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Chapter 3

EKG

QuestionAnswer
EQUIPMENT Electrodes/ sensors
Electrodes Plastic strips
Plastic strips Attach 10 to PTs skin they help in conduction of current from PTs body to EKG MACHINE THEY HAVE ELECTROLYTE GEL - helps in conduction
Alcohol swabs Cleaning the skin from oil and dirt or lotions and if PT has ( diaphoresis) excessive sweat
Absorbs sweat with Gauze and then cleanse with alcohol swab Sometimes sand paper
Disposable razors Remove hair for testing
Leads Is the passage of currant from one electrode to another ( this shows the motion on the stylus paper
12 lead EKG 10 sensors on PTs body Electrodes----4 limbs -----6 chest
6 limb 3 standard 3 standard limb leads ( bipolar leads) Needs 2 points to get complete ( pt to pt )
6 limb 3 augmented 3 augmented limb leads ( unipolar)
6 chest leads V1 ----- v6 Precordial leads
Vector Arrows that shows direction of the flow or the current
Leads 6 limb 6 standard Standard limb leads always in Roman numerals l , ll , lll
3 augmented limb leads AVR/ RT AVL /Lf AVF/ foot
AVR/AVL/ AVF ( AV STANDS FOR AUGMENTED VOLTAGE) AV STANDS FOR AUGMENTED VOLTAGE INCREASE= augmented voltage
Roman numeral # 1 ( standard ) Is between RA and LA
Roman numeral # 2 ( standard ) Is between RA and LL
Roman numeral # 3 ( standard) Is between LA and LL
Precordial lead 6 chest leads v1 threw v6
AVR / right From the midpoint LA and LL TOWARDS the RIGHT ARM
AVL /left From the midpoint of RA and LL TOWARDS THE LEFT ARM
AVF/ foot From the midpoint of the RA and LA TOWARDS LEFT LEG
RL / right leg Is a ground not taking part in the leads
Chest leads V1 RED V1 = 4th intercostal space ( ICS) RIGHT SIDE OF STERNUM
Chest leads V2 YELLOW V2= 4th (ICS ) LEFT SIDE OF STERNUM
Chest leads V3 GREEN V3 = IS BETWEEN V2 and V4
Chest leads V4 BLUE V4 = is 5th ( ICS) LEFT SIDE OF MIDCLAVICULAR LINE
Chest leads V5 ORANGE V5 = 5th ( ICS) LEFT SIDE ANTERIOR AXILLARY LINE
Chest leads V6 PURPLE V6 = 5th (ICS) LEFTSIDE MID AXILLARY LINE ( BY BACK SIDE)
12 leads = 10 electrodes passing of current
RA COLOR Right arm = WHITE
RL COLOR Right leg = GREEN ( GROUND)
LA COLOR Left arm = BLACK
LL COLOR Left leg = RED
V1 color ( traffic light) RED Short red placed at 4th ( ICS) right side of sternum
V2 color (Traffic light) YELLOW Is placed at 4th (ICS) Left side of sternum
V3 color ( traffic light) GREEN Short green placed at V2 and V4
V4 color ( bop ) BLUE Is placed at MIDCLAVICULAR line
V5 color ( bop) ORANGE Placed at anterior AXILLARY line
V6 color ( bop ) PURPLE Placed at midaxillary
What are the colors of the first 4 and where are they placed ( RL / GREEN) ( LL / RED) ( RA/ WHITE) ( LA / BLACK)
Which is the ground wire RL = GREEN
Name the 3 standard limb leads ROMAN NUMERALS 1/2/3
Standard leads are BIPOLAR
Name the 3 augmented leads AVR / AVL / AVF
Augmented leads are Unipolar
Another name for the chest leads Pre Cordial
Artifacts Tracings on the EKG paper that is not coming from the PTs heart
Normal patient position for performing an EKG SUPRINE
If the patient has a head injury raise the Bed to 30% angle
If the patient is having trouble breathing raise the Bed to 45% angle
This layer of the skin is composed of living cells and is needed to detect Electrical signals for the EKG The dermis
Clinical term for sweating profusely Diaphoresis
PTs with Diaphoresis need to be cleaned with Wipe with gauze and then cleanse skin with with alcohol swab
Interference on the EKG NOT COMING FROM THE PT is called ARTIFACTS/ AC INTERFERENCE
Who must recognize the ac interference and correct it The MA
What causes a WANDERING BASE LINE Loose electrodes/too little gel / too much hair
What does a wandering base line look like Uneven baseline
How do you fix a wandering base line Check all electrodes
What is a SOMATIC TREMOR Muscle movement (Voluntary-- laugh sneeze moves) ( unvoluntary ----Parkinson's) If Parkinson's place electrodes on torso
What does a SOMATIC TREMOR LOOK LIKE Unnatural baseline / deflection/ jägered peaks
Voluntary SOMATIC TREMOR HOW DO YOU FIX Check for dangling arms / legs -- make PT COMFORTABLE--- room temp PT IS SHIVERD
Involuntary SOMATIC TREMOR HOW DO YOU FIX Parkinson's PT s put electrodes on torso
What causes a 60 second interference Frayed wires / crossed wires / or other electrical equipment
What does a 60 second interference look like Small fuzzy lines
How do you fix a 60 second interference Check all wires and all electrodes
What causes an interrupted baseline Detached electrodes
What does interrupted baseline look like Breaks between complexes
How do you fix an interrupted baseline Check all electrodes
.AC INTERFERENCE AC = ALTERNATING CURRENT
If you see interference on leads 1 & 111 , which sensor Or electrode would you check LA
If you see interference on leads 11 & 111, which sensor Or electrode would you check LL
If you see interference on leads 1&11, which sensor or Electrode would you check RA
If you see interference on leads 1&AVR which sensor or Electrode would you check RA
If you see interference on leads 11. & AVF which sensor or Electrode would you check LL
If you see interference on leads 111 & AVL which sensor or electrode Would you check LA
If you found interference on leads 1&111 what other lead will most likely have interference AVL
If you found interference on leads 11&111 which other lead will most likely have interference AVF
ANTERIOR FRONT
POSTERIOR BACK /BEHIND
SEPTAL Pertaining to the septum ( heart )
SUPERIOR ABOVE
INFERIOR BELOW
APICAL PERTAINING TO THE APEX ( 5th ICS LEFT SIDE)
LATERAL SIDE
This is determined by measuring the R-R INTERVALS ACROSS THE ENTIRE RHYTHM STRIP RHYTHM
If the R-R Intervals all measure the same the The RHYTHM is termed REGULAR
Which lead is placed at the 4th ICS RT SIDE OF THE STERNUM V1 - RED
Which lead is placed at the 4th ICS LEFT SIDE OF THE STERNUM V1- YELLOW
Which lead is placed between V2 & V4 V3 - green
Which lead is placed at the 5th ICS LEFT SIDE OF MIDCLAVCAL LINE V4- BLUE
Which lead is places at the 5th ICS LEFT SIDE ANTERIOR AXILLARY LINE V5- ORANGE
Which lead is placed at the 5th ICS LEFT SIDE MIDAXILLARY LINE V6- PURPLE
Created by: Tbella
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