ECG Interpretation


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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

Blood Flow Through the Heart

Coronary Artery Blood Flow 

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.

Steps in ECG Rhythm Analysis

Normal ECG

Sinus Rhythm

Sinus Bradycardia

Sinus Tachycardia

Sinus Arrest

Sinus Arrythmia
Common Dysrythmias

The following are common dysrythmias:

Bundle Branch Block

Supraventricular Tachycardia

Atrial Flutter

Atrial Fibrillation

Junctional Escape Rhythm

Premature Junctional Contractions

Atrial Tachycardia

Premature Atrial Contractions

First Degree AV Block

Second Degree AV Block Type I (Wenckebach)

Second Degree AV Block Type II (Mobitz)

Third Degree AV Block (Complete Heart Block)

Ventricular Escape Rhythm

Accelerated Idioventricular Escape Rhythm

Wandering Atrial Pacemaker

Paced Rhythm
Lethal Arrhythmias

The following are all lethal arrythmias that you must be able to immediately identify:

Ventricular Fibrillation

Ventricular Tachycardia

Torsades De Pointes (Twisting of the Points)

Asystole

Assessing Chest Pain

Chest Pain

Causes of Chest Pain

ECG Tips

The following are useful tips when assessing an ECG:

Tips for Reducing ECG Artefact in an Ambulance

ST Elevation Imitators

Paramedic ECG Interpretation Debate



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All information is provided for educational purposes only and should not be taken as medical advice.
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