ECG for ACLS

ECG for ACLS

Ravindar Bethi

ECG in ACLS• ECG section 20

Questions-Matching answers• ECG scenarios in MCQ section• ECG in oral examination

• Certain confusing ECGS

Main classification

• Bradycardias• Tachycardias

• Arrest rhythms

Classificationdepending on ACLS algorithms

Bradycardias Tachycardias

Arrest rhythms

• VF• Pulseless VT

• PEA• Asystole

Normal sinus rhythm

Ectopic beatsBrady arrythmias Tachy arrythmias

Normal ECG

• What is normal ECG?

1

2

Normal ECG

• What is normal ECG? • What confuses with normal ECG?– Nodal rhythm– Sinus Bradycardia – Sinus Tachycardia

Normal ECG

• What is normal ECG? • What confuses with normal ECG?– Junctional rhythm– Sinus Bradycardia – Sinus Tachycardia

Arrest rhythms• VF• Pulseless VT

• PEA• Asystole

SINUS BRADYCARDIA

AV Blocks

First degree AV Block

AV Blocks

Second degree AV Block – Type 1

AV Blocks

Second degree AV Block – Type 2

Infra-nodalSupra-nodal

AV Blocks

Third degree AV Block

TACHYCARDIAS

SINUS TACHYCARDIA

PVCs

Ventricular Ectopics(PVCs)Monomorphic (unifocal)

Polymorphic (multifocal)

TACHYCARDIAS

Atrial Fibrillation

Atrial Flutter

TACHYCARDIAS

Paroxysmal SVT Re-entry SVT

TACHYCARDIAS

TACHYCARDIAS

TACHYCARDIAS

ECG in Myocardial Infarction

ECG in Myocardial Infarction

ECG in Myocardial Infarction

ECG in Myocardial Infarction

ECG in Myocardial InfarctionAntero-Lateral Myocardial Infarction• Widespread ST-elevation V1 - V6, I & aVL. • Reciprocal changes inferiorly (ST depression II, III, aVF)

ECG in Myocardial InfarctionInfero-Lateral Myocardial Infarction• ST elevation, II, III, aVF, V6• Reciprocal anterior depression

How to avoid getting confused !!

• Vague printing- black and white ECGs • Nomenclature – predicted name not found in given answers• Single lead strips with MI• MI with reciprocal changes• Multiple lead ECG in a single strip for

rhythm analysis• Arrest rhythm ECG with pulse• Non-arrest rhythm ECG without pulse• Morphological variations in asystole, VF etc• See the last part of the ECG not the first part• Artifacts (muscular contractions)

Thank you