Title NCM 112 RLE FINALS ✅

NCM 112 RLE FINALS by TONS and MADS COMPILED BT and ECG ELECTROCARDIOGRAM (ECG / EKG) DEFINITION: noninvasive test that is used to reflect underlying heart conditions by measuring the electrical activity of the heart. By positioning leads (electrical sensing devices) on the body in standardized locations, information about many heart conditions can be learned by looking for characteristic patterns on the EKG. PRINCIPLES: ➢ Electrical activity is generated by the cells of the heart as ions are exchanged across cell membranes. ➢ Electrodes that are capable of conducting electrical activity from the heart to the ECG machine are placed at strategic positions on the extremities and chest precordium. ➢ Electrical energy sensed is then converted to a graphic display by ECQ machine (electrocardiogram) ➢ Heart contraction is represented by wave forms on the ECG graph paper, which are designated P, Q, R, S, and T waves. ➢ Waveforms (deflections relative to an isoelectric line, a line that expresses no energy). The isoelectric line can be determined by looking at the T - P interval. ECG waveform basic components: P & T wave, QRS complex Divided into: PR interval, J point, ST segment, U wave, QT interval. ➔ P wave - first positive deflection and represents atrial depolarization. ◆ PR interval - time it takes an impulse to travel from the atria through AV nodes and the bundle of His. ◆ PR interval is measured from beginning of the P wave to the beginning of the QRS complex. ➔ Q wave - first negative deflection after the P wave ➔ R wave - first positive deflection after the P wave ➔ S wave - negative deflection after the R wave. ◆ QRS complex - ventricular depolarization (the time it takes for the impulse to travel through the bundle branches to the Purkinje fibers). ◆ J point - beginning of the ST segment. ◆ ST segment - part of ventricular repolarization ➔ T wave - follows the S wave and is joined to QRS complex by the S - T segment. ◆ T wave - represents the return of ions to the appropriate side of the cell membrane. This signifies relaxation of the muscle fibers and is referred to as repolarization of the ventricles. ◆ T wave usually follows the same deflection pattern as the O wave and represents ventricular repolarization. ◆ U wave follows the T wave but isn't always seen; it is seen most frequently during bradycardia in leads V2 and V3. ➔ Q-T interval - time between the Q wave and the T wave. ◆ Represents ventricular depolarization and repolarization. It extends from the beginning of the QRS complex to the end of the T wave. PROCEDURE: 1. Explain the procedure to the patient briefly and in simple terms. Reassure him/her that the procedure is painless Video: 12 leading ECG 1. Expose patient's chest, put pre-gelled electrode at each electrode position. 2. Connect lead wires to the electrodes. 3. Each lead wire lettered & color-coded for identificati a.Ask the patient to relax and breath normally b.Press the auto button. c.Observe tracing quality, machine will record all 12 leads automatically d.When machine finishes recording 12-lead ECG, Remove electrodes and clean the patient's skin. e.Disconnect lead wires from electrodes and dispose of the electrodes ○ White RA lead wire - right arm ○ Green or RL lead wire to the right leg ○ Red or LL lead wire to the left leg 2. The patient should be requested to remove watch/metal objects and hearing aid. No other electrical object should be switched on in the vicinity - They can affect the tracing 3. Remove clothing to expose chest, wrists and ankles. 4. The patient should lie on couch - ensure patient is warm enough and relaxed 5. Check with patient for skin allergies before applying electrodes or jelly 6. Attach limb electrodes on arm, just above flexion of the wrist, on dorsal surface of leg and on anterior bony portion of tibia. 2