Basic Ekg Facts
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About this ebook
Basic EKG Facts is a complete beginners guide to the understanding of EKG interpretation.
In this text, the user will learn the basic anatomy of an EKG waveform as it relates to the cardiac rhythm cycle. It provides step-by-step instruction from the initial to the final wave with simple, easy to read and understand rhythm strip examples.
Included are charts, tables, templates and other references to assist the user in the quick and accurate interpretation of EKG's.
James B. Martin RN
Jim is a registered nurse at Monongalia General Hospital in Morgantown, West Virginia. He is also a former Marion County Rescue Squad Paramedic and an ACLS instructor with over 26 years experience in both hospital and pre-hospital critical care settings. In his spare time, he enjoys photography, computers, electronics and attempting to be a handyman around the house. He and his wife Beth are the parents of two sons, Jeremy (Meghann) and Jared. He also has one granddaughter, Ava Elaine. He currently resides in Fairmont, West Virginia.
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Basic Ekg Facts - James B. Martin RN
Basic EKG Facts
49716.pngJames B. Martin, RN
©
Copyright 2004 James B. Martin.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without the written prior permission of the author.
ISBN: 978-1-4120-1710-7 (sc)
ISBN: 978-1-4122-1916-7 (e)
Because of the dynamic nature of the Internet, any web addresses or links contained
in this book may have changed since publication and may no longer be valid. The views
expressed in this work are solely those of the author and do not necessarily reflect the
views of the publisher, and the publisher hereby disclaims any responsibility for them.
Any people depicted in stock imagery provided by Getty Images are models, and such images
are being used for illustrative purposes only.
Certain stock imagery © Getty Images.
Trafford rev. 03/29/2022
33164.png www.trafford.com
North America & international
toll-free: 844-688-6899 (USA & Canada)
fax: 812 355 4082
To my wife, Beth,
for her encouragement and support,
And
To my sons, Jeremy and Jared,
for the artwork used in this book.
With
A special Thank You
to all of my co-workers
who encouraged me throughout the writing of this book.
Basic EKG Facts
Table of Contents
Introduction
Chapter One
Down the Correct Path
Electrical Anatomy of The Heart
Chapter Two
Wires, Wires, Everywhere
Lead Placement
ELECTRODE PLACEMENT
Chapter Three
Making Waves
The Paper
The Waves
Chapter Four
From the Top Atrial Rhythms
Sinus Rhythm
Sinus Bradycardia
Sinus Tachycardia
Supraventricular Tachycardia
Sinus Arrhythmia
Sinus Arrest
Sinus Block/ Sino-Atrial Block
Premature Atrial Contractions
Wandering Atrial Pacemaker
Atrial Tachycardia
Multifocal Atrial Tachycardia
Atrial Fibrillation
Atrial Flutter
Chapter 5
In the Middle Junctional Rhythms
Junctional Rhythm
Premature Junctional Contractions
Accelerated Junctional Rhythm & Junctional Tachycardia
Chapter Six
From the Bottom Ventricular Rhythms
Premature Ventricular Complexes
Ventricular Tachycardia
Torsades De Pointes
Wolfe-Parkinson-White Syndrome
Aberrant Ventricular Conduction
Accelerated Idioventricular Rhythm
Ventricular Fibrillation
Asystole
Agonal Rhythm-
Chapter Seven
Traffic Delays Blocks
First Degree AV Block
Second Degree Block Mobitz Type I
Second Degree Block Mobitz II
Third Degree Heart Block
Bundle Branch Blocks
Chapter Eight
Pacemakers
Pacemakers
Chapter Nine
Odds and Ends... Evens and Middles
Ischemia and Infarction
EKG Changes During the Evolution of an Infarction
Atrial Hypertrophy
Ventricular Hypertrophy
Common Drug Effects
Introduction
If one were to look at a timeline of medical history, events and discoveries would be spaced rather far apart at the beginning and extremely close together as today’s date approached. Much of early medicine was based on philosophy rather than biological principal, and it wasn’t until Hypocrites distinguished a difference between the two that modern
medicine began to evolve.
Early cave drawings depict man and animals with hearts at the center of their bodies. The ancient Egyptians are credited with the discovery of the pulse and it’s relationship to the circulation of blood, and as early as 600 B.C. the Greeks had distinguished between arteries and veins, and had reasoned that the brain, not the heart, was the center of sensation.
Medicine moved quite slowly into and through the Renaissance period with aseptic techniques, the use of anesthetics and advancements in the study of anatomy being the most noted achievements.
The 17th century brought us advances in physiology, gross pathology, and the clinical study of disease with inventions such as the microscope; while the 18th century brought serious doubt that the science was advancing at all. It did include advances however, such as the development and discoveries of the harnessing of electricity and it’s effects on animal tissues. In 1678 frog’s legs were found to respond to the passage of an electrical current through the tissues, and in 1775 chickens were rendered lifeless with a single shock to the head, and then shocked back to life using another shock to the thorax.
Narrowing now to the electrical advances, development moved somewhat faster during the 19th century; techniques became more refined, and inventions of various pieces of equipment advanced discoveries forward. The galvanometer was invented in 1880. It consisted of a magnetized needle, which moved when an electrical current would flow through a surrounding wire coil. The tracings were recorded on a paper moving at a fixed speed. In 1887 Augustus D. Waller published the first human EKG, and in 1893 Willem Einthoven introduced the term electrocardiogram to the Dutch Medical Association.
A timeline of the 20th century would include these highlights:
1902-Einthoven publishes the first human EKG using a string galvanometer, which weighs 600 pounds
1908- The University of Edinburgh purchases the first string galvanometer for clinical use
1909- EKG changes are noted during an angina attack
1920- EKG changes are noted during an acute myocardial infarction
1924- Einthoven wins the Nobel Prize
1926- An Australian physician, who wished to remain unknown because of ethical considerations at the time, resuscitates a newborn using a device later to be called a pacemaker.
1928- the first portable EKG machine, weighing 50 pounds and powered by a car battery, is introduced.
1931- a pacemaker small enough to fit into a doctor’s bag (and powered by a hand crank) is introduced.
1942- The 12 lead EKG is introduced.
1947- the first successful defibrillation of a human, a 14-year-old boy, is recorded.
1949- the first monitor capable