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How to Read Cardiac Rhythm Strips and the Electrocardiogram

April 12, 2012 | Comments: 0 | Views: 212

You're at the medical facility on your MedSurg rotation inside the Tele Unit and you're simply standing at the nurse's station admiring all the fantastic, impressive monitors. They are fantastic indeed, but what does it necessarily mean? They are all so distinctive to each and every patient and you start to wonder if this is an absolutely new language that you must learn! Well, it truly is! The cardiovascular language anyway. Allow me start off by saying, again, like I say a number of occasions, do not forget basic principles, go back to basic principles.

To start, when looking at an electrocardiogram strip, evaluate the pathophysiology and the electrical pathway through the heart. This can help all this make sense, especially if you tend to bea visual person. Let's quickly evaluate the electrical process, shall we? Don't forget that the electrical pathway begins with the SA node (the pacemaker), that is located in the right atrium. The route carries on along from the SA node towards the AV node (atrioventricular node) which is located just above the ventricles; so supraventricular. This route subsequently continues from the AV node to the bundle of HIS (AV bundle), at this time the electrical current is gearing up to run through the rest of the heart to provide ample power to the ventricles to pump which blood to the lungs and the rest of the body. Next, it journeys to the Right and Left bundle branches in which manage along side both ventricles and lastly to the Purkinje fibers that causes myocardial contraction! Voila! You've got yourself a cardiac contraction.

OK, now for the truly good stuff, that cardiac strip, those crazy lines, squiggles, jagged peaks and valleys. Let's put it all together. The very first wave you observe is the P wave, this wave occurs as the atria have contracted, aka atrial depolarization. If you see this you know the conduction has begun in the right atrium; conduction starts at SA node in atrium, causing atrium to contract thus seeing the P wave! Get it? Okay, moving on to the PR interval. The PR interval signifies time it will take for that exact same current to journey from the SA node to the AV node and down the bundle of HIS to the right and left branches.

So now we are inside the ventricles! Incredible, that's fast. The QRS waveform is one unit and represents ventricular depolarization, or ventricular contraction. Now, depending on how tall or broad this QRS waveform is can let you know a whole lot regarding those ventricles. How much force possibly there is and are they contracting at the perfect time? At the same time ventricular contraction is going on, atrial repolarization or relaxation of the atria occurs, however is not seen on the cardiac strip. Those ventricles are simply too powerful! Next, you get to the ST segment which represents ventricular repolarization or ventricular relaxation. Finally, the T wave will be the end of conduction, relaxation of the muscle tissue and the return of the ions to the proper side of the cell membrane so they can do all of it over again! That, my buddies, is but one full Lub Dub cycle!

At this point, its possible you have seen nurses working with calipers when viewing the cardiac strips. What they're doing is measuring each of those wave forms to know all the more of the story. Certain conditions may just be recognized by examining and interpreting an electrocardiogram strip including MI, cardiac dysrhythmias, electrolyte disturbances, inflammatory conditions of the heart and influences on the heart from things such as illegal drugs or medications.

This is a all round guide and no means will you be a specialist on electrocardiograms after looking at this, nonetheless it certainly will give you that much more understanding and self-confidence when you look at your next strip! This most definitely requires practice and the extra strips you look at and translate the better you'll get over time, specially when you get efficacious at putting every one of the puzzle pieces along with your patient. By way of example, when you see that your particular patient has an elevated potassium level, you would expect to see certain changes on your strip which include a higher T wave.

Don't forget, invest time to study these facts. No matter what type of learner you might be, you're capable. Find other methods to learn the data to ensure that it stays with you. After you have the conduction of the heart down and then educate yourself on the essentials of the electrocardiogram strip, tutor one of your classmates which might be having a difficult time understanding. See one, do one, educate one!

Source: EzineArticles
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