Medical Student Survival Skills

Philip Jevon is Honorary Clinical Lecturer at Birmingham Medical School and Academy Manager/Tutor, Walsall Teaching Academy, Manor Hospital, Walsall, UK. Jayant Gupta is Consultant Cardiologist, Senior Academy Tutor, Walsall Healthcare NHS Trust, Manor Hospital, Walsall, UK.

Preface vii

About the companion website ix

1 Introduction to ECG monitoring 1

2 Principles of ECG monitoring 3

3 Six stage approach to ECG interpretation 9

4 Sinus tachycardia 13

5 Sinus bradycardia 15

6 Sinus arrhythmia 17

7 Atrial ectopic beats 19

8 Atrial tachycardia 21

9 Atrial flutter 23

10 Atrial fibrillation 27

11 AV junctional ectopics 31

12 AV junctional escape rhythm 33

13 Junctional tachycardia 35

14 Ventricular ectopics 37

15 Idioventricular rhythm 41

16 Ventricular tachycardia 43

17 Torsades de pointes 47

18 First degree AV block 49

19 Second degree AV block Mobitz type I (Wenckebach phenomenon) 51

20 Second degree AV block Mobitz type II 53

21 Third degree (complete) AV block 55

22 Ventricular fibrillation 59

23 Ventricular standstill 61

24 Asystole 63

25 Recording a 12 lead ECG 65

26 What the standard 12 lead ECG records 71

27 Interpretation of a 12 lead ECG 75

28 ECG changes associated with myocardial infarction 81

29 ECG changes associated with myocardial ischaemia 87

30 ECG changes associated with bundle branch block 91

31 Wolff–Parkinson–White syndrome 97

Appendix A: Resuscitation council (UK) bradycardia algorithm 99

Appendix B: Resuscitation council (UK) tachycardia algorithm 101

Appendix C: Resuscitation council (UK) advanced life support (ALS) algorithm 103

Appendix D: Vagal manoeuvres 105

Appendix E: Synchronised electrical cardioversion 107

Appendix F: External (transcutaneous) pacing 111

Appendix G: Procedure for transcutaneous pacing 113

Appendix H: Definitions 115

References 117

Index 119