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tanmay_mehta
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Library: Learn ecg bed side easy way
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03.10.06 (2 years ago)
#1
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posting some useful tips to make ecg easier. hope they are helpful. plz send your inputs as per your experience.
work systematically through the ECG:
'The rate is...' To work out the rate take 300 and divide by the distance between two QRS complexes. Normal is 60 - 100 beats per minute in the average .
• 6 squares = 300/6 = 50bpm (bradycardia)
• 5 squares = 300/5 = 60bpm
• 4 squares = 300/4 = 75bpm
• 3 squares = 300/3 = 100bpm
• 2 squares = 300/2 = 150bpm (tachycardia)
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tanmay_mehta
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03.10.06 (2 years ago)
#2
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'The rhythm is...' Is the rhythm regular? This can be worked out by marking the QRS distances on a piece of paper and shifting it along to see if the pattern always fits. If it is irregular, is it irregularly irregular? If there are P waves before each QRS and it is regular, the rhythm is 'sinus'.
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tanmay_mehta
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03.10.06 (2 years ago)
#3
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The axis of the heart is the average direction of impulse flow. To assess this, look at leads I, II and III. For axis, look at the overall deflection of the QRS. Is it up (positive) or down (negative)? The normal axis of the heart is from +90° to -30°, measured from 3 o'clock as 0°.
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tanmay_mehta
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03.10.06 (2 years ago)
#4
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easiest way to think of this is as vectors. In the normal ECG all three leads are positive.
If lead I is negative, there is right axis deviation
If leads II and III are negative, there is left axis deviation
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tanmay_mehta
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03.10.06 (2 years ago)
#5
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The P wave should be normal in shape and size (<2.5mm tall). It reflects the atrial depolarization. Abnormalities reflect changes in the atria and valves.
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tanmay_mehta
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03.10.06 (2 years ago)
#6
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QRS should be less than 3 small squares wide. Wider complexes imply abnormal depolarization. Very tall R waves can reflect left ventricular hypertrophy.
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tanmay_mehta
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03.10.06 (2 years ago)
#7
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'The T wave is...' Normal is <10mm tall. Abnormal T waves can be peaked or inverted.
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tanmay_mehta
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03.10.06 (2 years ago)
#8
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U waves are rarely seen in normal people or hypokalaemia
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sd04
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03.11.06 (2 years ago)
#9
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gud work 
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tanmay_mehta
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03.14.06 (2 years ago)
#10
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Torsades de Pointes is a rapid ventricular rhythm caused by low potassium, medications (those that block potassium channels), or congenital abnormalities (e.g., Long QT Syndrome) that lengthen the QT interval. The rate is a variable 250 to 350 per minute, in brief episodes.
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