Electrocardiogram (ECG) 12-Lead

Sonography Fundamentals

Materials Included

Text
Video
Anatomy
Simulation
Quiz

Learn how to prepare for, record and interpret a 12-lead ECG.

An electrocardiogram (ECG or EKG) is a method to graphically display the electric current generated by the heart muscle during a heartbeat. This SIMTICS module teaches you how to prepare for, record and interpret a 12-lead ECG. The interactive simulator lets you learn and practice how to record an electrocardiogram, and how to interpret the heart rate and rhythms for common pathologies. Online simulations offer a safe practice environment and also enable you to try out procedures that you might not otherwise experience. This module is ideal if you are studying for the American Registry for Diagnostic Medical Sonography (ARDMS) registry exams.

You’ll learn

to practice, perfect and test your skills in setting up, recording and interpreting a 12-lead ECG
to better visualize and understand the anatomy and physiology of the heart, with our 3D model and illustrations
how to determine the heart rate and identify different heart rhythms on the ECG strip: atrial, junctional, ventricular, and pacemaker rhythms, and AV blocks
about stress testing and Holter monitoring
much more (see Content Details for specific information)

Introduction

Step 1 - Preparation

Step 1.1 - Tray preparation

Step 1.2 - Patient preparation

Step 1.3 - Operator preparation

Step 2 - Place electrodes

Step 2.1 - Place the limb electrodes

Step 2.1.1 - Bipolar limb leads

Step 2.1.2 - Unipolar limb leads: augmented leads

Step 2.2 - Place the chest electrodes

Step 2.2.1 - Unipolar leads: Chest leads

Step 3 - Record the ECG

Step 3.1 - Enter the patient's details into the machine

Step 3.2 - Check the machine is calibrated

Step 3.3 - Record the ECG

Step 3.4 - Annotate the presence of symptoms on the ECG tracing

Step 4 - Analyze the rhythm strip (2 lead)

Step 4.1 - Assess the rate

Step 4.1.1 - The 6-second ECG count

Step 4.1.2 - Count large squares

Step 4.1.3 - Count small squares

Step 4.1.4 - Sequence method

Step 4.2 - Assess the rhythm

Step 4.2.1 - Ventricular rhythm

Step 4.2.2 - Atrial rhythm

Step 4.2.3 - Regularity

Step 4.3 - Identify and assess the P wave

Step 4.4 - Assess the intervals (conduction)

Step 4.4.1 - PR interval

Step 4.4.2 - QRS duration

Step 4.4.3 - QT interval

Step 4.5 - Evaluate overall appearance

Step 5 - Sinus rhythms

Step 5.1 - Features of sinus rhythms

Step 5.2 - Sinus bradycardia

Step 5.3 - Sinus tachycardia

Step 5.4 - Sinus arrhythmia

Step 5.5 - Sinoatrial block

Step 5.6 - Sinus arrest

Step 6 - Atrial arrhythmia

Step 6.1 - Premature atrial complexes (PACs)

Step 6.2 - Wandering atrial pacemaker

Step 6.3 - Multifocal atrial tachycardia

Step 6.4 - Supraventricular tachycardia

Step 6.4.1 - Atrial tachycardia

Step 6.4.2 - AVNRT

Step 6.4.3 - AVRT

Step 6.5 - Atrial flutter

Step 6.6 - Atrial fibrillation

Step 7 - Junctional arrhythmia

Step 7.1 - Premature junctional complexes (PJCs)

Step 7.2 - Junctional escape beats/rhythm

Step 7.3 - Accelerated junctional rhythm

Step 7.4 - Junctional tachycardia

Step 8 - Ventricular arrhythmia

Step 8.1 - Premature ventricular complexes

Step 8.1.1 - Types of PVC

Step 8.2 - Ventricular escape beats

Step 8.3 - Idioventricular rhythm

Step 8.4 - Accelerated idioventricular rhythm (AIVR)

Step 8.5 - Ventricular tachycardia (VT)

Step 8.5.1 - Types of VT

Step 8.6 - Ventricular fibrillation (VF)

Step 8.7 - Asystole

Step 8.8 - Pulseless electrical activity

Step 9 - AV blocks

Step 9.1 - First-degree AV block

Step 9.2 - Second-degree AV block

Step 9.2.1 - Second-degree AV block type I (Wenckebach, or Mobitz type I)

Step 9.2.2 - Second-degree AV block type II (Mobitz type II)

Step 9.2.3 - Second-degree AV block, 2:1 conduction (2:1 AV block)

Step 9.3 - Third-degree/complete AV block

Step 10 - Pacemaker rhythms

Step 10.1 - Pacemaker terminology

Step 10.2 - Pacemaker systems

Step 10.2.1 - Single-chamber pacemakers

Step 10.2.2 - Dual-chamber pacemakers

Step 10.2.3 - Transcutaneous pacing

Step 10.3 - Pacemaker malfunction and complications

Step 10.4 - Analyzing pacemaker function with an ECG

Step 11 - Interpret the 12-lead ECG

Step 11.1 - Normal 12-lead ECG

Step 11.1.1 - Leads

Step 11.1.2 - Layout of the 12-lead ECG

Step 11.2 - Axis

Step 11.2.1 - Vectors

Step 11.2.2 - Einthoven's triangle/Hexaxial reference system

Step 11.2.3 - Two-lead method of axis determination

Step 11.3 - Myocardial ischemia

Step 11.3.1 - ST segment changes

Step 11.3.2 - T wave changes

Step 11.4 - Myocardial infarction

Step 11.4.1 - ST changes

Step 11.4.2 - T wave changes

Step 11.4.3 - Q waves

Step 11.5 - Pericarditis

Step 11.6 - Pericardial effusion

Step 11.7 - Electrolyte imbalance

Step 11.7.1 - Imbalance of sodium ions

Step 11.7.2 - Imbalance of calcium ions

Step 11.7.3 - Imbalance of magnesium ions

Step 11.7.4 - Imbalance of potassium ions

Step 11.8 - Conduction abnormalities

Step 11.8.1 - Right bundle branch block

Step 11.8.2 - Left bundle branch block

Step 11.9 - Analyzing an ECG

Step 11.9.1 - Systematic method

Step 12 - Stress testing and Holter monitoring

Describe the anatomy and physiology of the heart
Identify the basic electrophysiology of the heart
Describe the sinus mechanisms
Describe atrial rhythms
Describe junctional rhythms
Describe ventricular rhythms
Describe atrioventricular (AV) blocks
Describe pacemaker rhythms
Explain and demonstrate the 12-lead ECG
Describe stress testing and Holter monitoring

The SIMTICS modules are all easy to use and web-based. This means they are available at any time as long as the learner has an internet connection. No special hardware or other equipment is required, other than a computer mouse for use in the simulations. Each of the SIMTICS modules covers one specific procedure or topic in detail. Each module contains:

an online simulation (available in Learn and Test modes)
descriptive text, which explains exactly how to perform that particular procedure including key terms and hyperlinks to references
2D images and a 3D model of applied anatomy for that particular topic
a step by step video demonstration by an expert
a quiz
a personal logbook that keeps track of all the modules the learner has studied and how long