Reading 12- Lead EKGs
from www.icufaqs.org Mark Hammerschmidt, RN
I’m not sure if updating these articles is such a good idea - they just get bigger and bigger, and
we throw more and more stuff in, and they just get monstrous and probably scary for the new
kids. It’s fun to a point – but we’re trying to convey the basics here, or at least what passes for the
basics as we understand them. Well… let us know what you think. Too big? Too much? Or too full
of mistakes? (grin!). The whole thing already prints out like the telephone book…
1- What is an EKG?
2- What is a 12-lead EKG?
3- When you do an EKG, what are you looking for?
4- What do EKG lead groups have to do with cardiac anatomy?
5- What is the difference between coronary ischemia and a myocardial infarction?
5-1: A brief rant.
6- What does ischemia look like on a 12-lead?
6-1- What do I do if my patient is having ischemia? What is “flashing”?
7- What are the stages of an MI, and what to they look like on a 12-lead EKG?
7-1- Acute Injury: ST elevations.
7-2- Necrosis: Q-waves.
7-3- Resolution: persistent Q-waves or flipped T’s.
7-4- What do I do if my patient is having an MI?
8- What is reciprocity?
8-1- What is a right-ventricular MI, and why is it going in the section on reciprocity?
8-2- How are RVMIs managed?
9- Going through the evolving EKGs of an MI.
9-1- Stage 1- the acute infarct.
9-2- Stage 2- necrosis.
9-3- Stage 3 - resolution
10- Another one.
11- What are intervals all about?
11-1- PR interval
11-2- QRS interval
11-3- QT interval
12- What does a 12-lead EKG look like if a patient’s potassium is too high? Too low?
A couple of words about confidence: EKG interpretation often gets classified a nurse’s mind as
one of those things that he should just stay away from. I really think that this is just plain wrong. I
think that any nurse who is smart enough to make it into an ICU in the first place is certainly smart
enough to learn the basics of EKG interpretation: what