Equipped with a carefully formed clinical impression of the patient, a systematic approach to 12 lead ECGElectrocardiogram; also called an EKG; a representation of electrical voltage measured across the chest over a period of time. 1. Six Second ECG Guidebook (2012), T Barill, p. 196 interpretation makes the 12 lead ECG a reliable assessment tool. Mindful of false positives and false negatives, the patient’s old 12 lead ECG serves as an invaluable reference that greatly increases the likelihood of a correct interpretation.
While an ECG is a superior diagnostic tool, experienced practitioners are witness to false positive and false negative ECGs. A false positive ECGA false positive ECG occurs when ECG findings are abnormal for a patient that is quite healthy. An example of a false positive is the presence of ST elevation that is a benign early repolarization - more common with young... occurs when ECG findings are abnormal for a patient that is quite healthy. An example of a false positive is the presence of ST elevationThe upward placement of the ST segment greater than 1 mm from the isoelectric line; suggestive of cardiac infarction or ischemia. Between the QRS complex and the T wave, lies the ST segment. The ST segment usually follows the isoelectric... that is a benign early repolarizationWhile an ECG is a superior diagnostic tool, experienced practitioners are witness to false positive and false negative ECGs. A false positive ECG occurs when ECG findings are abnormal for a patient that is quite healthy. An example of a... – more common with young athletes. Conversely, a false negative ECGA false negative ECG does not indicate the presence of cardiac disease that is subsequently established. While an ECG is a superior diagnostic tool, experienced practitioners are witness to false positive and false negative ECGs. A false positive ECG occurs... does not indicate the presence of cardiac disease that is subsequently established. The bottom line: a 12 lead ECG is a tool best used in conjunction with previous ECGs, a thorough physical assessment and an in depth cardiac history.
The systematic ECG interpretation of a 12 lead ECG takes a bit more time than the six seconds necessary to correctly name most single lead rhythmOften refers to a discernible pattern in time or distance between QRS complexes and/or P waves. strips. While many excellent approaches to 12 lead interpretation exist, all methods include certain key points that are incorporated into a three-step system for 12 lead ECG analysis.
Step 1: BaselineThe baseline or isoelectric line is a reference point for the waves, intervals and segments. While the PR segment is often used as the baseline, the TP segment - between the end of the T wave and the beginning of...
Step 2: Search for ST, T and Q changes
Step 3: Rule Out Rule In
1. Six Second ECG GuidebookA Practice Guide to Basic and 12 Lead ECG Interpretation, written by Tracy Barill, 2012 Introduction The ability to correctly interpret an electrocardiogram (ECG), be it a simple six second strip or a 12 lead ECG, is a vital skill... (2012), T Barill, p. 152 [plus updates in the 12 Lead ECG Priority Actions document]