Approach to ECGs Check - Age, gender, name - 25mm/s; 10mm/mV - 1mm = 40ms; 0.1 mV Rate - 300 / big squares - RR only - #QRS in 10s - 2 dots = 3s; #QRS in 6s x 10 Rhythm (1) Pfor every QRS and vv (2) P+ve in l, II (3) 60-100 bpm - Axis - QRS +ve in I, II - LAD: Inf Ml, WPW, LVH, LBBB, LAFB - RAD: AntLat MI, WPW, RVH, RBBB, dextrocardia, normal LPFB, dextrocardia, normal Intervals - PR = 120-200ms (3-5 small boxes) - HiPR: AV block - LoPR: WPW, ectopic atrial pacemaker - QRS = < 100-120ms (<2.5-3 small boxes) - WideQRS: RBBB (V1/V2 rsr', lat leads slurred S), LBBB (V5/V6 rs, qs; lat leads rsr'), V-pacemaker, ↑K, ICD/pacer - QTc < 1/2 RR or M<420ms, F<440ms, no safe #, but >500 DANGER - Short QT <300-360 ms: ↑ca - Long QT: "antis and hypos"-ABx, antipsychotics, antidepressants, TCA, antihistamines, antiarhythmics, hypo K, hypo Mg, congenital, MI, high ICP Hypertrophy - Dr. Michael Wong @mchlwng #Approach #ECG #EKG #diagnosis #electrocardiogram #cardiology #interpretation
