Electrocardiogram (ECG)

a noninvasive diagnostic procedure that converts the heart s electrical activity into patterns of signals typically recorded on paper or displayed on a screen

Purposes
to assess the function of the heart can be baseline, diagnostic, or monitoring ROUTINE MEDICAL EXAMINATION Chest pain Palpitation Arrhythmia After cardiac surgery

P wave

sinoatrial (SA) node s pacing impulse initiates the CARDIAC CYCLE

Q wave

pacing impulse arrives at the ventricular apex

R wave S wave

main ventricular contraction completion of ventricular contraction

T wave

heart s return to readiness for the next cardiac cycle

Preparation

1 hour before the test

4 hours before the test

During the test

Equipments

CHEST LEADS

V1 V2 V3 V4 V5 V6

-right 4th intercostal space -two spaces below the angle of Louis -Left 4th intercostal space -two spaces below the angle of Louis between V2 and V4 -left 5th intercostal space -mid clavicular line between V4 and V6 -left 5th intercostal space -mid axillary line
l

Chest leads

POSITION

Limb leads

aVR:

-bony point between heart and right hand -wrist or acromioclavicular joint is ideal -Red is on the right -A bony point between heart and left hand -wrist or acromioclavicular joint is ideal - Lemon is on the left -A bony point between heart and left foot -the ankle/anterior superior iliac spine is ideal -Green is under the spleen -A bony point between heart and left foot -the ankle/anterior superior iliac spine is ideal

aVL

aVF

Obtaining a good ECG

Ensure comfort and a dry chest that supports electrodes
may require some minimal cutting of hair no shaving Shaving creates tiny wounds that can amplify current and cause serious burns following defibrillation

Use bony points as above

Recording the findings

Ensure the time and date is recorded Ensure the ECG trace is labelled clearly
loose, anonymous ECGs will be treated as refuse

ECG interpretation must be immediate