ECG Webinar SeriesEpisode 1: ECG Basics
11th May 2020 at 19:00
Presented by:
Mr Innes Eaton
Paramedic Practitioner
STC Training SolutionsAsk us about our BLS and ILS refresher training for
healthcare professionals!
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Session Plan
• Basic anatomy
• Electrophysiology
• How ECG machines work
• Indications for requesting an ECG
• Lead placement & ‘views’ of the heart
• Layout of the printed ECG
• Introduction to the individual waves
• Q&A Session
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ECG Webinar Series | Episode 1 | ECG Basics
1. Grab your smart phone
2. Go to: www.menti.com
3. Enter the code
4. Answer the question
Basic Anatomy & Coronary Arteries
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ECG Webinar Series | Episode 1 | ECG Basics
Electrophysiology
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ECG Webinar Series | Episode 1 | ECG Basics
B ’ B • The atria and ventricles are electrically isolated
from one another and all electrical signals pass
through the AV node (in a normal, healthy heart)
• The SA node is the main pacemaker of the heart –
if uncontrolled it will generate a HR of 100bpm
• Sympathetic and parasympathetic nerve fibres
innervate the SA node to control heart rate
• If the SA node were to fail, pacemaker cells in the
AV node and His-Purkinje system take over (at a
much slower rate)
Fast Cell Action Potentials
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ECG Webinar Series | Episode 1 | ECG Basics
Slow Cell Action Potentials
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ECG Webinar Series | Episode 1 | ECG Basics
Introduction to Cardiac Axis
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ECG Webinar Series | Episode 1 | ECG Basics
• Individual myocytes
create electrical
activity that results in a
VECTOR
• If you were to take the
‘average’ direction of
all of these vectors,
you can calculate the
AXIS
• Imagine the ECG leads
as cameras
• How the wave appears
will depend on the
angle of the ‘camera’
in relation to the axis
• An axis travelling
directly towards an
ECG lead will give a
positive wave
Turning Vectors into Waves
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ECG Webinar Series | Episode 1 | ECG Basics
ECG Indications
• Chest pain and/or dyspnoea that is not readily explained
• Unstable patients, where the cause is not immediately known
• TLoC or first presentation seizure
• Unexplained falls in the elderly
• Palpitations
• Abnormal pulse (<40, >150, newly irregular)
• Drug overdoses & recreational drug use
• Diabetics with unexplained symptoms
A normal ECG does not rule out acute coronary syndrome!
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ECG Webinar Series | Episode 1 | ECG Basics
Further Investigations
• Serial ECGs
• Serial Bloods
• Imaging – CXR, CT/MRI, Echo
• Angiography
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ECG Webinar Series | Episode 1 | ECG Basics
Lead Placement
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ECG Webinar Series | Episode 1 | ECG Basics
Lead Views
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ECG Webinar Series | Episode 1 | ECG Basics
Imagine you are standing
on the arrow head
looking back at the heart
Augmented views
(aVR/aVL/aVF) are just
views that are calculated
by the machine, as
opposes to ‘true’ views
ECG Views
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ECG Webinar Series | Episode 1 | ECG Basics
ECG Layout
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ECG Webinar Series | Episode 1 | ECG Basics
Print Speed:
• 25mm/s
Small Square:
• 40ms
• 1mV
Large Square:
• 200ms
To estimate rate:
300 ÷ LARGE
squares
between the R
waves
(or 1500 ÷
SMALL squares
between the R
waves)
ECG Waves Introduction
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ECG Webinar Series | Episode 1 | ECG Basics
Question Time
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ECG Webinar Series | Episode 1 | ECG Basics
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