Table Of Content

EECCGG__FFMM..iinndddd ii 77//88//22001100 1122::4488::1166 PPMM EECCGG__FFMM..iinndddd iiii 77//88//22001100 1122::4488::2200 PPMM EECCGG__FFMM..iinndddd iiiiii 77//88//22001100 1122::4488::2200 PPMM Staff The clinical treatments described and recommended in this publication are based on research and consulta- tion with nursing, medical, and legal authorities. To the Publisher best of our knowledge, these procedures reflect cur- Chris Burghardt rently accepted practice. Nevertheless, they can’t be considered absolute and universal recommendations. Clinical Director For individual applications, all recommendations must Joan M. Robinson, RN, MSN be considered in light of the patient’s clinical condition and, before administration of new or infrequently used Clinical Project Manager drugs, in light of the latest package-insert information. Jennifer Meyering, RN, BSN, MS The authors and publisher disclaim any responsibility Product Director for any adverse effects resulting from the suggested procedures, from any undetected errors, or from the David Moreau reader’s misunderstanding of the text. Product Manager Jennifer K. Forestieri © 2011 by Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part Editor of it may be reproduced, stored in a retrieval system, or Tracy S. Diehl transmitted, in any form or by any means—electronic, mechanical, photocopy, recording, or otherwise— Art Director without prior written permission of the publisher, except Elaine Kasmer for brief quotations embodied in critical articles and reviews and testing and evaluation materials provided by Illustrator publisher to instructors whose schools have adopted its Bot Roda accompanying textbook. Printed in China. For informa- Design Assistant tion, write Lippincott Williams & Wilkins, 323 Norristown Road, Suite 200, Ambler, PA 19002-2756. Kate Zulak Vendor Manager ECGIE5E11010 Beth Martz Associate Manufacturing Manager Library of Congress Cataloging-in- Publication Data Beth J. Welsh ECG interpretation made incredibly easy!. — 5th ed. Editorial Assistants p. ; cm. Karen J. Kirk, Jeri O’Shea, Linda K. Ruhf 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 EECCGG__FFMM..iinndddd iivv 77//88//22001100 1122::4488::2244 PPMM 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 EECCGG__FFMM..iinndddd vv 77//88//22001100 1122::4488::2244 PPMM 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 vvii EECCGG__FFMM..iinndddd vvii 77//2233//22001100 11::0066::1144 PPMM 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 EECCGG__FFMM..iinndddd vviiii 77//88//22001100 1122::4488::2244 PPMM EECCGG__FFMM..iinndddd vviiiiii 77//88//22001100 1122::4488::2266 PPMM

Description:

rently accepted practice. Nevertheless reviews and testing and evaluation materials provided by ECG interpretation made incredibly easy!. — Interpreting a rhythm strip. 43 .. During phases 1 and 2 and at the beginning of phase 3, the.