EKG TECHNICIAN STUDY GUIDE FOR EKG, ECG TESTING
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| ELECTROCARDIOGRAM | THE GRAPHIC RECORD OR TRACING OF THE HEARTS ELECTRICAL ACTIVITY PRINTED OR DRAWN
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| ELECTROCARDIOGRAPH | MACHINE WITH CODED OR NUMBERED LEADS THAT ATTACH TO ELECTRODES PLACED ON THE PATIENT'S CHEST, ARMS AND LEGS.
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| NUMBER OF ELECTRODES ON A STANDARD 12 LEAD EKG | 10
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| PLACEMENT OF ELECTRODES FOR 12 LEAD EKG TEST | RIGHT ARM, LEFT ARM, RIGHT LEG, LEFT LEG, V1 AT 4TH INTERCOSTAL RIGHT SIDE OF STERNAL BORDER, V2 4TH INTERCOSTAL LEFT SIDE OF STERNAL BORDER, V3 BETWEEN V2 & V4, V4 MIDCLAVICULAR 5TH INTERCOSTAL , V5 HORIZONTALLY WITH V4 , V6 IS MIDAXILLARY LEFT
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| COLOR CODES FOR LEADS | LA- BLACK, RA- WHITE, V1-RED, V2- YELLOW, V3- GREEN, V4- BROWN , V5 BLUE, V6- PURPLE, LL- BLACK, RL- WHITE
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| ECG RYTHYMS | MAY BE SHOWN ON AN LED DISPLAY OR AN OSCILLOSCOPE OR PRINTED ON GRAPH PAPER WITH STATIC TRACING
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| THE GRAPH PAPER | HORIZONTAL AND VERTICAL LINES THAT FORM GRIDS A TRACING MADE BY CALIPERS IS RECORDED ONTO BY MACHINE.
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| HORIZONTAL AXIS (LINES ) | USED TO CALCULATE DISTANCE AND RATE OF THE WAVEFORMS
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| VERTICAL LINES | USED TO CLACULATE AMPLITUDE OF THE WAVEFORMS
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| LARGE SQUARES | EQUAL 5 SMALL SQUARES, READ .20 Secs HORIZONTALLY OR .5mV VERTICALLY
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| SMALL SQUARES | EQUAL 1/5 OF LARGE SQUARES, EACH REPRESENTS .04 SECS IN DURATION HORIZONTALLY AND .1mV VERTICALLY
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| DYSRYTHMIA | ANY ABNORMAL RYTHYM
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| ARTIFACT | CAUSED BY ELECTRICAL OR MAGNETIC INTERFERENCE OR PATIENT MOVING, SWEATING, SEIZURES, LOOSE ELECTRODE DURING THE EKG TEST
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| LEADS | EACH PROVIDES A VIEW OF THE HEARTS ELECTRICAL OUTPUT DURING TESTING
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| UPWARD DEFLECTION | IMPULSES THAT TRAVEL TOWARDS A POSITIVE ELECTRODE ARE RECORDED /\
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| DOWNWARD DEFLECTION | IMPULSES THAT TRAVEL TOWARDS A NEGATIVE ELECTRODE ARE RECORDED `\/
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| EKG STEPS OF INTERPRETATION | 1.RYTHYM 2.RATE 3. P-WAVE 4. PR-INTERVAL 5. QRS- INTERVAL, 6. T-WAVE 7. Q-T INTERVAL 8. ST SEGMENT
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| RYTHYM | MEASURE DISTANCE FORM ONE R TO THE NEXT R, ARE THEY REGULAR, OR IRREGULAR, OR IRREGULARLY IRREGULAR
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| RATE | HEART RATE COUNT IS MEASURED BY QRS COMPLEXES OVER 6 SECOND X 10 P & R rates use # boxes X 10
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| P- WAVE | FIRST UPWARD DEFLECTION ON THE RECORDING PRECEDES THE QRS , REPRESENTS ATRIAL DEPOLARIZATION AMPLITUDE IS 0.05-0.25,
NORMAL DURATION IS 0.06-0.11 SECONDS
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| P-R INTERVAL | INDICATES AV CONDUCTION TIME, MEASURE FROM WHERE THE P WAVE BEGINS UNTIL THE BEGINNING OF THE
QRS , NORMAL INTERVAL IS 0.12 - 0.20 SECONDS( 3-5 SMALL BOXES)
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| QRS COMPLEX | MIDDLE UPWARD DEFLECTION, R-WAVE,INDICATES THE VENTRICULAR DEPOLARIZATION , QRS IS LARGER BECAUSE OF LARGER TISSUE MASS, MEASURE FROM END OF P to end of S NORMAL IS 0.06-0.12 SECONDS
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| T-WAVE | INDICATES REPLOARIZATION OF THE VENTRICLES, SLIGHTLY ASSYMETRICAL UPWARD DEFLECTION , NOTE IF THEY HAVE DOWNWARD OR POINTED DEFLECTIONS
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| Q-T INTERVAL | INDICATES TIME OF VENTRICULAR ACTIVITY BOTH DEPOLAR AND REPOLAR, MEASURED FROM BEGINNING OF QRS TO THE END OF THE T-WAVE, NORMAL INTERVAL IS 0.36-0.44 SMALL BOXES (9-11 SMALL BOXES) RATE VARIES AMONG ADULTS CHILDREN ELDERLY
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| S-T SEGMENT | REPRESENTS EARLY PART OF VENTRICULAR REPLOARIZATION, IS THE LINE THAT FORMS THE END OF QRS TO BEGINNING OF T- WAVE, NORMAL IS FLAT TO BASELINE.
