Understanding EKG Measurements: Rhythms, Rates & Interpretation

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Tarrant County College, Northeast *

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1304

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Electrical Engineering

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Jun 11, 2024

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PCT Module #5 - EKG Part 3 Heart Rhythm A ___Caliper__ is valuable in measuring the regularity of the waveforms. Measure from the beginning of one wave to the beginning of the next. A tracing of about __6-10__ seconds is necessary to assess the regularity of the P and QRS waveform. Regular : The QRS complexes are the exact same distance apart across the EKG tracing. Irregular: There is a notable difference in the spacing of the waveforms. Regularly Irregular : Consistent noticeable irregular pattern, pattern repeats throughout the tracing. Irregularly irregular: The tracing varies without any consistency throughout. Heart Rate 1500 Method The rhythm must be regular. Uses small boxes Count the number of __Small Boxes_ for a typical R-R interval or a P-P interval and divide by 1500. **If using R waves = Ventricular rate **If using P waves = Atrial rate 300 Method or Sequence Method or R-R Method Only used with __regular__ rhythms; uses large boxes (different from the 1500 Method) Count # of large boxes between the R waves but do not include any of the small boxes that fall in between the next R wave. Count the _large boxes_ and divide by 300. 6 Second Method Quick, simple, and works well in any situation including ___irregular rhythms__. Count number of __QRS__ waves in a 6-second strip (30 large squares) Multiply by 10 How to interpret an ECG: (6 basic steps) 1. Is the rhythm regular or irregular?

a. If irregular, is it regular or irregular or irregularly irregular? 2. Calculate the heart rate a. _60_-_100_ 3. Identify and examine the P wave a. Present? 4. Measure the PR interval a. 0.12 to 0.2 seconds 5. Measure the QRS interval a. <0.12 seconds 6. Interpret the strip Artifacts Most common reason for EKG artifacts caused by the patient __outside activity___ or __not heart activity__. Non-patient causes include __machine___ and ___enviornment____. Wandering Baseline The baseline is the time between each cardiac cycle, noted as a flat line. The baseline or isoelectric line is a time of _repolarization_ or relaxation. A wandering baseline often appears on the EKG when the electrodes are _not properly applied to skin_. Artifact can result from a variety of other causes such as: __movement of the cables during the procedure_____ ___patient movement___ ___loose electrodes___ ___labored breathing___ ___Improper skin prep___ What does each part of the ECG mean: P wave = ___atrial depolarization________ PR interval is the __ time between atrial depo and ventricular depo___ The PR interval is measured from the beginning of the ___P wave___ to the beginning of the __QRS complex__. Normal time = __.12 to .20 seconds__

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