Flip and See ECG - E-Book
165 pages

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165 pages
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When it comes to learning ECG interpretation, there's simply no faster or easier way to master basic rhythms than this unique book. Using a fun and easy-to-understand writing style, this updated new edition uses humor, cartoons, and personal stories to walk you through the entire ECG process: from finding a heartbeat, to monitoring an electrocardiogram, to interpreting the heart rhythm. A unique Flip and See section allows you to view normal ECGs on one side of the page and abnormal ECGs on the other, along with concise text that clearly explains the differences between them. Plus, the completely redesigned Cohn's Pocket Guide for ECG Interpretation aids both students and practitioners in rhythm interpretation.

  • Lay-flat spiral binding makes it easy to use anywhere, and the small size fits into a lab coat pocket.
  • Unique Flip and See section at the end of the book allows you to see each rhythm side-by-side with a normal ECG rhythm, while a written walkthrough explains the important differences between the rhythms.
  • Excuse Me! features highlight frequently asked student questions with easy-to-understand answers.
  • Conversational language and clear illustrations and cartoons make the information easy to remember and fun to learn.
  • New and updated information across the entire book includes coverage of new pacemaker strips and now includes 12-lead interpretation and 12-lead axis identification.
  • New cartoons have been added to make key points memorable and entertaining.
  • Updated algorithms reflect the new 2010 ECC Guidelines.
  • Completely redesigned Cohn's Pocket Guide for ECG Interpretation, a plastic heart rate ruler, aids both students and practitioners in rhythm interpretation.
  • Expanded appendix provides illustrations of ECG complexes as they relate to heart damage.



Publié par
Date de parution 10 décembre 2013
Nombre de lectures 1
EAN13 9780323292153
Langue English
Poids de l'ouvrage 14 Mo

Informations légales : prix de location à la page 0,0171€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.


