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ECG Forms/artifact

Waveforms representation of cardiac function and artifacts

P wave Atrial depolarization/contraction (see slides)
QRS Complex Ventricular depolarization/contraction (see slides)
T wave Ventricular repolarization (see slides)
Jagged peaks of irregular height and spacing with a shifting baseline Somatic (muscular) tremor - ask patient to lie still, if shivering get a blanket, etc (see slides)
Series of uniform spikes AC interference - make sure lead wires are not crossed, use three prong outlet; unplug electrical appliances; turn off fluorescent lights (see slides)
Stylus of ECG machine moves violently up and down on the paper and into the margin Interrupted Baseline - Check lead wire cables and connecting tips; check to see if an electrode has come loose or off.
Stylus moves in wavelike pattern up or down from base line Wandering baseline - patient may be moving; electrode may be loose; electrode may be on bone rather than soft tissue/intercostal spaces. (see slides)
Extra P waves atrial arrhythmias
Bradycardia < 60 bpm
Tachycardia > 100 bpm
Atrial flutter 200-350 bpm (see slides)
PVC - premature ventricular contraction Irratic large waveform (see PVC slide)
Time expressed on a large square of the ECG paper 0.2 seconds (See ECG paper slide)
Time expressed on a small square of the ECG paper 0.04 seconds (See ECG paper slide)
Height measurement expressed on a large square of the ECG paper 5 mm (See ECG paper slide)
Height measurement expressed on a small square of the ECG paper 1 mm (See ECG paper slide)
PR interval contraction traversing the AV node
ST segment time interval between ventricular contraction and the beginning of ventricular recovery
U wave (not always present) Associated with further ventricular relaxation
Baseline Heart at rest
QT interval Time interval between the beginning of ventricular contraction and the subsiding of ventricular contraction
Precordial Leads V1, V2,V3,V4,V5,V6
What skin prep may be necessary while hooking up the patient for ECG? Cleanse skin with alcohol pad and/or gauze sponge. Clip or shave away hair.
Color coding of ECG lead wires Right leg: Green Left leg: Red Right arm: White Left arm: Black V1: Red V2: Yellow V3: Green V4: Blue V5: Orange V6: Purple
P wave normal duration 0.06-0.11 seconds
PR interval normal duration 0.12-0.20 seconts
QRS complex normal duration 0.08-0.12 seconds
ST segment normal location on baseline (isoelectric line)
T wave normal amplitude less than or equal to 5 mm in Leads I, II, III; less than or equal to 10 mm in V1-V6
QT interval normal duration Should not be more than half the RR interval if patient has a regular rhythm
V-fib (ventricular fibrillation) complete loss of synchronization of conduction system. Erratic deflections on the ECG (can be either coarse or fine)
Asystole < 5 beats/min; death imminent; flatline
Biochemical arrhythmias Digitalis Toxicity - swooping ST segment depression and/or extended PR intervals. Hypokalemia - Low potassium shows prominent U waves, T wave and U wave look like two-hump camel. Hyperkalemia - High K shows peaked T wave (can be as tall as R) wide forms
SA Node (sinoatrial) Found in right ventrical, known as pacemaker of the heart. Intrinsic rate of 60-80 bpm
Created by: cskinner