ECG Interpretation
ECG Interpretation is a course designed by paramedics for paramedics. There is a reason why the medical profession has acknowledged the concept that ECG readings are only an “interpretation” of what is happening to the heart. There are many different types of ECG rhythms and for every additional cardiologist, there is usually another interpretation of any given ECG. That said and done, this tutorial is designed to arm you with the basic methods used to interpret ECGs and familiarize yourself with some of the more common ECG Rhythms.
It is important to recognise that ECG rhythms are rarely clear on a real patient and getting rid of the last of the ECG artefact is always difficult in the back of an Ambulance. For this reason, we have tried to include numerous examples from actual patients.
Before you start to learn about ECG Interpretation it is important to review the anatomy and physiology of the heart, so that the relevance of each aspect of the ECG can be applied to the clinical science. A strong knowledge of and understanding of the Conduction System of the Heart is required when identifying pathological abnormalities in an ECG. Furthermore, basic concepts such as Blood Flow Through the Heart and Coronary Artery Blood Flow should be understood before learning about ECG Interpretation.
As we are still collecting ECGs from paramedics, some links are missing or do not yet have an ECG as an example of that type of ECG rhythm.
Anatomy and Physiology of the Heart:
The following will help you revise the normal physiology of the heart and identify the pathophysiological basis of any abnormal ECGs:
Conduction System of the Heart
Phases of the Cardiac Action Potential
ECG Examples
The following are examples of ECGs in which the heart beat originates from the Sino-Atrial Node.
Sinus Arrythmia
Common Dysrythmias
The following are common dysrythmias:
Premature Junctional Contractions
Second Degree AV Block Type I (Wenckebach)
Second Degree AV Block Type II (Mobitz)
Third Degree AV Block (Complete Heart Block)
Accelerated Idioventricular Escape Rhythm
Paced Rhythm
Lethal Arrhythmias
The following are all lethal arrythmias that you must be able to immediately identify:
Torsades De Pointes (Twisting of the Points)
Assessing Chest Pain
ECG Tips
The following are useful tips when assessing an ECG: