12 lead EKG cheat sheet acls class paramedic PDF

Preview

Summary

12 lead EKG cheat sheet acls class paramedic paper work sheet for anyone that needs some extra help...

Description

Coronary Arteries Left = anterior descending & Circumflex Covers left side, and septum in most people Right = covers right ventricle and inferior wall

Conduction System SA – Pacemaker (60 – 100) Internodal Pathways AV (40 – 60) Bundle of His R/L Bundle Branches Ventricles (20 – 40)

Bipolar Leads (I, II, III)

Augmented Leads

One positive, one negative

Think of the heart as the negative lead

Precordial Leads V1: R side of sternum in 4th intercostal space V2: L side of sternum in 4th intercostal space V3: midway between V2 and V4 V4: midclavicular line, 5th intercostal space V5: anterior axillary line at same level as V4 V6: midaxillary line at same level as V4

P Waves & PR Segment P wave will be upright and rounded in 2, 3 and AVF if originating in SA PR Segment – travel to ventricles

Q Waves –

Pathological Q Waves –

First downward wave of QRS complex height of the R-wave

0.03 seconds or wider or its height is equal to or greater than 1/3 the Found during MI (tissue death) and can persist after MI

QRS Complex Normal conduction from the atria produces narrow QRS complexes (Superhighway) If the conduction is through the myocardium it will slow down the transmission

J Point Elevation or depression - seen with the various causes of ST segment changes. Notching of the J point occurs with Early Repolarization/Pericarditis. A positive deflection at the J point is termed a J wave (Osborn wave) and is characteristically seen with hypothermia.

ST Segment Depression - Ischemia ST Segment Elevation – Injury or Infarction (MI in progress)

Acute Coronary Syndrome Combination of mycardial ischemia, injury and infarction. Most commonly resulting from a blood clot in a diseased coronary artery. • Initially, this results in ISCHEMIA and occurs almost immediately after loss of blood supply. o Causes ST segment depression and T wave inversion o Goal is prompt return of blood supply. The quicker oxygenated blood is returned, the less chance of permanent injury. • If untreated, ischemia leads to INJURY. (actual tissue damage) o Tissue is “stunned” and does not contribute to pumping ability. o Can lead to life threatening arrthymias. • If the occlusion persists, the injured tissue will die, resulting in INFARCTION. Eventually, this will be replaced by scar tissue.  Ischemia  Inverted T waves in 2 congruent leads  Normal in V1 and III  ST segment depression  Injury  ST elevation >1 mm in 2 congruent leads  >2 mm in septal leads  Infarction  Path Q waves  >.04 sec wide or 1/3 of R, with ST elevation  STEMI  Non-STEMI •

Reciprocal views 

II, III, AVF (I and AVL is reciprocal)



I, AVL (III, AVF is reciprocal)...