EKG

Rapid Review

• Background
  • A basic, systematic approach to interpreting the EKG includes determination of Rate, Rhythm, Axis, Hypertrophy, Intervals, and Infarction
• Findings
  • Rate
    • Normal
    • Tachycardia
    • Bradycardia
  • Rhythm
    • Regular
    • Regularly Irregular
    • Irregularly Irregular
  • Axis
    • Normal Axis
    • Left Axis Deviation
    • Right Axis Deviation
    • Extreme Right Axis Deviation
  • Hypertrophy
    • Left Atrial Enlargement
    • Right Atrial Enlargement
    • Left Ventricular Hypertrophy
    • Right Ventricular Hypertrophy
  • Intervals
    • Shortened PR
    • Prolonged PR
    • Widened QRS
    • Prolonged QT
  • Ischemia
    • Q-Waves
    • ST-Segment Elevation
    • ST-Segment Depression
    • Hyperacute T-Waves
    • Inverted T-Waves

Pearls

Deep Dive

• Computer Based ECG Interpretation: It’s Use in the ED (EMOttawa)

Rapid Review

• Background
  • Defined as any EKG with a rate of > 100 bpm. Further divided based mechanism/etiology.
• Common Types
  • Sinus Tachycardia
  • Atrial Fibrillation
  • Atrial Flutter
  • Multifocal Atrial Tachycardia
  • Supraventricular Tachycardia
  • Ventricular Tachycardia

Pearls

Deep Dive

• Tachydysrhythmias with Amal Mattu and Paul Dorion (EM Cases)

Rapid Review

• Background
  • Defined as any rhythm < 60 bpm. Further divided based on mechanism/etiology. 
• Common Types
  • Sinus Bradycardia
  • Junctional Bradycardia
  • Sinus Arrest
  • AV Nodal Blocks
    • 1st Degree
    • 2nd Degree, Mobitz Type I (Wenckebach)
    • 2nd Degree, Mobitz Type II 
    • 3rd Degree

Pearls

Deep Dive

• 4-Step Approach to Bradycardia (EM Cases)

Rapid Review

• Background
  • Cardiac ischemia and/or infarction can be diagnosed by analyzing the QRS complexes, ST segments, and T-waves on a 12-lead ECG. 
• Common Findings
  • Ischemia
    • St-Segment Depression
    • T-Wave Flattening or Inversion
    • Hyperacute T-Wave
  • Infarction
    • ST-Segment Elevation
    • LBBB (If meets Sgarbossa criteria)

Pearls

Deep Dive

• Upping our ECG Game: OMI vs STEMI (REBEL EM)