ECG, EKG, Electrocardiogram  The ECG is easy to understand  The abnormalities happen for a reason.

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Presentation transcript:

ECG, EKG, Electrocardiogram  The ECG is easy to understand  The abnormalities happen for a reason

CONSTANT VIGILANCE !!!

The electricity of the heart

What to expect from the ECG  Essential monitor  Rate, rhythm, propagation of the excitation wave, heart position, muscle hypertrophy, regional ischemia  NO information about pump function

3-lead system

Lead Selection Lead II is the same as standard lead two as seen in a 12 lead ECG. It is the most common monitoring lead. It is not the optimal monitoring lead.

Lead Selection V5 = the best lead to detect ST-T change Move the LA lead to V5 position Monitor lead I

The shape of the ECG P P T T QRSQRS Q R S

Normal ECG

ECG interpretation 1.Rate 2.Rhythm 3.Intervals 4.QRS complexes 5.ST segments & T waves

Abnormal Normal

ECG abnormalities  Myocardial ischemia / infarction  arrhythmias

Myocardial ischemia / infarction  ST depression (0.1mv)  ST elevation (0.2mv)  T wave inversion  Abnormal Q

Myocardial ischemia / infarction

Condition associated with perioperative dysrhythmias Electrolyte disturbances (hypokalemia, hypocalcemia, hypomagnesemia) Hypothermia Medications such as digitalis, theophylline, anesthetic agents Metabolic alkalosis Presence of indwelling central venous or pulmonary artery catheters Sympathetic stimulation (hypoxia, hypercarbia, surgical or anesthetic stimulation) Parasympathetic stimulation (distention of bladder or bowel)

Bradyarrhythmias

Bradyarrhythmias

Bradyarrhythmias

Bradyarrhythmias : 2 nd degree AVB

Bradyarrhythmias : 3 rd degree AVB

Tachyarrhythmias : Premature complexes

Tachyarrhythmias

Tachyarrhythmias

Tachyarrhythmias

Tachyarrhythmias

Tachyarrhythmias

Tachyarrhythmias

Asystole