ECG Success: Exercises in ECG Interpretation - Shirley A. Jones

Год выпуска: 2007

Автор: Shirley A. Jones

Жанр: Кардиология

Формат: PDF

Качество: OCR

Описание: No one is born knowing how to read ECG strips. We learn to do many things in a lifetime, and nearly all of them get better with practice. If you're planning to use this book, ECG isn't completely new to you — you have a good idea of what's involved in generating and interpreting a tracing.

ECG Success covers all the information you will need — anatomy and physiology, practice, and case scenarios, and relevant emergency care — to help you feel competent and in control, whether the situation involves an emergency or just a nonthreatening ECG. This book has staying power. You will find its content useful across a spectrum of situations, from classroom study through clinical experience and later in actual practice.

Pattern recognition lies at the heart of ECG interpretation. This skill develops with experience, gained through repetition and variety. You need to see the same patterns over and over again, but you also need to see as great a persity as possible. In ECG Success you'll find more than 550 ECG tracings.

The book is organized into four units. First, two introductory chapters review the background information you need for working with ECG. Chapter One discusses heart anatomy and physiology, including biomechanics and electrophysiology. Chapter Two gives you the basics of ECG: limb and chest leads, electrode placement, cable connections, components of a tracing, rhythm strip analysis, and more.

In Unit Two, seven chapters explain and illustrate the different types of rhythm, some dangerous, others merely troublesome, and a few even normal. Each of these chapters gives you a group of nine practice strips to analyze, with the answers given at the end of the chapter. All types of arrhythmias are discussed and illustrated: sinus, atrial, junctional, and ventricular; atrioventricular and bundle branch blocks; artifact; and artificial pacemaker rhythm. The section ends with a chapter on myocardial infarction and the 12-lead ECG.

The chapter practice strips will warm you up for Unit Three, the working core of the book. You'll find four test chapters with a total of 300 strips and the answers given at the end of each chapter so you can check your work. In case you're hungry for more, the two chapters in Unit Four comprise eleven real-life case studies, followed by multiple-choice questions and illustrated by more ECG strips. Four appendices round out the book: Healthcare Provider Guidelines for Cardiopulmonary Resuscitation, Advanced Cardiac Life Support Protocols, Emergency Medications, and Emergency Medical Skills.

As you page through this book you'll find some special features to guide you. In Units One and Two, frequent Clinical Tips provide valuable information on how an arrhythmia can affect the patient. Hints on rhythm interpretation appear throughout the first practice strip chapter.

I couldn't have written this book without building up a track record of my own ECG successes. The secret: I had a good instructor who was patient and explained everything in detail. She kept emphasizing that we had to follow every step when analyzing a rhythm; shortcuts are dangerous because you can miss critical details on the rhythm strip. Then we had to practice, practice, practice. That repetition, combined with careful attention to every step, was the real key to my success.

Take your time now, and use ECG Success to improve your skills. Once you run into a genuine emergency you will have only minutes, or less, to interpret the ECG correctly and ensure the right treatment for the patient.

---

Contents

«ECG Success: Exercises in ECG Interpretation»

Heart Structure and Electrical Activity

ANATOMY AND PHYSIOLOGY OF THE HEART

• Anatomy of the Heart
  • Layers of the Heart
  • Heart Valves
  • Heart Chambers and Great Vessels
  • Coronary Vessel Circulation
• Anatomy of the Cardiovascular System
  • Blood Vessel Structures
  • Arterial Circulation
  • Venous Circulation
• Physiology of the Hear
  • Mechanical Physiology
  • Electrophysiology

THE ELECTROCARDIOGRAM

• Limb Leads
• Standard Chest Leads
• Cable Connections
• Electrode Placement Using a Three-wire Cable
• Electrode Placement Using a Five-wire Cable
• Modified Chest Leads
• The Right-sided 12-Lead ECG
• The 15-Lead ECG
• Recording of the ECG
• Components of an ECG Tracing
• Methods for Calculating Heart Rate
• Rhythm Strip Analysis
• Instructions for Analyzing ECG Practice and Test Strips

Rhythms and Their Analysis

SINOATRIAL NODE ARRHYTHMIAS

• Normal Sinus Rhythm (NSR)
• Sinus Bradycardia
• Sinus Tachycardia
• Sinus Arrhythmia
• Sinus Pause (Sinus Arrest)
• Sinoatrial (SA) Block
• ECG Practice Strips
• Answers to Chapter
  • ECG Practice Strips

ATRIAL ARRHYTHMIAS

• Wandering Atrial Pacemaker (WAP)
• Multifocal Atrial Tachycardia (MAT)
• Premature Atrial Contraction (PAC)
• Atrial Tachycardia
• Supraventricular Tachycardia (SVT)
• Paroxysmal Supraventricular Tachycardia (PSVT)
• Atrial Flutter
• Atrial Fibrillation
• Wolff-Parkinson-White (WPW) Syndrome
• ECG Practice Strips
• Answers to Chapter
  • ECG Practice Strips

JUNCTIONAL ARRHYTHMIAS

• Junctional Rhythm
• Accelerated Junctional Rhythm
• Junctional Tachycardia
• Junctional Escape Beat
• Premature Junctional Contraction (PJC)
• ECG Practice Strips
• Answers to Chapter
  • ECG Practice Strips

