1 / 37

Pediatric EKG

Pediatric EKG. Tuesday Noon Teaching Session Developed by Dr. Lisa Lemieux Original slides courtesy of Dr. Lindsay Long (adapted). Learning Objectives. Basic Approach to Pediatric EKGs Rhythm recognition How to use the EKG machine. Learning Objectives. Basic Approach to Pediatric EKGs

shasta
Download Presentation

Pediatric EKG

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Pediatric EKG • Tuesday Noon Teaching Session • Developed by Dr. Lisa Lemieux • Original slides courtesy of Dr. Lindsay Long • (adapted)

  2. Learning Objectives • Basic Approach to Pediatric EKGs • Rhythm recognition • How to use the EKG machine

  3. Learning Objectives • Basic Approach to Pediatric EKGs • Rhythm recognition • How to use the EKG machine

  4. Approach to EKG interpretation:Rate Rhythm AxisIntervalsUps and Downs

  5. What are some challenges to interpreting Pediatric EKG’s?

  6. What are some challenges to interpreting Pediatric EKG’s? • age-related changes -- such as? • movement artifact

  7. Take a look at the settings • Standard amplitude is ___ mm/mV • Paper speed is ___ mm/s

  8. Double-check the settings • Standard amplitude is 10 mm/mV • Paper speed is 25 mm/s

  9. Waveforms and Intervals

  10. Rate Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.

  11. Rate Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.

  12. Rate Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.

  13. Rate Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.

  14. Rate Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.

  15. Rate Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.

  16. Rate Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.

  17. Rhythm • What defines a sinus rhythm? • P wave before every QRS • QRS after every P wave • Normal PR interval for age • Normal P wave axis • Upright I and aVF

  18. Rhythm • What defines a sinus rhythm? • P wave before every QRS • QRS after every P wave • Normal PR interval for age

  19. Axis

  20. Which quadrant represents a “normal” QRS axis in an adult?

  21. Where would you see Left Axis Deviation?

  22. Left Axis Deviation

  23. What would this be?

  24. Extreme Right Axis Deviation

  25. And this?

  26. Right Axis Deviation

  27. Axis • QRS axis is usually directed toward a hypertrophied ventricle • What is the expected axis in a newborn?

  28. Axis • What is the expected axis in a newborn? Large R ventricle = Right axis deviation

  29. Normal neonatal EKG in a 1-week-old infant. QRS axis is 125°, which would be considered right axis deviation in an adult. Note the tall R waves in V1, V2, and V3, which are normal. O’Connor, M., McDaniel, N., Brady, W. The Pediatric Electrocardiogram Part I: Age-related Interpretation. American Journal of Emergency Medicine (2008) 26, 221–228

  30. Ups and Downs: Look at ST segment, T wave progression, ?extra blips (U waves, etc)

  31. Learning Objectives • Basic Approach to Pediatric EKGs • systematic approach • refer to tables with age-related values • Rhythm recognition • How to use the EKG machine

  32. Learning Objectives • Basic Approach to Pediatric EKGs • systematic approach • refer to tables with age-related values • Rhythm recognition • How to use the EKG machine

  33. Precordial Leads Adapted from: www.numed.co.uk/electrodepl.html

  34. The End Any questions?

  35. References • Chan, T., Sharieff, G., Brady, W. Electrocardiographic Manifestations: Pediatric EKG. Journal of Emergency Medicine. 35(4):421–430 • Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84. • O’Connor, M., McDaniel, N., Brady, W. The Pediatric Electrocardiogram Part I: Age-related Interpretation. American Journal of Emergency Medicine (2008) 26, 221–228 • Sharieff GQ, Rao SO. The pediatric EKG. Emerg Med. Clin North Am 2006;24:196. • Pediatric Advanced Life Support, 2006 Edition. • Wathen JE, Rewers AB, Yetman AT, et al. Accuracy of EKG interpretation in the pediatric emergency department. Ann Emerg Med. 2005;46:507-11.

More Related