ECG quiz #2 + answer

Re: ECG quiz #2

morrane — Fri, 29 Aug 2014 01:19:50 GMT

These ECG posts are great, really helpful :)

I am doing the ECC certificate and starting to panic about the exams so please keep them coming! THANKYOU

Re: ECG quiz #2

maylane — Sun, 26 Jan 2014 19:16:02 GMT

I love these! I just don't go on here very often - every couple of weeks so I'm always too late to pitch in with an answer.

Please keep doing them.

Re: ECG quiz #2

Susan Jackson — Fri, 24 Jan 2014 18:49:08 GMT

[quote user="Mike Martin"]

Thanks 'Fuzzyduck'.

But everyone else I'm not getting the vibe that this is something of interest to you? How else can I engage your enthusiam?

Suggestions please....

[/quote]

Hi Mike. Loved the ECG but Fuzzyduck said it all.

I did think of something that would be very useful to us nurses. Do you have any heart sounds? We have to examine animals regularly including listening to the heart. Do you have anything that would be helpful for us to hear...murmurs....irregular rhythms?

Re: ECG quiz #2

Mike Martin — Fri, 24 Jan 2014 17:04:07 GMT

Thanks for taking part everyone and the silent observers....

Here's an interesting YouTube movie showing depolarisation of the heart...... link

The sinoatrial (SA) node is the pacemaker control centre of the heart. It is stimulated to speed up by adrenaline - so heart rate increases. Or slow down with vagal influence - when we relax, heart rate slows. Reducing the anaesthetic depth, or pain, during surgery releases adrenaline, so heart rate increases. Too deep an anaesthetic causes the heart rate to slow.

The SA node is an automatic 'firing' centre that releases a 'spark' across the heart. This produces a ripple (like dropping a stone in a pond) through the two atria first. The electical wave stimulates the atrial muscle to contract and thus pumping blood into the ventricles. The electrcial wave that depolarises the atria is seen as the P wave on the ECG.

The electrical signal then passes down through the AV node (a passage between the atria and ventricles). Once it reaches the ventricular muscle, the wave ripples across the two ventricles, causing the ventricular muscles to contract. This electrical signal is seen as the QRS complex on the ECG. It comes in a variety if shapes from little to large, but generally is much bigger than the P wave, because there is a greater mass of muscle in the ventricles.

Repolarisation naturally follows, ready for the next stimulus and this is seen as the T wave - which must always occur after the QRS.

Since the sequence is all triggered by the sinus node, this is referred to as a sinus beat. A series of sinus beats is termed a sinus rhythm. And this is the normal.

An anaesthetic ECG monitor usually detects the tallest deflection, which is usually the QRS complex. It records each as a beat and thus count the heart rate. Occasionally monitors make mistakes because the T wave can be very tall in some dogs, so then it 'double counts' the heart rate. It gives the HR as twice what true is. So taking a pulse is still always important.

Whilst I understand ECGs are seen as 'vetty', more and more in the human world, nurses/technicians (+ anaesthetists) are reading the ECGs, not the doctors. The same is happening in veterinary. Nurses/technicians are going to get better at this than the vets. And its always nice to learn new stuff.

Hope this helps. Would you like another ECG challenge?

PS. Next ECG workshop is 6th March 2014 - designed for nurses

Re: ECG quiz #2

arcticfox — Tue, 21 Jan 2014 16:50:18 GMT

Although I think ECG is seen as 'vetty' for anyone using an ECG for anaesthetic monitoring I think its important to be able to identify abnormalities. for interest its good to know why they occur though.

Personally i wouldn't be able to attend a day CPD, so for me online webinars are by far the way to go.

If you don't have an ecg machine, you can sometimes pick them up secondhand on ebay of all places, or speak to the company reps as they will be supplying new ones - another option is to contact your local NHS to see if any hospitals have any old ones they no longer use. :)

Re: ECG quiz #2

Honeybadger — Mon, 20 Jan 2014 13:58:38 GMT

I would love to learn more but my practice doesnt have an ecg machine :(

So.... any advice on a cheapish one or 2nd hand ones to look for? And how often does everyone carry out ECG's and examples of cost?? I might be able to convince my boss to get one if I can show that we will make money back from it.

Re: ECG quiz #2

zara — Mon, 20 Jan 2014 12:51:31 GMT

Im interested, as it is not something that is always done, with the last one i printed up and wrote the answers and stored it in my esvps anaesthesia folder.

Please keep going as i on the south coast

Re: ECG quiz #2

Fuzzyduck — Fri, 17 Jan 2014 19:07:00 GMT

Nurses aren't generally encouraged to be able to read ECGs I don't think. I think explaining the importance of knowing the basics would perhaps engage interest. Like knowing abnormalities under GA why they occur and what to do. But to be honest I've come across a fair number of vets than cant read ecgs either

Re: ECG quiz #2

Mark Hedberg — Fri, 17 Jan 2014 15:33:06 GMT

January's usually a bit of a slow time in terms of CPD - I liked it, even though I'm frankly terrible at ECG reading. I think some of it may be as simple as some examples of what nurses can do in situations like this; possibly a general ECG is considered a bit 'vetty'.

Re: ECG quiz #2

Mike Martin — Fri, 17 Jan 2014 12:15:13 GMT

Thanks 'Fuzzyduck'.

But everyone else I'm not getting the vibe that this is something of interest to you? How else can I engage your enthusiam?

Suggestions please....

Re: ECG quiz #2

Fuzzyduck — Thu, 16 Jan 2014 18:33:15 GMT

First is P wave, representing sinus depolarisation and atrial contraction. Then QRS complex representing ventricular depolarisation. Then the ST segment followed by the T wave representing ventricular repolarisation?

Re: ECG quiz #2

Teh Fluffeh — Wed, 15 Jan 2014 23:38:07 GMT

Do you do online courses or webinars at all? If not please do so.