Term
| Five steps to reapid interpretation of EKG. |
|
Definition
Rate.
Rhythm.
Axis.
Hypertrophy.
Infarction. |
|
|
Term
|
Definition
Height < 2.5mm in lead II.
Width < 0.11 in lead II |
|
|
Term
What is the mv per small box?
What is the time per small box? |
|
Definition
|
|
Term
Where is the V1 lead placed?
Where is lead V2 placed |
|
Definition
2nd intercostal space, right of sternum.
2nd intercostal space, lef t of the sternum. |
|
|
Term
| Where are leads V3 and V4 placed. |
|
Definition
V4 placed left midclavicular line at 5th intercostal space.
V3 placed in between V2 and V4. |
|
|
Term
| Where does V5 get placed? |
|
Definition
Lateral to V4 on the same plane.
Notes say 5th intercostal space, axillary line. |
|
|
Term
| Where does V6 get placed? |
|
Definition
| Left midaxillary line, 5th intercostal space. |
|
|
Term
| Where does the brown V electrode get placed? |
|
Definition
| Axillary line in the 5th intercostal space. |
|
|
Term
| what should be considered with short PR interval. |
|
Definition
|
|
Term
| What should be considered if QRS greater than 0.12. |
|
Definition
Right or left bundle branch block.
Ventricular rhythm.
Hyperkalemia. |
|
|
Term
| What are some causes of ST Elevation |
|
Definition
MI - anterior or inferior.
LBBB
Acute pericarditis.
Athletic Person. |
|
|
Term
| How many big boxes in a six second strip |
|
Definition
|
|
Term
| What defines a normal QT interval. |
|
Definition
| QT should be 1/2 R to R interval. |
|
|
Term
| Tall P wave in lead II (3 mm or more) signifies. |
|
Definition
| Right atrial enlargement. |
|
|
Term
| A bifid flattened P wave in V1 signifies? |
|
Definition
|
|
Term
| What constitutes a significant Q wave? |
|
Definition
| 1 mm or is 1/3 the height of the QRS. |
|
|
Term
| What constitutes a significant change in ST elevation or ST depression. |
|
Definition
| Greater than or equal to 1mm from base line. |
|
|
Term
| What are inverted T waves indicative of? |
|
Definition
|
|
Term
|
Definition
ST depression or scooped shape.
Mild PR prolongation. |
|
|
Term
|
Definition
|
|
Term
|
Definition
Wide QRS.
Flattened P wave |
|
|
Term
| Hypokalemia effect on EKG. |
|
Definition
ST depression.
Flattened T wave.
Prominent U wave. |
|
|
Term
| Hypercalcemia effect on EKG. |
|
Definition
|
|
Term
| Hypocalcemia effect on EKG. |
|
Definition
|
|
Term
|
Definition
300 / big boxes R-R.
10 x QRS in a six second strip. |
|
|
Term
| What are the diagnostic criteria for the Right bundle branch block? |
|
Definition
Tall R in V1 or rabbit ears in V1.
QRS > 0.12
Pominent S in I, V5-V6. |
|
|
Term
| What are the diagnostic criteria for the Left bundle branch block? |
|
Definition
QRS > 0.12
Tall notched R waves V1 V2.
Tiny Q waves absent and tiny R waves in V1 absent. |
|
|
Term
Axis deviation using I and AVF.
Indicates Extreme Right Axis Deviation |
|
Definition
|
|
Term
Axis deviation using I and AVF.
Indicates Left Axis Deviation |
|
Definition
|
|
Term
Axis deviation using I and AVF.
Indicates Right Axis Deviation |
|
Definition
|
|
Term
Axis deviation using I and AVF.
Indicates Extreme Left Axis Deviation |
|
Definition
|
|
Term
| What are the causes of Left Axis Deviation? |
|
Definition
Left Anterior Fasicular Block
Inferior MI with Qr complex in lead II (making lead II negative).
Some cases of left ventricular hypertophy.
Some cases of LBBB.
Some cases of WPW. |
|
|
Term
| What are the causes of Right Axis Deviation? |
|
Definition
Left Posterior Fasciular Block.
Right heart overload and pulmonary HTN.
High lateral wall MI with Qr or QS complex in leads I and avl.
RBBB
WPW
children, teenagers, and some young adults. |
|
|
Term
| Signs of Right Ventricular Hypertrophy. |
|
Definition
R wave greater than S in V1, bur R wave gets progressively smaller from V1-V6.
S wave persists in V5 and V6.
R axis deviation with slightly widened QRS.
Rightward rotation in the horizontal plane. |
|
|
Term
| Signs of Left Ventricular Hypertrophy. |
|
Definition
S wave in V1.
+ R wave in V5.
Left axis deviation with slightly widened QRS.
Leftward rotation in horizontal plane. |
|
|
Term
| What does ST Elevation indicate? |
|
Definition
|
|
Term
| What does ST depression indicate? |
|
Definition
|
|
Term
Name that MI.
ST depression in V1, V2 |
|
Definition
Posterior MI.
Left Circumflex Artery or Right Coronary Artery. |
|
|
Term
Name that MI.
ST Elevation in V5-V6, I, and AVL without abnormal Q wave. |
|
Definition
Lateral MI
Left Circumflex. |
|
|
Term
Name that MI.
ST elevation in V1-V4 without abnormal Q wave. |
|
Definition
Anterior or Anteriorseptal.
Left Anterior Descending. |
|
|
Term
Name that MI.
ST elevation in II, III, and AVF without an abnormal Q wave. |
|
Definition
Inferior MI.
Right Coronary Artery. |
|
|
Term
Name that MI.
ST elevation in V3-V4 |
|
Definition
Antero Apical MI.
LAD distal |
|
|
Term
| What differentiates ischemia, injury, and infarct. |
|
Definition
Ischemia - inverted T wave or ST depression.
Injury - ST elevation
Infarct - Pathologic Q waves |
|
|
Term
| What EKG signs determine acute vs old MI? |
|
Definition
Inverted T waves and possibly q waves will be present from old MI.
Acute: ST elevation. |
|
|
Term
|
Definition
Standard of care.
Increased arrhythmias during anesthesia and surgery.
Increase in CAD in surgical population.
Pacemakers more common. |
|
|
Term
| Myocardial Ischemia indicated by? |
|
Definition
| ST depression and chest pain. |
|
|
Term
| What may indicate a blockage in RCA |
|
Definition
| ST elevation in II, III, aVF. |
|
|
Term
| What may indicate a blockage in CIRC |
|
Definition
| ST elevation in I and AVL. |
|
|
Term
| What may indicate a blockage in LAD |
|
Definition
| ST elevation in V3 through V5. |
|
|
Term
| What are the many causes of arrhythmias? |
|
Definition
General Anesthesia - halogenated.
Local/regional anesthesia.
Abnormal electroytes and ABG's
Endotracheal intubation.
Reflexes - Vagal response.
CNS and ANS dysfunction - subarachnoid bleed.
Cardiac disease.
Cardiac manipulation. |
|
|
Term
| What to assess when abnormal rhythm present. |
|
Definition
ABCD.
Airway: patent.
Breathing: listen to lungs.
Circulation: Pulse, blood pressure, oxygen sat, hemodynamic compromise.
Drugs: Anesthetic depth to much or to little. |
|
|
Term
| What are things to consider when abnormal rhythm is present? |
|
Definition
Increase inspired oxygen.
Reduce agent.
Ensure ventilation is adequate to reduce Co2 build up.
What is the surgeon doing? Ask them to stop while you treat arrhythmia. |
|
|
