# Electrical Flow of the Heart

## Presentation on theme: "Electrical Flow of the Heart"— Presentation transcript:

Electrical Flow of the Heart
NRSG450 Module Two CLICK FORWARD BUTTON TO ADVANCE TO NEXT SLIDE

Background of Electrical Flow of the Heart
The flowing electricity is summarized to give a general direction. This is called the vortex. The vortex is the electrical direction viewed on the monitor. Electrical flow toward a positive electrode gives a upward deflection. Flow away from the positive electrode gives a downward deflection. Lead II - + cc.stimula.edu

Background of Electrical Flow of the Heart
The electrical activity of the heart is examined from several different views or directions, commonly called leads. The common leads are six limb leads and six chest leads. Many more leads are possible and are used in special situations. Most patients with a non-cardiac condition are monitored in Lead II. Cardiac patient monitoring is based on the expected problems, usually MCL1 &/ MCL 5/6

Reading Electrical Flow of the Heart
12 Lead EKG V4 or MCL4 VI or MCLI I AVR V5 or MCL5 AVL V2 or MCL2 II II V6 or MCL6 III V3 or MCL3 AVF Lead II monitoring strip

Reading the Electric Flow of the Heart
The EKG Rhythm Strip

Reading the Electrical Flow of the Heart
A straight line is called the isoelectric line. It is seen when no electrical flow is detected in the heart.

Reading the Electrical Flow of the Heart
The electrical activity of the heart is picked up be electrodes, travels through the wires to a heated stylus and transferred to specially designed EKG paper.

Reading the Electrical Flow of the Heart
EKG is recorded on graph paper traveling at 25mm per second The horizontal axis is time. 1 small block=1mm=0.04 sec 5 small blocks= 1 big block = 5mm = 0.2 sec 5 big blocks = 1 second 30 big blocks = 6 seconds The vertical axis is voltage. 1 small block = .01 mv 10 small blocks=2 big blocks = 1 mv

Reading the Electrical Flow of the Heart
One heart beat or an electrical wave propagation Depolarization wave Heart muscle contraction

Reading the Electrical Flow of the Heart
San Diego Paramedics San

Reading the Electrical Flow of the Heart
Putting it together!

DRAG LABELS TO CORRECT LOCATION AND REBUILD THE CHART
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Anchoring the Information
qrs Label the waves. T p qrs qrs qrs qrs qrs p T p p T p T T p T pr = 0.20 QRS = o.o4 p p p T T qrs qrs qrs p T p p T p T qrs qrs qrs p T p pr = 0.12 QRS = .06 pr = 0.44 QRS = o.o6

DRAG LABELS TO CORRECT LOCATION AND REBUILD THE CHART
THIS SLIDE WILL SHOW A FLASH DRAG AND DROP QUIZ CLICK FORWARD BUTTON TOADVANCE TO NEXT SLIDE

Reading the Electrical Flow of the Heart
p wave = atrial depolarization Accounts for the time electrical stimulation moves across the atria. Duration 0.06 – 0.12 sec (2 small blocks> 4 small blocks) Located before QRS complex Height 2-3 mm ( mv) Shape rounded & positive (upright) Normal Suran rutgers.edu

Reading the Electrical Flow of the Heart
PR interval involves the atrial and nodal depolarization Measure from beginning of p wave to the beginning of the QRS Duration 0.12 – 0.20 sec

Reading the Electrical Flow of the Heart
Ventricular depolarization is represented by the QRS complex Normal location Location follows the PR interval. Duration seconds Amplitude dependent on Lead (~5-30 mm) Configuration dependent on Lead Deflection usually a combination of negative and positive, varies with leads Schwimmin

Reading the Electrical Flow of the Heart
ST segment from the end of the S wave to the beginning of T wave Usually isoelectric, May be from mm from the isoelectric line

Reading the Electrical Flow of the Heart
T wave is ventricular repolarization Normal Location follows the s wave Configuration is round & smooth (looks like a big p wave) Deflection is usually positive

Reading the Electrical Flow of the Heart
QT segment is measured from the beginning of the QRS complex to the end of the T wave. Duration is rate dependent Not routinely measured

Reading the Electrical Flow of the Heart
Wave Summary