Electrocardiogram (EKG) for physiology practice at Ceu Universidad Cardenal Herrera

CEU Universidad Cardenal Herrera

ELECTROCARDIOGRAM (EKG) PHYSIOLOGY PRACTICES. 2ND YEAR ACADEMIC YEAR 2024-2025 Dr Ana Checa Ros MD, PhD. Lecturer in the Department of Medicine & Surgery Contact: ana.checaros@uchceu.es Physiology @ 2024 by Ana Checa-Ros is licensed under CC BY-NC 4.0

ORGANISATION OF THE PRACTICE

1. Tips on how to perform the ECG
2. Practical skills: role play; theoretical test to review the workshop

WHAT IS AN EKG?

It is a recording of the electrical activity of the heart at the moment it is recorded ELECTROCARDIOGRAM = ECG or EKG

LEADS AND EKG ELECTRODES

10 electrodes Z. 4 in limbs + 6 in chest 12 leads 12 positions from which cardiac electrical activity is recorded

12 EKG LEADS

Right Left VL VR I III II VF Inferior NOS V6 V2 V5 V3 V4 Right ventricle Left ventricle Septum

HOW DOES THE EKG MACHINE WORK?

promed Calibration circuit Oscilloscope Protection circuit Lead selector Instrumentation amplifier Filtering > Final amplifier > Driver amplifier Recorder Fault detector Pen motor Signal reception Filtering Amplification Recording

WHAT WE SEE ON AN EKG

2 VR V1 1 a VL V2 V3 a VF LOC 00000-0000 Speed: 25 mm/ sec Limb: 10 mV Chest:10 mm mV QRS Complex R ST Segment T P Q PR Interval S QT IntervalQRS Duration R Atrial Ventricular depolarisation Ventricular repolarisation P depolarisation T U PR Interval Q S JT Intverval Bundle Branches Activation of the Activation of the Recovery wave atria ventricles

WHEN SHOULD WE PERFORM AN EKG?

1. Arrhythmias
2. Myocardial infarction
3. Cardiac arrest

ELECTRODE POSITIONS ON THE EKG

RIGHT ELECTRODE POSITIONS

LEFT V2 V1 V3 V6 V5 V4 Left wrist (outer aspect of wrist) Limb electrodes Left ankle (laterally) Precordial electrodes Right wrist (or shoulder) Right ankle (laterally)

Limb Electrodes

Right wrist (or shoulder) ELECTRODE POSITIONS ON THE EKG Limb electrodes Left wrist (outer aspect of wrist) Limb electrodes Right ankle (laterally) Left ankle (laterally)

Precordial Electrodes

ELECTRODE POSITIONS ON THE EKG Precordial electrodes RIGHT LEFT Mid-clavicular line 1st rib Anterior axillary line 2nd rib Mid-axillary line 3rd rib 4th rib 5th rib 1 6th rib V3 V 4 6 5 7th rib 8th rib 9th rib 10th rib

Anatomical References for Electrode Placement

ELECTRODE POSITIONS ON THE EKG Anatomical references

MATERIAL

1. Hand sanitiser
2. ECG machine
3. 10 electrodes (4 limb electrodes and 6 precordial electrodes)
4. 10 sticky pads for attaching the electrodes to
5. Wipes and/or razor 3M Red De SM Red Dot" 3M Rea 3M 3MR Dot"" 3 :d Dot™ Red Dot" VI Red Dot 3M Red 3M Red Dot" ? 3M Red Dot™ 3M Red.P clinell' UNIVERSAL WIPES 200 WIPES CE DI Much 3 BET C P

TECHNIQUE

Wash Hands and Introduce Yourself

Wash Wash hands and introduce yourself

Consent for the Technique

Consent Explain the technique and gather consent

Patient Comfort

Comfort Ensure the patient is comfortable (chaperone if necessary)

Skin Contact for ECG Pads

Skin contact Ensure good contact between the ECG pads and the skin

TECHNIQUE STEPS

Patient Data Input

Patient data Introduce patient data into the machine

Sticky Pads Application

Sticky pads Place sticky pads onto the skin

Electrode Attachment

Electrodes Attach electrodes to the pads

Recording and Patient Check-up

Recording Start recording & check up on the patient

https://forms.office.com/e/dAJuREtQ79 WS 2. EKG