Sunday, May 08, 2005

ECG material

The web is a mine of useful information on the ECG. I found a very useful primer at http://www.fleshandbones.com/readingroom/pdf/505.pdf. After a quick read of this I found some more material at http://medstat.med.utah.edu/kw/ecg/ on pages dedicated to an old master of ECG teaching in the U.S. This site has lots of information and some really useful quizzes to test your knowledge. I was very impressed with the explanation of the cardiac axis - the first time I really understood this I think!
Anyway, useful thoughts are:
  • Check there is a 1mV calibration 1cm high and that the paper speed is 25mm/s (that much I remembered from my student days.
  • Report rate, rhythm, axis, the QRS and then the ST segment and T waves, again this seemed familiar.
  • Normal ranges are - rate 60-90 beats per minute, P-R interval (start of P to end of QRS) - 0.12-1.2ms, QRS less than or equal to 0.12ms, axis -30 to +90 degrees
  • Look for the P waves, are they a consistent distance from the QRS? Is the distance in the normal range?
  • Look at the QRS, is it a normal duration? Are there Q waves where there shouldn't be Q waves?
  • Is the ST segment depressed? Elevated?
  • Are T waves inverted?
  • Back to calculating rates and intervals - one little square = 0.04s, one big square = 0.20s. For rate, count the little squares between 2 complexes and divide into 1500, assuming sinus rhythm.
Enough - am not a cardiologist!

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