- •Contents
- •Contributors and consultants
- •Not another boring foreword
- •A look at cardiac anatomy
- •A look at cardiac physiology
- •A look at ECG recordings
- •All about leads
- •Observing the cardiac rhythm
- •Monitor problems
- •A look at an ECG complex
- •8-step method
- •Recognizing normal sinus rhythm
- •A look at sinus node arrhythmias
- •Sinus arrhythmia
- •Sinus bradycardia
- •Sinus tachycardia
- •Sinus arrest
- •Sick sinus syndrome
- •A look at atrial arrhythmias
- •Premature atrial contractions
- •Atrial tachycardia
- •Atrial flutter
- •Atrial fibrillation
- •Wandering pacemaker
- •A look at junctional arrhythmias
- •Premature junctional contraction
- •Junctional escape rhythm
- •Accelerated junctional rhythm
- •Junctional tachycardia
- •A look at ventricular arrhythmias
- •Premature ventricular contraction
- •Idioventricular rhythms
- •Ventricular tachycardia
- •Ventricular fibrillation
- •Asystole
- •A look at AV block
- •First-degree AV block
- •Type I second-degree AV block
- •Type II second-degree AV block
- •Third-degree AV block
- •A look at pacemakers
- •Working with pacemakers
- •Evaluating pacemakers
- •A look at biventricular pacemakers
- •A look at radiofrequency ablation
- •A look at ICDs
- •A look at antiarrhythmics
- •Antiarrhythmics by class
- •Teaching about antiarrhythmics
- •A look at the 12-lead ECG
- •Signal-averaged ECG
- •A look at 12-lead ECG interpretation
- •Disorders affecting a 12-lead ECG
- •Identifying types of MI
- •Appendices and index
- •Practice makes perfect
- •ACLS algorithms
- •Brushing up on interpretation skills
- •Look-alike ECG challenge
- •Quick guide to arrhythmias
- •Glossary
- •Selected references
- •Index
- •Notes
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 |