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Prepeared By Dr: Manal Moussa

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Electrocardiogram. Prepeared By Dr: Manal Moussa. Electrocardiogram Definition: ECG is a graphic record of the electrical currents that are generated by the heart. Purposes: The nurse performs a 12- lead ECG to: 1- Provide information about the electrical system of the heart.

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Electrocardiogram

Prepeared By

Dr: Manal Moussa

slide3

Electrocardiogram

Definition:

ECG is a graphic record of the electrical currents that are generated by the heart.

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Purposes:

The nurse performs a 12- lead ECG to:

1- Provide information about the electrical system

of the heart.

2- Record cardiac electrical activity for diagnostic

or documentary reasons.

3- Diagnose myocardial infarction.

4- Detect cardiac enlargement.

5- Differentiate between different types of

dysrrhythmias.

6- Determine the effects of administered drugs

and/or electrolytes on the heart\'s electrical

system.

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Conductive system of the heart:

*The Sino Atrial node (S.A node) has the highest

rate of depolarization in the whole system. It starts

each heart beat (pace maker).

*From the S.A node, the impulse spreads to the

atria through Bachmann\'s Bundle to the left atrium.

*Stimulation of the atria produces the P wave on

the ECG. After that a brief delay at the

atrioventricular node (A.V node) to allow the atria

sufficient time to squeeze additional blood into the

ventricles.

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*Then the impulse travels to the Bundles of His

  • down the left and right bundle branches and
  • terminates in the Purkinje fibers resulting in
  • contraction of the ventricles.
  • * The result of electrical stimulation of the
  • ventricles produces QRS complex on ECG.
  • *After that the relaxation of the cardiac muscle
  • occurs which represent T wave in ECG.
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-Interpretation of ECG leads:

Bipolar limp leads:*

Lead I (LI): When the ECG is attached to the

right and left arms. It represents the difference in

electrical impulse between these two points.

Lead II (LII): When the ECG is attached to the

right arm and left leg. It represents the difference

in electrical impulse between these two points.

Lead III (LIII): When the ECG is attached to the

left arm and left leg. It representsthe difference in

electrical impulse between these two points.

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aVR: Located in right arm.

Records the changes in electrical current

occurring in the part of heart which faces the right

shoulder.

aVL: Located in left arm.

Records the changes in electrical current occurring

in the part of heart which faces the left shoulder.

aVF: Located in left leg.

Records the changes in electrical current occurring

in the part of heart which faces the left leg.

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Chest or precordial leads:

Chest leads:

V1-----fourth intercostals space (ICS) at right sternal border.

V2-----Fourth ICS at left sternal border.

V3-----Midway between V2 and V4.

V4-----Fifth ICS at midclavicular line.

V5-----Left anterior axillary line at level of V4.

V6-----Left midaxillary line at level of V4 horizontally.

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V. Documentation:

Record in the patient\'s chart:

-Patient\'s name.

-Age.

-Diagnosis.

-Date.

-Time of procedure.

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