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ECG Interpretation Made Incredibly Easy (5th edition).pdf
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Staff

Publisher

Chris Burghardt

Clinical Director

Joan M. Robinson, RN, MSN

Clinical Project Manager

Jennifer Meyering, RN, BSN, MS

Product Director

David Moreau

Product Manager

Jennifer K. Forestieri

Editor

Tracy S. Diehl

Art Director

Elaine Kasmer

Illustrator

Bot Roda

Design Assistant

Kate Zulak

Vendor Manager

Beth Martz

Associate Manufacturing Manager

Beth J. Welsh

Editorial Assistants

Karen J. Kirk, Jeri O’Shea, Linda K. Ruhf

The clinical treatments described and recommended in this publication are based on research and consultation with nursing, medical, and legal authorities. To the best of our knowledge, these procedures reflect currently accepted practice. Nevertheless, they can’t be considered absolute and universal recommendations. For individual applications, all recommendations must be considered in light of the patient’s clinical condition and, before administration of new or infrequently used drugs, in light of the latest package-insert information. The authors and publisher disclaim any responsibility for any adverse effects resulting from the suggested procedures, from any undetected errors, or from the reader’s misunderstanding of the text.

© 2011 by Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means—electronic, mechanical, photocopy, recording, or otherwise— without prior written permission of the publisher, except for brief quotations embodied in critical articles and reviews and testing and evaluation materials provided by publisher to instructors whose schools have adopted its accompanying textbook. Printed in China. For information, write Lippincott Williams & Wilkins, 323 Norristown Road, Suite 200, Ambler, PA 19002-2756.

ECGIE5E11010

Library of Congress Cataloging-in-Publication Data

ECG interpretation made incredibly easy!. — 5th ed.

p. ; cm.

Includes bibliographical references and index. ISBN 978-1-60831-289-4 (pbk. : alk. paper)

1. Electrocardiography. 2. Heart—Diseases— Nursing. I. Lippincott Williams & Wilkins.

[DNLM: 1. Electrocardiography—Nurses’ Instruction. 2. Arrhythmias, Cardiac—Nurses’

Instruction. WG 140 E172 2011]

 

RC683.5.E5E256 2011

 

616.1’207547—dc22

 

ISBN-13:

978-1-60831-289-4 (alk. paper)

ISBN-10:

1-60831-289-5 (alk. paper)

2010022956

iv

Contents

Contributors and consultants

vi

Not another boring foreword

vii

Part I

ECG fundamentals

 

 

 

 

1

Cardiac anatomy and physiology

3

2

Obtaining a rhythm strip

23

3

Interpreting a rhythm strip

43

Part II

Recognizing arrhythmias

 

 

 

 

4

Sinus node arrhythmias

63

5

Atrial arrhythmias

87

6

Junctional arrhythmias

111

7

Ventricular arrhythmias

127

8

Atrioventricular blocks

153

Part III

Treating arrhythmias

 

 

 

 

9

Nonpharmacologic treatments

175

10

Pharmacologic treatments

205

 

 

Part IV The 12-lead ECG

 

 

 

 

11

Obtaining a 12-lead ECG

239

12

Interpreting a 12-lead ECG

255

 

 

Appendices and index

 

 

 

Practice makes perfect

286

ACLS algorithms

304

Brushing up on interpretation skills

310

Look-alike ECG challenge

348

Quick guide to arrhythmias

359

Glossary

 

364

Selected references

366

Index

 

367

v

Contributors and consultants

Diane M. Allen, RN, MSN, ANP, BC, CLS

Karen Knight-Frank, RN, MS, CNS, CCRN, CCNS

Nurse Practitioner

Clinical Nurse Specialist, Critical Care

Womack Army Medical Center

San Joaquin General Hospital

Fort Bragg, N.C.

French Camp, Calif.

Nancy Bekken, RN, MS, CCRN

Marcella Ann Mikalaitis, RN, MSN, CCRN

Nurse Educator, Adult Critical Care

Staff Nurse, Cardiovascular Intensive Care

Spectrum Health

Unit (CVICU)

Grand Rapids, Mich.

Doylestown (Pa.) Hospital

Karen Crisfulla, RN, CNS, MSN, CCRN

Cheryl Rader, RN, BSN, CCRN-CSC

Clinical Nurse Specialist

Staff Nurse: RN IV

Hospital of the University of Pennsylvania

Saint Luke‘s Hospital of Kansas City (Mo.)

Philadelphia

Leigh Ann Trujillo, RN, BSN

 

Maurice H. Espinoza, RN, MSN, CNS, CCRN

Clinical Educator

Clinical Nurse Specialist

St. James Hospital and Health Center

University of California Irvine Medical Center

Olympia Fields, Ill.

Orange

Rebecca Unruh, RN, MSN

 

Kathleen M. Hill, RN, MSN, CCNS-CSC

Nurse Manager – Cardiac Intensive Care

Clinical Nurse Specialist, Surgical Intensive

Unit & Cardiac Rehabilitation

Care Unit

North Kansas City (Mo.) Hospital

Cleveland Clinic

Opal V. Wilson, RN, MA, BSN

 

Cheryl Kabeli, RN, MSN, FNP-BC, CNS-BC

RN Manager, PC Telemetry Unit

Nurse Practitioner

Louisiana State University Health Sciences

Champlain Valley Cardiothoracic Surgeons

Center

Plattsburgh, N.Y.

Shreveport

vi

Not another boring foreword

If you’re like me, you’re too busy to wade through a foreword that uses pretentious terms and umpteen dull paragraphs to get to the point. So let’s cut right to the chase! Here’s why this book is so terrific:

1.It will teach you all the important things you need to know about ECG interpretation. (And it will leave out all the fluff that wastes your time.)

2.It will help you remember what you’ve learned.

3.It will make you smile as it enhances your knowledge and skills.

Don’t believe me? Try these recurring logos on for size:

Ages and stages identifies variations in ECGs related to patient age.

Now I get it offers crystal-clear explanations of complex procedures, such as how to use an automated external defibrillator.

Don’t skip this strip identifies arrhythmias that have the most serious consequences.

Mixed signals provides tips on how to solve the most common problems in ECG monitoring and interpretation.

I can’t waste time highlights key points you need to know about each arrhythmia for quick reviews.

See? I told you! And that’s not all. Look for me and my friends in the margins throughout this book. We’ll be there to explain key concepts, provide important care reminders, and offer reassurance. Oh, and if you don’t mind, we’ll be spicing up the pages with a bit of humor along the way, to teach and entertain in a way that no other resource can.

I hope you find this book helpful. Best of luck throughout your career!

Joy

vii

Part I ECG fundamentals

1

Cardiac anatomy and physiology

3

2

Obtaining a rhythm strip

23

3

Interpreting a rhythm strip

43

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