 - Anatomy and Physiology of the Heart• November 11 - Congestive Heart Failure and

Pulmonary Edema

© 3M 2013. All Rights Reserved www.dobrador.com


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Thank You

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