In the past few decades, the marriage between technological innovation and medical necessity has created countless machines capable of providing a greater level of quality care. While these machines make it possible to quickly and effectively respond to a situation, they are not without their own learning curve. With that in mind, it takes special training to be able to read and interpret what the machine is telling you.
This is especially true when it comes to an ekg machine. Serving a specific function in hospitals, an EKG can provide life saving information if you know how to read it. Whether you are a studying nursing or medicine, or are looking to better understand how an EKG functions, the following guide is for you. We will briefly review the role of an EKG in the hospital setting, as well as all of the basic points behind EKG interpretation. With any luck, you will be able to use this knowledge as a springboard to continue learning about the various machines in medicine.
What Is An EKG?
An EKG, or ECG, stands for an electrocardiogram. The purpose of this machine is to check for problems with your heart. Specifically, it is responsible for monitoring your heart’s electrical activity. The electrocardiogram records information regarding the heart and then shows this information as a line tracing on paper. Waves are formed between the spikes and the dips as the EKG monitors the heart.
AN EKG is popular because it is painless and does not harm people. Electrodes are attached to the skin of the arms, legs, and chest. Typically, around 12 patches are attached to the body and parts of the body may be shaved to make it easier to attach the electrodes. For an EKG machine test, expect about 10 minutes worth of time to complete. In addition to being a part of a general test, it can be utilized in a stress test as well. In addition, there are Holter and Event Monitors designed to record your heart’s electrical activity. They are small, can be easily carried around, and can record the heart’s electrical activity for 24 to 48 hours.
An EKG can be active as well. Along with passively recording the heart rate, some portable EKG monitors are designed to alert individuals if an abnormal heartbeat is detected. This allows for at-risk individuals to be monitored without constantly being watched by an attending physician, freeing up man hours and improving quality of care as a result.
No matter how well constructed an EKG is, it is useless if the attending physician does not know how to interpret and step in accordingly. By understanding what you are seeing with an EKG reading, you can be more knowledgeable about what is going on with the individual.
Interpreting An EKG Reading
1. Knowing The Basics
The first thing you can do is to familiarize yourself with the basic nomenclature behind EKG readings. Typically, you will see an EKG reading on a grid and represented as a line with several high and low points. In between two beats, the line is horizontal along the graph. The first sign of a beat comes with a minor rise known as a P wave. This represents the first time the wave moves upwards, or positively. This is followed by the QRS complex, beginning with a quick return to normal and then a slight downward bump known as a downward deflection. The R represents the top of the upward deflection and is usually the highest point in the reading for a heart beat. This is then followed by a drop again, known as an S wave. After returning to base line, there are two more vertical bumps similar in size to the first P wave. They are known as the T wave and the U wave. Sometimes, the U wave is not observable. So together, there is the P wave, the QRS complex, the T wave, and the U wave.
2. Looking At The Rhythm
With the individual components of a wave identified, it is time to establish a rhythm from what you see. Known as an R, a rhythm is established from finding one repeatable point and calculating the distance between that point and the next point in the following heartbeat. A rhythm is considered normal if the distance between each R is the same, or within a 10% difference. If the rhythm is beyond a 10% difference, then the heartbeat is considered irregular and the person has an irregular heartbeat. As a final note, for atrial rhythms, use a P to P, as opposed to an R to R to establish rhythm.
3. Calculate the Heart Rate
With the rhythm identified, you can calculate the heart rate. Simply look at the amount of QRS complexes that there are in a 6 second period of time. Multiply this by 10 to determine the heart rate. As an example, if there were 8 QRS complexes in 6 seconds, then the heart rate would be 80. As a final note, if the EKG is on graph paper, then you can calculate by counting the boxes in between the R points, and then divide the number into 1500 to determine the heart rate. Having 23 boxes in between each R would mean a heart rate of 65.2.
4. What Differences in PQRSTU Tell Us
The heartbeat begins with the P wave, which represents the atrial depolarization. Smooth and rounded, the P wave usually precedes the QRS complex. The P to Q range can be used to determine PQ intervals which can provide useful information. The distance between the P and Q is shorter for people who are younger, and longer for the elderly. It is useful to determine whether or not the PQ intervals are steady or irregular, as this can tell you more about problems concerning the heart.
While the P wave represents atrial depolarization, the QRS complex represents the ventricular depolarization. It is bigger then the P wave because there is more tissue mass involved, and one or two of these components may be missing if there is something up. The benefits of looking at QRS complexes can be helpful for afib ecg calculations.
The atrial depolarization is followed by the repolarization of the ventricles and appears as the T wave on the EKG. Following the QRS after a pause, the T wave is sometimes followed by a noticeable U wave. In addition, understanding the QRS complex as well as the T and U wave can help in determining chronic afib.
The Purpose Of Knowing How To Interpret An EKG Machine
There are ranges of situations where an individual will be hooked up to an EKG. Some of these, including basic monitoring for a person who is having a baseline established by a doctor will be relatively simple, primarily stress-free, and provide plenty of time to understand the results. There are other situations however where the person’s health will be at risk, and quick action is required. Knowing how to interpret an EKG quickly and effectively can save a person’s life through providing time critical care before it is too late.
One of the most important things that an EKG machine can do is to inform you of a heart attack that is either about to begin or currently in progress. In addition to finding which part of your heart may be damaged, the EKG can make it known that there is something wrong long before symptoms begin to surface. In addition to showing signs of a heart attack in progress, an EKG can also help to identify previous heart attacks, providing medical professionals information they need if the person is irresponsive.
Along with providing information regarding past and current heart attacks, an EKG is excellent at providing information for structural abnormalities in the heart. As each of these abnormalities will affect how the EKG records the pattern on the graph, it can be easy to identify where the problems are and help to direct a course of treatment. The EKG can also show the effects of inadequate blood to the heart, as well as relative oxygen supply. In addition, if the EKG is done while you are having symptoms, then it can direct doctors as to what the true cause of your symptoms are if it involves your heart.
Providing a wealth of information regarding a heart, an EKG is an incredibly powerful tool when in the right hands. Through the identification of abnormalities in design and patterning versus a standard template, individuals trained to interpret an EKG can use the information to be better informed of what may be troubling an individual. While no machine is perfect, the EKG represents a tried-and-true tool utilized for countless decades towards providing better standards of care for patients. Whether it is used in a life-threatening situation or just as a part of a heart-health check up or stress test, the EKG continues to play an important role in modern medical practice.