12 Lead EKG Interpretation

Introduction

• Topic: Introduction to 12 lead EKG interpretation
• Presenter: Eddie Watson from ICU Advantage
• Purpose: Provide confidence in ICU by simplifying critical care topics
• Additional Resources:
  • ICU Advantage Academy for CE credits and audio lessons
  • YouTube/Patreon for access to additional materials

Overview of EKG Interpretation Series

• Series of lessons focusing on 12 lead EKGs
• Not an exhaustive study, but focuses on ICU-relevant interpretation

Basic Components of EKG Waveform

• Isoelectric Line: Baseline with no electrical activity
• P Wave: Atrial depolarization
• QRS Complex: Ventricular depolarization
• T Wave: Ventricular repolarization
• Intervals/Segments:
  • PR Interval: Start of P wave to start of QRS
  • QRS Width: Time for ventricular depolarization
  • QT Interval: Start of QRS to end of T wave
  • ST Segment: Ventricles depolarized with no movement, should be on isoelectric line

EKG System Components

• Electrodes:
  • Measure electrical signals, attached to patient
  • Leads connected for positive/negative readings
• Waveform Orientation:
  • Towards positive electrode: Positive waveform
  • Away from positive electrode: Negative waveform
  • Perpendicular: Biphasic waveform

Electrode Placement

• Importance: Accurate placement essential for accurate EKG
• Preparation:
  • Clip hair, clean with alcohol, use prep
  • Patient should be still and warm
• Placement:
  • 10 electrodes placed to produce 12 leads
  • Specific placements for right/left arms and legs, various V leads

EKG Leads and Planes

• Planes:
  • Vertical/Frontal Plane: Divides front to back
  • Axial/Horizontal Plane: Divides top and bottom
• Leads:
  • Limb Leads: Leads I, II, III (Vertical plane)
  • Augmented Limb Leads: AVR, AVL, AVF (Average views)
  • Precordial Leads: V1-V6 (Horizontal plane)

Artifact Correction

• Identification: Determining which lead is causing artifact
• Steps:
  • Correct limb lead artifacts first, then precordial leads

EKG Paper Standardization

• Speed: 25 mm/s
• Voltage: 10 mm = 1 mV
• Box Size:
  • Big box: 5 mm by 5 mm, 0.2 seconds
  • Little box: 1 mm by 1 mm, 0.04 seconds

12 Leads on EKG Paper

• Arrangement:
  • Limb leads: Left columns
  • Precordial leads: Right columns
  • Rhythm lead: Full length at bottom
• Time Markers: Indicate 10 seconds total length

Anatomical Relationship of Leads

• Contiguous Leads: Grouping leads based on heart region
• Regions:
  • Inferior: Leads II, III, AVF
  • High Lateral: Leads I, AVL
  • Septal: Leads V1, V2
  • Anterior: Leads V3, V4
  • Low Lateral: Leads V5, V6

Conclusion

• Provides foundational knowledge for future lessons on 12 lead EKG interpretation
• Emphasizes importance of understanding EKG basics to interpret changes effectively

Additional Resources

• Encouragement to subscribe for more content and support the channel
• Future lessons to delve deeper into specific aspects of EKG interpretation