Lesson 1: Introduction to EKG
WHAT IS AN EKG TECHNICIAN??
* EKG techs conduct various test & are well trained
* May work in testin depts,care of the critically ill, & even help in managing cardic devices(pacemakers)
*EKG tech has the opportunity to interact w/patients in both the offi
Lesson 1:
EKG Basics
*EKG: The recording of the electrical activity generated by the cells of the heart muscle that reaches the body surfaces using electrodes.
-This electrial activity initiates muscular contraction of the heart muscle, which allow blood to pump to
Lesson 2: Cardiac Anatomy & Physiology
CARDIAC ANATOMY
* According to the American Heart Association someone in the US suffers a heart attack approximately every 30 seconds
* Heart is a 4 chambered muscular organ w/the function of pumping or propelling, blood forward to the body's organs & tis
Lesson 2: Cardiac Anatomy & Physiology continued
CARDIAC ELECTRICAL ACTIVITY & CONDUCTION
*The electrical impulse that starts the conduction system is found in the upper wall of the RA & is called the SA (sinoatial node). This the hearts primary "pacemaker",which can cause the heart to beat 60 to 100 ti
Lesson 3: Introduction to the EKG Machine
OVERVIEW OF AN EKG MACHINE
**OFFLINE READING :EKG MACHINE PARTS!!!!!
EKG MACHINE SETUP & CALIBRATION
* Ensuring proper calibration of the machine is a more genreal matter across machines & involves always documenting any changes made to machine settings,c
Lesson 4: Recording the EKG
PATIENT INFORMATION GATHERING
*Confirming patient information is very important step in any medical procedure.
-Not doing so can result in errors as serious as performing an unnecessary procedure on the incorrect patient, prescribing a dangerous combinati
lesson 4
3 Lead placement EKG
* Often used in ER rooms, during surgery, & during inpatient monitoring, is the type of EKG 1st recorded by Willem Einthoven more then 100 yrs ago.
* It uses 3 electrodes attached to the patient, forming Einthoven's Triangle
* The 3-l
Lesson 4:
ALTERNATIVE LEAD PLACEMENTS
**OFFLINE READING: Guide to Alternative Lead Placements
*Mason-Likar: Used for patients w/amputated limbs...Used when leads cold become tangled
* Pediatric EKG: Uses Leads V3R,V4R & sometimes V7
*Right-side EKG: Used w/patients
Lesson 5: Normal EKG
EKG WAVEFORMS
*Btw these grouping which represent one deopolarization & the resulting repolarization of the myocardium(one cardiac cycle), is the baseline. The baseline is isoelectric or flat-think flat line.
*A depolarizing wave moves through the heart m
Lesson 5: Normal EKG continued
CALCULATE HEART RATE
*Heart rate,or HR is a count of the # of QRS complexes. It may not equal the patient's pulse
* HR Measures electrical activity. The pulse represents the fact that blood flow has reached the tissues
* All modern EKG machines will calcu
Lesson 6: Abnormal EKGs -Rate & Rhythm
SINUS ARRHYTHMIAS
*NSR (Normal Sinus Rhythm) describes the heart's electrical impulse beginning regularly in the SA(Sinotrial)node on every beat
* On EKG tracing, this normla rhythm shows as a regular distance btw each QRS complex & heart rate btw 60 to 1
Lesson 6:
*WANDERING PACEMAKER: When the heart paces from multiple nodes or FOCI & the rhythm is regular,we call this wandering pacemaker. The rate is usually less then 100 bpm.IF the rate is greater than 100 bpm,we call this MULTIFOCAL ATRIAL THACYCARDIA,(MAT).
-I
Lesson6:
JUNCTIONAL ARRHYTHMIAS
-are the result of the SA node failing
-If the SA node fails, the AV node will start the impluse, conducting about 40 to 60 bpm. THe AV node sits ateh JUNCTION btw the atria & the ventricles.
-This is a JUNCTIONAL RHYTHM or more acc
Lesson 7: Abnormal EKGs- Conduction
MEASURING CONDUCTION
-Conduction is the electrical impulse in the heart that controls contractions. Each beat of the heart begins in the RA(right atrium) at the SA(sinoatrial)node.
-When the RA fills w/blood, the SA node sends an impulse that travels thro
Lesson 7:
HEART BLOCKS
-Think once again to the pathway the electrical impulses travel through the heart during conduction. The impulse starts at the SA node & spreads throughout the atria until it reaches the AV node, where it would normally continue down through
Lesson 8: Injury, Ischemia, & Infraction Patterns
INTRO. TO CORONARY ATERY DISEASE
* Plaque is a substance that deposits on the inside of teh artieries, reducing their diameter & restricting the flow. Narrowed arteries result in a decreased flow of oxygen to the heart. Decreased oxygen supply to the hear
Lesson 8:
T-WAVE & Q-WAVE VARIANCES
* Remember a T-wave on a normal EKG tracing. The T-wave represents the time o ventricular repolarization or recovery.
* Inverted T-waves happen for many reasons, several of which are not associated w/ CAD.
*Inverted T-waves can h
Lesson 8 : continued ....
USING THE EKG TO LOCALIZE AREA OF INFARCT
* Leads of the EKG machine can help distinguish where an infraction is occurring as a direct result of their positioning.
-Remember that the Chest leads cluster around the heart in a horizontal plane. V1-V4 look a
Lesson 9 : Patient Care
MONITOR VITAL SIGNS
* Obtaining vital signs before the testing begins ensures baseline readings. Then you will have the ability to compare vital signs during the test w/the baseline to check for fluctuations.
-Usually, the nursing staff will have already
Lesson 9 : .................
RESPONDING TO STRESS TEST EMERGENCIES
* REMEMBER that the goal of exercise stress testing on a treadmill or stationary bicycle is to slowly increase the patient's heart rate to a predicted maximal. This predicted maximal is defined as 85% of 220 minus the
lesson 9 : Continued
PATIENT RECORDS
* Once the EKG testing is complete, remove the tracings from the EKG machine & place them in the patient's chart. Keep in mind that your facility will most likely have a specific process for you to follow. You will also need to be sure tha
Lesson 10 : EKG Interpretations
EKG INTERPRETATION SYSTEM
*A Systematic Method Of EKG interpretation that you can apply to all types of EKG tracings. These are the steps, in Order:
-Verifying basic information
-Determining cardiac rhythm
-Calculating heart rate
-Evaluating the P-wave
-E
Lesson 10:>>>>>>>>>>
* Baseline EKGs from routine physical exams of high risk patients are extremely useful for later comparison purposes. In general, multiple or serial EKGs over time benefit patient management as comparisons of changes provide helpful evidence of issues.
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