EKG Page
Week 3 Scholarly Questions and Analytical Thinking

EKG Basics
In discussing EKG paper we always use the terms large boxes and small boxes.
On the vertical axis we measure what? (hint–amplitude)
On the horizontal axis we measure what? (hint-time)
IMPORTANT!!: Know your time in seconds with EKG graph paper! Remember to always write your units such as seconds or beats/min (b/min or bpm are fine too).
PLEASE REFER TO YOUR GRAPH PAPER NOTES ON PAGE 5 OF YOUR WORKBOOK AND ANSWER THESE QUESTIONS.
One small box (on the horizontal axis is how many seconds? How many seconds is 2 small boxes? How many seconds is 3 small boxes? How many seconds is 4 small boxes? How many seconds is 5 small boxes?
How many seconds in 1 large box?
How many seconds in 5 large boxes?
How many large boxes in 3 seconds?
How many large boxes in 6 seconds?
How many seconds in 12 small boxes? In 20 small boxes? In 26 small boxes? In 38 small boxes?
How many small boxes in 2.0 seconds?
How many small boxes in 1.32 seconds?
How many small boxes in 1.64 seconds?
What is the heart rate if you have 5 large boxes and 4 small boxes?
What is the heart rate if you have 6 large boxes and 3 small boxes?
What is the heart rate if you have 2 large boxes and 10 small boxes?
What is the heart rate if you have 3 large boxes and 12 small boxes?
What is the speed of EKG paper?
What are the Triplets? Practice, Practice, Practice and Practice some more labeling them on you EKG strips in your text.
What does biphasic mean?
What does isoelectric mean? (is it the same as baseline on an EKG--YES)

Class continue reviewing the Triplets HR method. Get very familiar and comfortable with this HR estimation method.
Practice, Practice, and Practice the ‘R wave to R wave‘ HR measurement method. Get very comfortable and efficient at this method. CLICK HERE for a LINK and YOUTUBE video that explains the Triplets and Rwave to Rwave HR method
SPECIAL NOTE: We use a .16 second difference (or greater) in different R wave to R waves as the criteria for a an IRREGULAR HR rhythm. The text uses a .12 second difference, but other KEY sources use the .16 second or geater difference. If you see this ONE TIME in the lead you are given, the classification is IRREGULAR rhythm. How many small boxes in .16 seconds?
If the tracing is irregular rhythm, how do you determine heart rate? (We call this the 6-sec method. How many large boxes do you use with this method? (Yes, 30 large boxes). CLICK HERE for a LINK and YOUTUBE video that explains the 6-second HR method.

Practice measuring HRs with the triplets and R wave to R wave methods with the many EKG tracings in your text.
Reminder, the precordial or chest view the heart in what plane?
Reminder, what are the 6 limb leads and where are the charges on them?
What plane do the 6 limb leads view the heart?

PLEASE REMEMBER: A DEPOLARIZATION IS A POSTIVE EVENT ON THE INSIDE OF THE CELL!
Which way will a deflection go on the EKG paper if the depolarization is going towards the electrode?
Which way will a deflection go on the EKG paper if the depolarization is going away from the electrode?
If the deflection is going towards the electrode, will it have the greatest amplitude if it is parallel to the lead or at an angle to the lead.
Make sure you can identify depolarization directions and what will happen on the EKG stylus.
If the depolarization is perpendicular to the lead, what will you see on the EKG stylus?

What is a wave?
What is a segment?
What is an interval?
What are the components that we measure on a P, Q, R, S, T? Can you draw and label them correctly!
What is the J point.
What is the PR segment?
What is the ‘transition lead’ of the 'R wave transition'? Where do you find the transition lead (standard leads, augmented leads, precordial leads)?

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