Flip and See ECG
Elizabeth Gross Cohn, RN, ACNP, DNSc Columbia University, New York, New York
Table of Contents
Cover image
Title page
A Word from Our Sponsor Physical Examination SAMPLER System OPQRST-I System Vital Signs
Symbols Used in This Book
How To Approach ECGS
How the Heart Works The Heart Cardiac Cycle Conduction Pathways
Introduction to the Rhythms Introduction to the Rhythms
How to Interpret ECGs ECG Paper Normal ECG Calculating the Heart Rate Summary
Introduction to 12-Lead Interpretation A Gentle Introduction to 12-Lead ECG Interpretation
How to Use the Flip and See How to Use the Flip and See Portion of This Book Flip and See Guided Tutorial Summary A FEW Golden Rules
Appendix and ACLS Algorithms
FLIP AND SEE ECG ISBN: 978-0-323-08452-9 Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website:www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
Previous editions copyrighted 1996, 2002, 2009 Acquisitions Editor:Laura Bayless Developmental Editor:John Tomedi Publishing Services Manager:Julie Eddy Project Manager:Richard Barber Cover Designer:Brian Salisbury Text Designer:Brian Salisbury Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1
This book is dedicated to: My father:Ronald Gross, a life-long champion of meaningful conversation, a leader of provocative thought, and the inspiration behind all I have done and all I will do. My family:Bruce, Michelle and Zachary, who taught me about the meaning of true love, the power of deep thought, and the force of courage, respectively. My mentors:Dr. Elaine Larson, Dr. Olajide Williams, Dr. Sarah Sheets Cook, Dr. Arlene Smaldone, Dr. Stacie Deiner, Dr. Erfan Hussein, Ms. Kristine Kulage and Mrs. Patricia R. Butts, who have selflessly provided guidance, wisdom, vision and friendship. The professionals at Elsevier:Rich Barber, Laura Bayless, and John Tomedi The memory of my mother, Beatrice Gross, who would have been so proud.
We would like to thank the following individuals for their review of the material for this fourth edition ofFlip and See ECG: John Cole, MD Fidel Garcia, EMT-P Karen Tetz, RN, PhD Walla Walla University Portland, Oregon Erik Usher, RN, EMS-RN, CEN, CFRN, CPEN, EMT-P Thomas Worms, MSN, RN Truman College Chicago, Illinois
AWord from Our Sponsor
This book is humbly dedicated to Willem Einthoven, inventor of the electrocardiograph machine. For hundreds of years, the only known method for observing the beating of the heart was by opening the chest, breaking the sternum in half, and having a look. S adly, the patients usually died. The discovery that the movements of muscles are regulated by electrical current began in 1664 when J an S wammerdam removed the heart of a living frog. W hen the frog was dissected and the nerve endings were stimulated with a scalpel, the muscles twitched—refuting the theory that “animal spirits” controlled muscles. I n the years that followed, through brilliant scientific work, careful observations, and some random chance, it was discovered that the electrical impulses controlled muscle movements. The recording of this electrical activity became the basis for the ECG. I n 1887, Augustus Waller invented theelectrode. This electrode allowed the electrical currents to be measured throughintact skin,which was a tremendous boon to both patients and medical personnel. The electrode was a large magnetic plate that hooked up to acapillary electrometer, a column of mercury that rose and fell with changes in the electrical field. This elegant invention had advantages and disadvantages. The advantage was in not having to cut the patient open to expose the heart. The disadvantage was the long lag time between the action of the heart and the action of the mercury. Moreover, you needed to perform a complex mathematical calculation to establish a heart paern. By the time the measurement was finished, so was the patient. Willem Einthoven is credited with the invention of the electrocardiograph machine, and for this, he was awarded the N obel Prize in 1924. Theelectrocardiogram, the graphic representation of electrical activity, is also known as theEKG orECG (“electrokardiogramm” from the German, abbreviated EKG). The medical profession currently uses these abbreviations interchangeably. Einthoven’s ECG machine was a fine quar; wire suspended in a magnetic field. W hen subjected to an electrical current, the wire deflected according to the charge. This motion was magnified and photographed on a moving reel of film. Because it was very light in weight, the wire responded almost instantaneously to any changes in the electrical current. Einthoven established the criteria for normal ECGs and named the waves P, Q RS , and T. He further designated the three points on the body where the electrodes should be placed. A fuller history of the ECG is available athttp://www.ecglibrary.com/ecghist.html. Today the ECG machine remains one of the most important tools in medicine used for diagnosis, monitoring, gauging response to therapy, and recording past events. We rely on ECGs daily in ambulances and hospitals to save the lives of thousands.
Physical Examination
PhysicalExamination Obtaining a Patient History A complete assessment of the patient can be obtained when you use an organized approach to patient history and physical examination. Experienced clinicians start their assessment with how the patient looks. They ask if there is a past cardiac 1 history. There are more than 30 differential diagnoses for the chest pain patient. The beginning practitioner should be aware thatacute myocardial infarction, or heart attack, is among the most critical of the chest pain scenarios. However, all chest pain should be taken seriously and treated as cardiac until proven otherwise.
SAMPLER System The S A MPLER system assists practitioners in a quick and accurate assessment. I n the SAMPLERsystem, the patient is asked about: Signs and Symptoms—specifically related to cardiac events such as the time of onset, symptoms, was it relieved with nitroglycerin, is it associated with shortness of breath? See OPQRST-I system (next section). Allergies—especially to medications, shellfish, or iodine. Medications—especially cardiac medications, antihypertensive drugs, antiarrhythmics, and insulin. Past history—anyone with a history of a cardiac condition or presenting with signs and symptoms of a heart attack is considered to be a cardiac patient until proven otherwise. Last meal—necessary information for anesthesia. Events leading to this episode of chest pain, it is especially noteworthy if the pain woke the patient from sleep or continued even when the patient was at rest. Risk factors—smoking, diabetes, hypertension, coronary artery disease, high 2 cholesterol, or a family history of heart disease.
OPQRST-I System T heOPQRST-I system helps patients to describe signs and symptoms related to a heart attack: Onset: What were you doing when the symptoms started? Provokes: What makes the symptoms better or worse? Does it change with movement? Stop when you rest? Can you take a deep breath? Question: Signs and symptoms can differ in men and women. In men, chest pain is a common presenting symptom. However, in women, unusual fatigue is reported as an early symptom in 70% of the patients who had a heart attack, and shortness of breath and weakness were the most common presenting symptoms at the time the heart attack was happening. More than two thirds of women do not experience chest pain when they are having a heart attack. There are eighteen symptoms of heart attacks in women, and they can vary by race. So be on the lookout in women for fatigue and tiredness, sleep disturbance, anxiety, shortness of breath, nausea and vomiting, dizziness, and headache. Presenting signs and symptoms of heart attacks:
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