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| PARTS OF A WAVEFORM | P-WAVE, QRS COMPLEX, T- WAVE (sometimes a U-WAVE)
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| LOCATION OF WAVES ON WAVE FORM | 1. P -WAVE 2.Q 3. R 4. S TOGETHER 5.T- WAVE 6. U-WAVE
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| BLACK MARKS AT TOP | INDICATE 3 SECOND INTERVALS 1AND BEGINNING 2 MIDWAY 3 AT END OF PAPER,
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| WAVE FORM | MOVEMENT AWAY FROMT HE ISOELECTRIC (BASE) LINE IN EITHER AND UPWARD OR DOWNWARD DEFLECTION
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| SEGMENT | LINE BETWEEN 2 WAVE FORMS
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| INTERVAL | A WAVEFORM PLUS A SEGMENT
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| COMPLEX | SEVERAL WAVE FORMS
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| ECTOPIC BEATS | BEATS OUT OF THE ORDINARY
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| REPOLARIZATION | IS REPRESENTED BY THE T-WAVE
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| DEPOLARIZATION AND INITIATION OF IMPULSE IN SA NODE PRODUCE | THE P-WAVE
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| MOST ACCURATE WAY OF ACQUIRING HEART RATE | 1500 METHOD ; COUNT NUMBER OF SMALL SQUARES BETWEEN 2-R WAVES DIVIDE BY 1500 CAN NOT BE USED WITH IRREGULAR HEART BEATS
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| BIPOLAR STANDARD LEADS | LEFT ARM POSITIVE RIGTH ARM NEGATIVE
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| LEAD AVR | RIGHT ARM POSITIVE ALL OTHERS NEGATIVE
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| LEAD AVL | LEFT ARM POSITIVE ALL OTHERS NEGATIVE
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| LEAD AVF | LEFT LEG POSITIVE ALL OTHERS NEGATIVE
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| UNIPOLAR PRECORDIAL LEAD | V1 POSITIVE LEAD LEFT OF STERNAL BORDER V2-V6 LEFT OF STERNAL BORDER
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| CARDIAC INFARCTION | DEATH OF CELLS TO THE HEART MYOCARDIAL, EPICARDIAL, ENDOCARDIAL
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| CARDIO | OF OR PERTAINING TO THE HEART
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| TECHNICIAN | PERSON PERFORMING THE EKG TEST
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| ELECTRODES | PAPER, FOAM , PLASTIC PADS THAT ADHERE TO THE PATIENT'S SKIN WHEN PERFORMING AN EKG TEST, THEY ATTACH TO THE LEADS OF THE MACHINE AND HAVE COLOR CODED CABLES FOR RECIEVING ELETRICAL IMPULSES OF THE HEART (SOMETIMES)
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| E K G PROTOCOL | STEPS FOR ADMINISTERING AN E K G TEST, INTRODUCE YOURSELF, VERIFY PATIENT NAME ADN DOB, ASK DO THEY HAVE ANY QUESTIONS AND SO ON.....
