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ECG Basics

By: Marie
Rodriguez and Joey
Cueto
Normal Conduction
System
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Lead Placement
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All Limb Leads
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EKG Distributions
Anteroseptal: V1, V2, V3, V4
Anterior: V1V4
Anterolateral: V4V6, I, aVL
Lateral: I and aVL
Inferior: II, III, and aVF
Inferolateral: II, III, aVF, and V5
and V6



Usual Waveforms
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Second Page
What do components represent?
P wave = atrial depolarization
Normal <3mm, <0.08 seconds
PR interval: time between depol or atria and
ventricular depolarization: normal is 0.12 to 0.2
seconds
QRS = ventricular depolarization
less than 0.12
ST segment: isoelectric line, corresponds to MI or
ischemia
T = repolarization of ventricles
QT: normal is 0.38 to 0.42
U wave: after T wave, thought to be due to
repolarization of atrial septum
Interpretation:

Interpret EKG systematically by looking at:

1) Rate
2) Rhythm
3) Axis
4) Hypertrophy
5) ischemia
1) RATE: To get the rate:

Rule of 300- Divide 300 by the number of large boxes
Between each QRS
Or
Divide 1500 by the number of small boxes between
Each QRS segment

For irregular rhythms: count the number of R waves
In 6 second strip and multiply by 10 to get the rate

Normal HR: 60-100
HR > 100 is tacycardia
HR < 60 is bradycardia
2: Rhythm
Sinus
Originating from SA node
P wave before every QRS
P wave in same direction as QRS

Normal Intervals:
PR:
0.20 sec
QRS:
-0.08 to 0.10 sec
QT:
Usually: 450 ms in men,
460ms in women, based
On heart rate, sex


3) Axis: represents overall direction of hearts activity
Axis of -30 to +90 is normal
QRS up in I and up in aVF is normal


Second Page
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References:

1) Medics.cc
2) The Only EKG Book Youll Ever Need

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