electrical flow of the heart nrsg450 module two click forward button to advance to next slide
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Electrical Flowof the Heart
NRSG450 Module Two
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Background of Electrical Flow of the Heart
• The flowing electricity is summarized to give a general direction. This is called the vortex.
• The vortex is the electrical direction viewed on the monitor.
• Electrical flow toward a positive electrode gives a upward deflection. Flow away from the positive electrode gives a downward deflection.
cc.stimula.edu
Lead II
+
-
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Background of Electrical Flow of the Heart
• The electrical activity of the heart is examined from several different views or directions, commonly called leads.
• The common leads are six limb leads and six chest leads. Many more leads are possible and are used in special situations.
• Most patients with a non-cardiac condition are monitored in Lead II.
• Cardiac patient monitoring is based on the expected problems, usually MCL1 &/ MCL 5/6
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Reading Electrical Flow of the Heart• 12 Lead EKG
I
IIII
III
AVR
AVL
AVF
VI or MCLI
V2 or MCL2
V3 or MCL3
V4 or MCL4
V5 or MCL5
V6 or MCL6
Lead II monitoring strip
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Reading the Electric Flow of the Heart
The EKG Rhythm Strip
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• A straight line is called the isoelectric line. It is seen when no electrical flow is detected in the heart.
Reading the Electrical Flow of the Heart
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Reading the Electrical Flow of the Heart
The electrical activity of the heart is picked up be electrodes, travels through the wires to a heated stylus and transferred to specially designed EKG paper.
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Reading the Electrical Flow of the Heart
• EKG is recorded on graph paper traveling at 25mm per second
• The horizontal axis is time.– 1 small block=1mm=0.04 sec– 5 small blocks= 1 big block =
5mm = 0.2 sec– 5 big blocks = 1 second– 30 big blocks = 6 seconds
• The vertical axis is voltage.– 1 small block = .01 mv– 10 small blocks=2 big blocks = 1
mv
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Reading the Electrical Flow of the Heart
• One heart beat or an electrical wave propagation
Depolarization wave
Heart muscle contraction
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Reading the Electrical Flow of the Heart
San
San Diego Paramedics
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Reading the Electrical Flow of the Heart
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DRAG LABELS TO CORRECT LOCATION AND REBUILD
THE CHART
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Anchoring the Information• Label the waves.
p
p
p
p
p
p
p
p p
p
p p
p
p
p
qrs qrs
qrs qrs
qrs qrs
qrs qrs
qrs
qrs
qrs
qrs
T
T T
TT
T T
T
T
T
T
T
pr
pr = 0.44
pr = 0.20
= 0.12
QRS = .06
QRS = o.o4
QRS = o.o6
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DRAG LABELS TO CORRECT LOCATION AND REBUILD
THE CHART
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Reading the Electrical Flow of the Heart
• p wave = atrial depolarization• Accounts for the time electrical
stimulation moves across the atria.
• Duration 0.06 – 0.12 sec (2 small blocks> 4 small blocks)
• Located before QRS complex• Height 2-3 mm (0.2-0.3 mv)• Shape rounded & positive
(upright)
Suran Dutsan@ rutgers.edu
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Reading the Electrical Flow of the Heart
• PR interval involves the atrial and nodal depolarization
• Measure from beginning of p wave to the beginning of the QRS
• Duration 0.12 – 0.20 sec
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Reading the Electrical Flow of the Heart
• Ventricular depolarization is represented by the QRS complex
location
Location follows the PR interval.Duration 0.06 - 0.12 secondsAmplitude dependent on Lead (~5-30 mm)Configuration dependent on Lead Deflection usually a combination of negative and positive, varies with leads
Schwimmin
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Reading the Electrical Flow of the Heart
• ST segment from the end of the S wave to the beginning of T wave
• Usually isoelectric, • May be from -0.5 - +1 mm
from the isoelectric line
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Reading the Electrical Flow of the Heart
• T wave is ventricular repolarization
Location follows the s waveConfiguration is round & smooth (looks like a big p wave)Deflection is usually positive
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Reading the Electrical Flow of the Heart
• QT segment is measured from the beginning of the QRS complex to the end of the T wave.
• Duration is rate dependent
• Not routinely measured
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Reading theElectrical Flow of the Heart
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