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Reading and Interpreting EKG

The EKG. P waveDepolarization atriaQRSDepolarization ventricleT waveRepolarization Ventricle. EKG (pic of QRS). . Normal Rates. O-3 months85-205 (140)3m-2years100-190 (130)2-10years60-140 (80)> 10years60-100 (75). Determining Rates (counting boxes). . Identifying Rhythm. Too Slowbra

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Reading and Interpreting EKG

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    1. Reading and Interpreting EKG T Petrillo-Albarano, MD Division of Pediatric Critical Care Children’s Healthcare of Atlanta

    2. The EKG P wave Depolarization atria QRS Depolarization ventricle T wave Repolarization Ventricle

    3. EKG (pic of QRS)

    4. Normal Rates O-3 months 85-205 (140) 3m-2years 100-190 (130) 2-10years 60-140 (80) > 10years 60-100 (75)

    5. Determining Rates (counting boxes)

    6. Identifying Rhythm Too Slow bradycardia Too Fast tachycardia Absent Pulseless arrest

    7. Bradycardia (strip)

    8. Bradycardia HR less than 60 Associated with poor perfusion Can be caused by many factors Hypotension, hypoxemia, acidosis, ingestion In children Hypoxemia is often culprit Support the airway

    9. Bradycardia Algorithm

    10. Tachy-arrhythmias ABC Adequate airway Respiratory effort Does the child have a pulse? No Pulse: CPR; define rhythm Positive pulse.. Define rhythm Assess QRS duration

    11. Sinus Tachycardia Causes? Hypovolemia Fever Anxiety Pain Metabolic stressors drugs

    12. Sinus Tachycardia P waves present and normal Variability to rate Constant PR interval Infants usually less than 220; children usually less than 180 Treat the cause

    13. Sinus Tachycardia (strip)

    14. Supra-ventricular Tachycardia Usual sudden onset No history to support ST P waves are often absent ( but can be present) Abrupt changes Usually greater than 220 or 180

    15. SVT Assess Perfusion Good perfusion: Call cardiology Vagal maneuvers Adenosine Poor perfusion Cardioversion Adenosine Beta blockers

    16. SVT (strip)

    17. V Tach with pulse Most will have underlying congenital heart disease or myocarditis/ cardiomyopathy Can be related to electrolyte imbalance, toxin, drugs Cardioversion Consider Amiodirone

    18. V Tach

    19. Tachycardia Algorithm

    20. Pulseless Rhythms VT V-fib PEA Asystole

    21. V Fib

    22. V Tach

    23. PEA

    24. Asystole

    25. Pulseless Algorithm

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