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| HIPAA | HEALTH INSURANCE PORTABILITY & ACCOUNTABILTY ACT
EST. 1996 TO PROTECT A PATIENTS PRIVACY
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| 3-LEAD PLACEMENT | WHITE RIGHT SHOULDER , BLACK LEFT SHOULDER, RED LEFT LOWER ABDOMIN, GREEN RIGHT LOWER ABDOMIN
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| 5-LEAD PLACEMENT FOR HOLTER MONITOR | WHITE RIGHT STERNAL/CLAVICLE AREA, BLACK LEFT STERNAL/CLAVICLE AREA, RED LEFT LOWER THORACIC AREA, GREEN RIGHT LOWER THORACIC AREA, BROWN JUST BELOW RIGHT OF STERNUM
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| PRECORIDAL LEADS LEFT SIDE | STANDARD SET UP RA, LA, RL, LL, 4TH, 5TH, MIDCLAVICUAL, MIDAXILLARY,
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| PRECORDIAL LEADS RIGHT SIDE | OPPOSITE OF STANDARD, PLACED ON RIGHT,
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| WHAT TO CHECK BEFORE TESTING | ALL LEADS ARE CONNECTED, WIRES AND LEADS ARE CONNECTED TO EACH OTHER, WIRES SECURELY PLUGGED IN TO MACHINE
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| MAJOR CLASSES OF ARRHYTHMIAS ORIGINATING IN SINUS NODE | REGULAR SINUS RYTHYM, SINUS BRADYCARDIA, SINUS TACHYCARDIA, SINUS ARRHTHMIA
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| ATRIAL FLUTTER | P-WAVE NONE, P-R INT. NONE, QRS 80-120 miliseconds, VENTRICULAR RATE 240-320/ min, RYTHYM REGULARITY REGULAR BUT IRREGULAR W/ VARIABLE CONDITIONS
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| SUPRAVENTRICULAR TACHYCARDIA | P-WAVE HARDLY VISIBLE, 1 PER QRS, P-R INT NOT MEASURABLE, QRS 80-120milliseconds, VENTRICULAR 150-240/min RYTHYM REGULARITY REGULAR ACROSS STRIP
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| ATRIAL FIBRILATION WITH RAPID VENTRICULAR RESPONSE | P-WAVE NONE, FIBILLATORY WAVES(f) P-R INT, NONE , QRS 80-120 milli, VENTRICLAUR RATE >100/min, ATRIAL RATE 300-600/min, RHYTHYM REGULARITY IRREGULARLY IRREGULAR
ALL WAVES LOOK SKETCHED
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| ATRIAL FIBRILATION | P-WAVE NONE FIBRILATORY WAVE(f), P-R INT NONE, QRS 80-120 milli, VENTRICULAR RATE 300-600/min, RHYTHYM REGULARITY IRREGULARLY IRREGULAR
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| SINUS ARRHYTHMIA | P WAVE UPRIGHT EVERY QRS, P-R INT 120-200/milli, QRS 80-120/milli, VENTRICLE RATE 60-100/min slower or faster
RHYTHYM REGULARITY IRREGULAR
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| SINUS TACHYCARDIA | P WAVE FOR EVERY QRS, P-R INT 120-200milli, QRS 80-120 milli, VENTRICLE RATE >100/min, RHYTHYM REGULARITY REGULAR
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| SINUS BRADYCARDIA | P-WAVE FOR EVERY QRS, P-R INT 120-200 milli, QRS 80-120 milli, VENTRICULAR RATE < 60/MIN, RHYTHYM REGULARITY REGULAR,
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| REGULAR / NORMAL SINUS RYTHYM | P-WAVE FOR EVERY QRS, P-R INT 120-200 milli, QRS 80-120milli, VENTRICULAR RATE60-100/min, RHYTHYM REGULARITY REGULAR ACROSS STRIP
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| AORTIC ARTERY | LARGEST ARTERY IN THE HUMAN BODY
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| APEX | LOWER POINTED END OF HEART , LEFT 5TH INTERCOSTAL,
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| ARRHYTHMIA | ABNORMAL HEART RYTHYM,
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| ARTERIOSCLEROSIS | THICKENING OR HARDENING OF THE ARTERIES
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| ASYSTOLE | ABSENCE OF ANY ELECTRICAL ACTIVITY
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| A.V. NODE | SPECIALIZED TISSUE THAT REGULATES IMPULSES BETWEEN ATRIA AND VENTRICLES
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| AUGMENTED LEADS | CREATED BY COMBINING 2 OF THE 3 LIMBS TO CREATE A POSITIVE ELECTRODE, 3RD IS NEGATIVE
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| BASE | TOP OF THE HEART
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| BASELINE | ISOELECTRIC LINE ACROSS EKG, GRAPH PAPER, DETERMINES UPWARD DOWNWARD DEFLECTION
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| ISCHEMIC | INSUFFICIENT OXYGENATATION OF TISSUE
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| PACEMAKER | ARTIFICIAL STIMLATION TO HEART MUSCLE TO TRIGGER CONTRACTIONS,
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| STANDARD WAVES ON E K G | P-, QRS-, T- U-
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| PRECORDIAL LEADS | 6 LEADS ANTERIOR OF CHEST EITHER RIGHT OR LEFT
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| SUPER VENA CAVA | 2ND LARGEST VEIN IN HUMAN BODY,
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| VASOCONSTRICTION | CONSTRICTION OF A BLOOD VESSEL
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| VASODILATION | OPENING OF A BLOOD VESSEL
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| HOLTER MONITOR | PORTABLE E K G TO MONITOR PATIENT OVER THE COURSE OF 24-72 HOURS FOR OBSERVATION DURING PHYSICAL ACTIVITY OR AT REST,
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| P H I | PROTECTED HEALTH INFORMATION, ANYTHING CAN IDENTIFY A PATIENT (history, Rx, procedures, tests, personal info)
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| STRESS TEST | DESIGNED TO PROVOKE ISCHEMIA &RELATED E K G CHANGES W/CORONARY DISEASE
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