SOS COMMUNITY NURSING SCHOOL

PRESENTATION
2019 CLASS
GROUP 3
WELCOME
8\9\2021
 Group members
 Fadumo abdulkadir hassan
 Fuad mohamed abukar
 Hamdi abdi mohamud
 Aniso khalif elmi
 Yusuf abdullahi abdulle
 Mohamed ahmed nur
 Naima elmi horow
 Raml ahmed mhamed
 Naima ahmed elmi makaran
 contents
 Part four auxiliary examination
 basic knowledge of ECG
 Graphed sequenced interpretation of ECG
 Common types of tachycardia

 Arterial blood gas analysis, detarmnation of acid

and alkali
 Pulmonary function test
Basic knowledge of electrocardiogram

the first sight:

What can you see when you get first sight of this ECG?

First, you will find that there are a lot of square boxes;

Second, you will find that there are many

confusing waves; Finally, you may also find

that there are some Roman numerals(I, II, III)

 Cont…..
as well as some combinations of letters
and numbers (aVR, aVL, aVF,V1, V2, V3, V4, V5,
V6).
 Cont..

 What are the confusing waves?

Before we explain the waves, we

should review some basic cardiac electrophysiology.

The electrical impulses is derived from

a special pacemaking area in the right atrium

called sinoatrial (SA) node. and then triggers

 Cont..

the contraction of heart in course of its

gradual conduction.

how the impulse is produced by the SA node

and spread to the entire heart?

The impulse would first move through right

and left atrium,

 Cont…

 Finally the impulse moves to stimulate

the ventricular muscle through the bundles

of His and the left and right bundle branches.

It’s noteworthy that the SA node

has no stable resting potential and it has

automaticity, meaning it possess the feature
 Cont..

 of automatic depolarization and repolarization

thus acting as the pacemaker of the heart.
Normally, the cardiac muscles, conduction
system aside, are unable to depolarize
automatically, they can only be stimulated by the
impulse from the other part of the heart.
 The Depolarization and Repolarization of
Heart

 When the cell membrane is stimulated

by the outer electric activity, The

negatively charged ions move inward, to
alter the state to negative outside

and positive inside. This process is called

depolarization .
 Cont..

 At the recovery phase of cardiac muscle cells,

the positively charged ions, again, move back
to the outside of the cell membrane, and the
negatively charged ions move to the inside
Graphics-Sequenced Interpretation of ECG

 Graphics Sequenced Interpretation of ECG.

There are two key words here, one

is ECG Graphics, which means understanding

the mechanisms that cause normal and
abnormal ECG tracing and memorizing them
based on Graphics.
 Cont..
 Another one is Sequence, which means
interpreting an ECG tracing following the order
that it is generated (P wave, PR interval, QRS
complex, ST segment, T wave, QT interval, U
wave). In this way, analysis of ECG can be quite
easy and would not miss any significant diagnostic
information
 Cont..

 when you come across an ECG tracing, you should

follow these steps:
 Step 1: Calculating heart rate in regular or
irregular rhythm
 Step 2: Analyze P wave

 Step 3: Analyze PR interval

 Cont..

 Step 4: Analyze QRS complex

 Step 5: Analyze ST segment

 Step 6: Analyze T wave
 Step 7: Other ECG variants
 Common Types of Tachycardia

 Tachycardia with Narrow QRS Complex have a QRS

interval less than or equal to 120 ms,
and a frequency greater than or

equal to 100 bpm. 95% of the cases

are supraventricular tachycardia, which
originates from above the division of

the bundle branches; 5% are

 Cont…

 ventricular tachycardia, particularly idiopathic

ventricular tachycardia in children which can
have a QRS interval less than 120 ms.
 Atrioventricular Nodal Reentrant Tachycardia

 The structural basis of AVNRT is

the two types of conduction pathways

with different properties in the AV node,
which is called dual atrioventricular nodal pathway.
One of the pathways has a slow conduction
rate and short refractory period.
 Cont..

 called slow pathway (α pathway). The other

pathway has a fast conduction rate, but
 longer refractory period, and is known
 as fast pathway (β pathway).
 Slow-Fast Atrioventricular Nodal Reentrant
Tachycardia

1.Tachycardia is usually induced by premature

atrial contraction, frequency at 160–200 bpm.
2. RR interval is even, heart rhythm is regular.
3. In most cases there are no P waves because

the retrograde p wave is buried in QRS complex.

 Arterial Blood Gas Analysis and
Determination of Acid and Alkali
• The suitable power of hydrogen (pH) of

the internal environment is essential for

the organism’s metabolism. value of PH
is 7.35–7.45 and the mean is 7.40.

The process of maintaining a relatively stable

internal environment is called the acid-base
balance.
 Cont..
 However the acid-base disorders usually

occur in the pathological state, in which

the acid or base overloads or is severely inadequate.

The judgment of acid-base

state based on the arterial blood gas

Analysis has been the basic method in

the clinical diagnosis and treatment.

 The Values and Clinical Significance of the
Common Indices

 Power of Hydrogen (PH) is the

index which reflects the concentration of H+.

Because the concentration of H+ is difficult

to measure, PH is represented by

the negative log of the concentration.

Reference Value: 7.35–7.45 (the mean, 7.40), the

 Cont…

• pathologically maximum range is 6.80–7.80.

Clinical significance: PH<7.35 is called
academia or acidosis, PH>7.45 is called alkalemia
or alkalosis. The normal PH is commonly seen in
these conditions: no acid-base disorders,
compensatory acid-base disorders and mixed
acid-base disorders.
 Pulmonary Function Test

• Pulmonary function test is an important

method to check the respiratory diseases.

The aims of pulmonary function test include:

 judgment whether the respiratory symptoms such
as dyspnea, cough and cyanosis are

caused by respiratory diseases;

 Cont…

 management and monitoring of severity

progression and therapeutic reaction of the
established respiratory diseases;
 assessment of potential risks of respiratory

failure or other respiratory complications after

surgery or drug therapy;
 Common Test Items

 The items of pulmonary function test

 include: lung volume test, ventilation function

test, gas exchange function test, pneodynamics
test etc. How to choose the items
 for the certain subjects
 cont..

 depends on the purpose of diagnosis,

however, no matter which item is chosen,

the interpretation of the pulmonary function test
results needs to be combined with
the clinical and radiological data of the patients.
THE END
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