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Dr Kupe_ ECG

Dr Kupe_ ECG

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Published by Irfan Ziad
An ECG revision
An ECG revision

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Published by: Irfan Ziad on Mar 02, 2011
Copyright:Attribution Non-commercial


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Dr Kupe
Home Revision Topics
W E D NE S D A Y ,  M A R C H  2,  2011
Transthoracic interpretation of the electrical activity of the heart over time captured and externally recorded by skin electrodes
How it works?
The ECG works mostly by detecting and amplifying the tiny electrical changes on the skin that are caused when the heart muscle "depolarizes" during each heart beat.
Cardiac conduction systemHow to do ECG?
Place the patient in a supine or semi-Fowler's position. If the patient cannot tolerate being flat, you can do the ECG in a more upright position.Instruct the patient to place their arms down by their side and to relax their shoulders.Make sure the patient's legs are uncrossed.Remove any electrical devices, such as cell phones, away from the patient as they may interfere with the machine.If you're getting artifact in the limb leads, try having the patient sit on top of their hands.Causes of artifact: patient movement, loose/defective electrodes/apparatus, improper grounding#
02/03/2011 Dr Kupe: ECGhttp://drkupe.blogspot.com/2011/03/ecg.html?m=1 1/14
Placement of electrodesElectrodes-
usually consist of a conducting gel, embedded in the middle of a self-adhesive pad onto which cables clip. Ten electrodes are used for a 12-lead ECG.
The limb electrodes
RA - On the right arm, avoiding thick muscleLA - In the same location that RA was placed, buton the left arm this time.RL - On the right leg, lateral calf muscleLL- In the same location that RL was placed, buton the left leg this time.
The 6 chest electrodes
V1 - Fourth intercostal space, right sternal border.V2 - Fourth intercostal space, left sternal border.V3 - Midway between V2 and V4.V4 - Fifth intercostal space, left midclavicular line.V5 - Level with V4, left anterior axillary line.V6 - Level with V4, left mid axillary line.
the tracing of the voltage difference between two of the electrodes and is what is actually produced by the ECG recorder.Limb leadsLimb leads refer to lead I, II and III.Lead I - voltage between LA & RALead II - voltage between LL & RALead III - voltage between LL & LAThese three are the only bipolar leads (have one+ve & one -ve pole)Einthoven's triangle = triangle formed by the limbleads.Augmentedlimb leadsaVR, aVL, aVF (also derived from RA, LA, LL, they measure the electric potential at onepoint with respect to a null point)PrecordialleadsV1, V2, V3, V4, V5 and V6 (Because of their close proximity to the heart, they do notrequire augmentation)These leads help to determine heart’s electrical axis. The limb leads and the augmented limb leads form the frontal plane. The precordial leads form the horizontalplane.
02/03/2011 Dr Kupe: ECGhttp://drkupe.blogspot.com/2011/03/ecg.html?m=1 2/14
Leads Anatomical representation of the heartV1, V2, V3, V4 AnterioI, aVL, V5, V6 left lateralII, III, aVF inferioaVR, V1 Right atrium
ECG Graph paper 
Standard calibrationspeed= 25mm/sAmplitude = 0.1mV/mm12 Lead ECG- short segment of the recording of each of the 12-leads.
Waves and Intervals
02/03/2011 Dr Kupe: ECGhttp://drkupe.blogspot.com/2011/03/ecg.html?m=1 3/14

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