Electrocardiogram Basics

Jefferson C. Ramos, RMT, RN

ECG Basics
Used to identify:
Rhythm disturbances Conduction abnormalities Electrolyte imbalances

Steps in ECG Determination

Recognize the key components Analyze the components separately Reach a conclusion about the electrical activity of the heart

ECG Basics

LEADS AND PLANES

Leads
Provides a view of the hearts electrical activity between two points, or poles Consists of one negative and one positive pole.

Planes

Cross section of the heart that provides a different view of the hearts electrical activity

 Frontal plane
vertical cut through the middle of the heart from top to bottom The six limb leads provides view of the frontal plane

 Horizontal plane
A transverse cut through the middle of the heart dividing it into upper and lower portions The six precordial leads are viewed from the horizontal plane

ECG Basics

TYPES OF ECG RECORDINGS

12-Lead ECG

 Different leads provide different information. Six limb leads I, II, III, aVR, aVL, aVF
Provides information about the frontal plane

Six precordial (chest) leads V1, V2, V3, V4, V5, V6

Provides information about the hearts horizontal plane

Rhythm Strip
Provides continuous information about the hearts electrical activity from one or more leads simultaneously Leads II, V1, V6 commonly monitored leads

ECG Basics

ECG MONITORING SYSTEMS

Hardware Monitoring
The electrodes are connected directly to the cardiac monitor

Telemetry
The patient carries a small, batterypowered transmitter that sends electrical signals to another location where the signals are displayed on a monitor screen

ECG Basics

ELECTRODE PLACEMENT

Standard Limb Leads

Standard Limb Leads

Standard Limb Leads

Electrode Placement

Jefferson C. Ramos, RMT, RN

Einthovens Triangle

Augmented Unipolar Leads

Precordial Unipolar Leads

Elements of Chest Leads

Lead V1 V2 V3 V4 V5 V6 Positive Electrode Placement 4th intercostal space to R of sternum 4th intercostal space to L of sternum Directly between V2 and V4 5ht ICS at left midclavicular line Level w/ V4 at L anterior axillary line Level with V5 at L midaxillary line View of Heart Septum Septum Anterior Anterior Lateral Lateral

Chest Leads

Jefferson C. Ramos, RMT, RN

ECG Basics

NURSING CONSIDERATIONS

Patient Preparation

Skin Preparation

Application of Electrode Pads

ECG Basics

ECG GRID

ECG Grid

ECG Grid