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ECG Interpretation

This document provides an overview of ECG interpretation and the conduction system. It defines the key components of the ECG like the P wave, PR interval, QRS complex, and QT interval. Common arrhythmias like AV block and pacemakers are discussed. Treatment for arrhythmias includes atropine, beta blockers, calcium channel blockers, or pacemakers. Post pacemaker care involves avoiding strong magnetic fields and exercise restrictions.

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BIANCA ROMELLE STEPHANIE PAYOT
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189 views3 pages

ECG Interpretation

This document provides an overview of ECG interpretation and the conduction system. It defines the key components of the ECG like the P wave, PR interval, QRS complex, and QT interval. Common arrhythmias like AV block and pacemakers are discussed. Treatment for arrhythmias includes atropine, beta blockers, calcium channel blockers, or pacemakers. Post pacemaker care involves avoiding strong magnetic fields and exercise restrictions.

Uploaded by

BIANCA ROMELLE STEPHANIE PAYOT
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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ECG INTERPRETATION (IR) LECTURER: RYAN ALEXANDER LIM,

USRN
POWER DEVELOPMENT REVIEW CENTER NOTES BY: GROUP 5

AV NODE
NORMAL ECG
- Traveling of impulse
- Gateway to the ventricles
P WAVE
- Represents: Atrial depolarization or BUNDLE OF HIS
contraction - Pathway to the ventricles (muscles)
- Conduction site: SA node
- Duration: < 0.11 seconds (< 3 small boxes) PURKINJE FIBERS
- Site: Ventricular muscles
PR INTERVAL - Electrical contraction: Depolarization (QRS)
- Measurement: Beginning of P wave to the
beginning of QRS
- Conduction sites: SA to AV node to Bundle STEPS IN INTERPRETING
of His
- Duration: 0.12-0.20 seconds (3-5 boxes) 1. Rhythm
- Measure R wave to R wave
QRS COMPLEX - Determine: Regular or irregular
- Represents: Ventricular depolarization or 2. Rate
contraction - Determine: Normal (60-100),
- Conduction site: Purkinje Fibers tachycardic (>100), or bradycardic
- Duration: <0.10 or <0.12 seconds (<60)
- Method: Count the number of R waves
ST SEGMENT in 6 second trip and multiply by 10
- Early repolarization or relaxation - Normal: 6-10 R waves (multiplied by
- Measurement: End of the QRS to the 10)
beginning of T wave - Types:
● Sinus Bradycardia
T WAVE - Rate:<60
- Represents: Ventricular repolarization or - DOC: Atropine sulfate 0.5-
relaxation 1 mg (increases the HR)
- Resting mode ● Sinus Tachycardia
- Rate: >100 bpm
QT INTERVAL - DOC: Beta Blockers to
- Whole cycle of contraction and relaxation decrease the HR
- Measurement: Beginning of QRS to end of - Calcium Channel Blockers
T Wave (Verapamil, Diltiazem) to
decrease HR
3. P Wave
CONDUCTION SYSTEM
- Identify the P wave
- Ask
SA NODE ● Is there a P wave before each
- Impulse originated: Pacemaker (Generator) QRS complex?
- Site: Junction of the superior vena cava and ● Are the P waves similar in size,
the right atrium shape, and position?
- Rate: 60-100 bpm
ECG INTERPRETATION (IR) LECTURER: RYAN ALEXANDER LIM,
USRN
POWER DEVELOPMENT REVIEW CENTER NOTES BY: GROUP 5

●Are the P waves normal in - PR interval: Prolonged (> 0.20 seconds)


appearance? - S/S: None
4. PR Interval
- Normal: 0.12-0.20 seconds (duration) 2ND DEGREE AV BLOCK
- Beyond 0.20 seconds is heart block ● Type 1 (Mobitz or Wenckebach)
- Ask: - PR interval: Prolonged (> 0.20
● Is the PRI consistently the same seconds)
length? - Progressively longer
● Is the PRI normal? - S/S: Syncope, dizziness, ↓ LOC
5. QRS Complex ● Type 2 (Mobitz 2)
- Normal QRS Duration: < 0.10-0.12 - PR interval: Prolonged (> 0.20
seconds seconds)
- If more than 0.12 seconds: Ventricular - Intermittent (on and off)
problem - Duration of PRI: Constant

3RD DEGREE AV BLOCK


DYSRHYTHMIAS
- Impulse or signal: Completely blocked
- HR: < 40-60 bpm
PREMATURE ATRIAL CONTRACTION - S/S: Same with 2nd degree + dyspnea,
chest pain
- Problem: P wave; early, not consecutive
- Management:
● It does not require treatment
● Needs rest and to avoid caffeine
NURSING MANAGEMENT
(stimulate tachycardia)
● Identify underlying cause
● Treatment
ATRIAL TACHYCARDIA - Atropine (0.5-1 mg)
- Transcutaneous Pacing
AV BLOCK ● Through electrodes on the skin
- Causes: ● For emergency
● Fibrosis: Scarring - Permanent pacing
- Ischemia (decreased O2 → ● Device implanted → Pacemaker
heart muscles)
- Infarction → cell death (+) PACEMAKER
necrosis - Indicated:
- Impaired conduction (blocked) ● AV Block (Heart Block)
● Partial: 1st and 2nd degree ● Bradycardia
AV block - Minor surgery
● Complete: 3rd degree AV - Action:
block ● Control abnormal heart rhythm
- Impulses cannot reach ventricles ● Uses electrical impulses
- Parts:
1ST DEGREE AV BLOCK ● Battery (5-10 or 5-15 years)
- Impulse: Slow or delayed but still makes it ● Computerized generators
ECG INTERPRETATION (IR) LECTURER: RYAN ALEXANDER LIM,
USRN
POWER DEVELOPMENT REVIEW CENTER NOTES BY: GROUP 5

● Wires with sensors

HEALTH TEACHINGS
● Avoid vigorous exercise
- Lifting > 3 lbs weekly
● Report malfunction S/S
- Irregular pulse: Check pulse daily
- ↓ CO (dyspnea, ↓ UO, edema)
- Hiccups
● Avoid close contact with strong magnetic
field devices
- MRI
- Metal detectors
● Medic Alert bracelet

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