VENTRICULAR ARRHYTHMIAS

• Idioventricular Rhythm
• Accelerated Idioventricular Rhythm
• Premature Ventricular Contraction (PVC)
• Premature Ventricular Contraction: Uniform
• Premature Ventricular Contraction: Multiform
• Premature Ventricular Contraction: Ventricular Bigeminy
• Premature Ventricular Contraction: Ventricular Trigeminy
• Premature Ventricular Contraction: Ventricular Quadrigeminy
• Premature Ventricular Contraction: Couplets
• Premature Ventricular Contraction: R on T Phenomenon
• Premature Contraction: Interpolated PVC
• Ventricular Tachycardia (VT): Monomorphic
• Ventricular Tachycardia (VT): Polymorphic
• Torsade de Pointes
• Ventricular Fibrillation (VF)
• Pulseless Electrical Activity (PEA)
• Asystole
• ECG Practice Strips
• Answers to Chapter
  • ECG Practice Strips

ATRIOVENTRICULAR AND BUNDLE BRANCH BLOCKS

• First-degree AV Block
• Second-degree AV Block: Type I (Mobitz I or Wenckebach)
• Second-degree AV Block: Type II (Mobitz II)
• Third-degree AV Block
• Bundle Branch Block (BBB)
• ECG Practice Strips
• Answers to Chapter
  • ECG Practice Strips

ARTIFICIAL CARDIAC PACEMAKERS

• Artificial Pacemaker
• Pacemaker Modes
• Understanding Pacemaker Codes
• Artificial Pacemaker Rhythm
• Single-chamber Pacemaker Rhythm—Atrial
• Single-chamber Pacemaker Rhythm—Ventricular
• Dual-chamber Pacemaker Rhythm—Atrial and Ventricular
• Pacemaker Malfunctions
• Failure to Capture
• Failure to Sense
• Oversensing
• ECG Practice Strips
• Answers to Chapter
  • ECG Practice Strips

ARTIFACT

• Loose Electrical Connection
• Variation with Respiration
• 60-cycle Interference
• Muscle Artifact
• ECG Practice Strips
• Answers to Chapter
  • ECG Practice Strips

THE 12-LEAD ECG AND ACUTE MYOCARDIAL INFARCTION

• Troubleshooting ECG Problems
• R Wave Progression
• Electrical Axis Deviation
• Ischemia, Injury, and Infarction
• Progression of an Acute Myocardial Infarction
• ST Segment Elevation and Depression
• The Normal 12-lead ECG
• Anterior Myocardial Infarction
• Inferior Myocardial Infarction
• Lateral Myocardial Infarction
• Septal Myocardial Infarction
• Posterior Myocardial Infarction
• Left Bundle Branch Block
• Right Bundle Branch Block

ECG Practice Tests

ECG PRACTICE TEST ONE

• Test Strip Section One
• Answers to Practice Test One

ECG PRACTICE TEST TWO

• Test Strip Section Two
• Answers to Practice Test Two

ECG PRACTICE TEST THREE

• Test Strip Section Three
• Answers to Practice Test Three

ECG PRACTICE TEST FOUR

• Test Strip Section Four
• Answers to Practice Test Four

Case Studies

ECG CASE STUDIES ONE

• Case Study One
• Case Study Two
• Case Study Three
• Case Study Four
• Case Study Five
• Answers to Case Study One
• Answers to Case Study Two
• Answers to Case Study Three
• Answers to Case Study Four
• Answers to Case Study Five

ECG CASE STUDIES TWO

• Case Study One2
• Case Study Two
• Case Study Three
• Case Study Four
• Case Study Five
• Case Study Six
• Answers to Case Study One
• Answers to Case Study Two
• Answers to Case Study Three
• Answers to Case Study Four
• Answers to Case Study Five
• Answers to Case Study Six

Appendices

Appendix A: HEALTHCARE PROVIDER GUIDELINES FOR CARDIOPULMONARY RESUSCITATION (CPR)

• CPR Healthcare Provider Skill Performance
• CPR: Adult
• CPR: Child
• CPR: Infant
• OBSTRUCTED AIRWAY: Conscious Adult or Child
• OBSTRUCTED AIRWAY: Conscious Infant
• OBSTRUCTED AIRWAY: Unconscious Adult
• OBSTRUCTED AIRWAY: Unconscious Child
• OBSTRUCTED AIRWAY: Unconscious Infant
• CPR and Obstructed Airway Positions

Appendix B: ADVANCED CARDIAC LIFE SUPPORT PROTOCOLS

• Ventricular Fibrillation (VF) or Pulseless Ventricular Tachycardia (VT)
• Pulseless Electrical Activity (PEA)
• Asystole
• Acute Coronary Syndrome (ACS)
• Bradycardia
• Tachycardia — Unstable
• Narrow-complex Tachycardia — Stable Regular Rhythm
• Narrow-complex Tachycardia — Stable Irregular Rhythm
• Wide-complex Tachycardia — Stable Regular Rhythm
• Wide-complex Tachycardia — Stable Irregular Rhythm

Appendix C: EMERGENCY MEDICATIONS

Appendix D: EMERGENCY MEDICAL SKILLS

• Defibrillation
• Cardioversion (Synchronized)
• Transcutaneous Pacing
• Carotid Sinus Massage (Vagal Maneuver)

Abbreviations Used in Text
Selected References