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CSB335 > Introduction to 12 lead ECGs > Flashcards

Introduction to 12 lead ECGs Flashcards

1
Q

What does aV stand for in cardiac monitoring?

A

Augmented view

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2
Q

What is the best lead for viewing bundle branch block?

A

V1 (septal view)

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3
Q

What are continuous leads?

A

Leads that are beside one another

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4
Q

Leads I, II, and III are called the ____ ____ ____

A

Standard limb leads

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5
Q

Are leads I, II, and III bipolar or unipolar leads?

A

Bipolar

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6
Q

Leads aVR, aVL, and aVF are called the ____ ____ ____.

A

Augmented limb leads

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7
Q

Are leads aVR, aVL, and aVF bipolar or unipolar leads?

A

Unipolar

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8
Q

Leads V1 through to V6 are called the ____ ____.

A

Chest leads

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9
Q

Are leads V1 through to V6 bipolar or unipolar leads?

A

Unipolar

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10
Q

What is a reciprocal change?

A

An effect mirrored in opposite lead views

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11
Q

What are the diagnostic settings of an ECG?

A

x1.0
.05-40Mhz
25mm/sec

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12
Q

What is x1.0 on an ECG monitor?

A

Amplitude

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13
Q

What is .05-40Mhz on an ECG monitor?

A

Frequency response

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14
Q

What is 25mm/sec on an ECG monitor?

A

Paper speed

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15
Q

What is the J point?

A

The junction between termination of the QRS and the ST segment

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16
Q

At which point is ST segment elevation/depression measured?

A

0.08 seconds from the J point (two small boxes)

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17
Q

How many squares above the isoelectric line are significant when viewed by the limb leads?

A

One

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18
Q

How many squares above the isoelectric line are significant when viewed by the chest leads?

A

Two

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19
Q

Which are the lateral leads?

A

Leads I, aVL, V5, and V6

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20
Q

Which are the inferior leads?

A

Leads II, III, and aVF

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21
Q

Which are the septal leads?

A

Leads V1 and V2

22
Q

Which are the anterior leads?

A

Leads V3 and V4

23
Q

When is thrombolysis used?

A

When you’re more than an hour from a PCI hospital

24
Q

What drug class is clopidogrel?

A

Antiplatelet

25
Q

What is the indication for clopidogrel?

A

Patients with STEMI who have been accepted for pPCI when the receiving cardiologist is requesting clopidogrel administration OR when the patient has received tenecteplase and has been given aspirin and enoxaparin.

26
Q

What are the contraindications for clopidogrel?

A
  • KSAR
  • Pts contraindicated for fibrinolysis
  • Current clopidogrel or ticagrelor therapy
  • Pt <18
  • Active bleeding (excluding menses)
  • Prior intracranial haemorrhage
27
Q

What are the precautions for clopidogrel?

A

Severe renal impairment

28
Q

What are the side effects of clopidogrel?

A

Haemorrhage

29
Q

What is the presentation of clopidogrel?

A

75mg tablet

30
Q

What is the dosage of clopidogrel?

A

Cardiologist requested: 600mg

Post-tenecteplase admin: 300mg

31
Q

What drug class is enoxaparin?

A

Anticoagulant

32
Q

What is the indication for enoxaparin?

A

STEMI pts who will receive tenecteplase as as adjunct to clopidogrel and aspirin

33
Q

What are the contraindications for enoxaparin?

A
  • KSAR to enoxaparin OR heparin

- Pts contraindicated for fibrinolysis

34
Q

What are the precautions for enoxaparin?

A
  • Renal/hepatic impairment
  • Females <45kg and males <57kg
  • Elderly
35
Q

What are the side effects of enoxaparin?

A
  • Haemorrhage

- Thrombocytopenia

36
Q

What drug class is tenecteplase?

A

Fibrinolytic

37
Q

What is the indication for tenecteplase?

A

STEMI pts who meet the criteria for prehospital tenecteplase

38
Q

1% of patients given tenecteplase will have a ____ ____.

A

Haemorrhagic stroke

39
Q

What drug class is ticagrelor?

A

Antiplatelet

40
Q

What is the indication for ticagrelor?

A

STEMI pts who have been accepted for pPCI and the receiving cardiologist is requesting ticagrelor administration

41
Q

What are the side effects of ticagrelor?

A

Haemorrhage and bradycardia

42
Q

What are the criteria adult pts must meet for consideration of autonomous fibrinolysis administration?

A
  • Proximity to a pPCI facility (>60 minutes transport time)
  • GCS 15 pt with ongoing ischaemic chest pain for <6 hours
  • 12 lead ECG is consistent with STEMI
43
Q

What are the contraindications for autonomous fibrinolysis administration?

A
  • <18 or >75
  • Uncontrolled hypertension and/or diastolic BP >110 at any stage in paramedic care
  • Known allergy to tenecteplase, enoxaparin, or clopidogrel
  • LBBB identified on 12 lead ECG
  • Current or hx of thrombocytopenia
  • Active tuberculosis
  • Known cerebral disease, particularly malignant intracranial neoplasm or arteriovenous malformation
  • Prior intracranial haemorrhage
  • Ischaemic stroke or TIA in last 3 months
  • Hx of significant closed head or facial trauma in last 3 months
  • Suspected aortic dissection
  • Hx of major trauma or surgery in last 6 weeks
  • Internal bleeding in last 6 weeks
  • Bleeding or clotting disorder
  • Current use of anticoagulants
  • Non-compressible vascular punctures
  • Prolonged CPR (>10 minutes)
  • Known pregnancy or has given birth in last 2 weeks
  • Hx of serious systemic disease
  • Resident of aged care facility requiring significant ADL
  • AMI in traumatic setting
44
Q

What are the complications of autonomous fibrinolysis administration?

A
  • Life-threatening stroke
  • Haemorrhage
  • Failure to achieve reperfusion
45
Q

What are the criteria adult pts must meet for consideration of autonomous primary percutaneous coronary intervention (pPCI) referral?

A
  • Proximity to a pPCI facility (<60 minutes transport time from time of diagnostic 12 lead ECG)
  • GCS 15 pt with ongoing ischaemic chest pain for <12 hours
  • 12 lead ECG is consistent with STEMI
46
Q

What are the contraindications for autonomous pPCI referral?

A
  • Hx of serious systemic disease
  • Resident of an aged care facility requiring significant ADL
  • MI in acute traumatic setting
47
Q

List things that promote myocardial salvage

A
  • Rest and reassurance
  • Oxygen
  • GTN
  • Aspirin
  • Enoxaparin/Clexane
  • Heparin
  • Clopidogral
  • Analgesia
  • Methoxyflurane
  • Dysrhythmia management
  • Beta blockers
  • Tirofiban
  • ACEls
48
Q

List what can be used in dsyrhythmia management

A
  • Defibrillation
  • Valsalva manoeuvre
  • Cardioversion
  • Lignocaine
  • Atropine
  • Beta blockers
  • Transcutaneous pacing
  • Adrenaline infusion
  • Amiodarone
49
Q

What are beta blockers?

A

Adrenoreceptor antagonists

50
Q

What is the effect of beta blockers?

A
  • Decreases the rate of rise of phase 4 in the pacemakers
  • Slows down conduction from the SA node through to the AV node
  • Creates a partial AV block
  • Prophylaxis against recurrent tachdysrhythmias

CSB335 (12 decks)

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