ECG INTERPRETATION IN ACLS

Electrocardiogram (ECG) interpretation is a crucial skill in ACLS. Recognizing specific ECG rhythms is essential for guiding appropriate interventions during cardiac emergencies. This lesson focuses on the key ECG rhythms encountered in ACLS.

BASIC ECG COMPONENTS

• P wave: Represents atrial depolarization (contraction).
• QRS complex: Represents ventricular depolarization (contraction).
• T wave: Represents ventricular repolarization (relaxation).
• PR interval: Represents the time it takes for the electrical impulse to travel from the atria to the ventricles.
• QT interval: Represents the total time for ventricular depolarization and repolarization.

KEY ACLS RHYTHMS

• Normal Sinus Rhythm: Regular rhythm with a P wave preceding each QRS complex, a normal PR interval, and a normal QRS complex.
• Sinus Bradycardia: Slow heart rate (less than 60 bpm) with a regular rhythm and normal P waves, PR intervals, and QRS complexes.
• Sinus Tachycardia: Fast heart rate (greater than 100 bpm) with a regular rhythm and normal P waves, PR intervals, and QRS complexes.
• Atrial Fibrillation (AF): Irregularly irregular rhythm with no discernible P waves, and irregular R-R intervals.
• Atrial Flutter: Rapid atrial rate with characteristic “sawtooth” pattern of P waves.
• Ventricular Tachycardia (VT): Rapid ventricular rate with wide QRS complexes. Can be monomorphic (uniform QRS complexes) or polymorphic (varying QRS complexes).
• Ventricular Fibrillation (VF): Chaotic, disorganized electrical activity in the ventricles, resulting in no effective cardiac output. Characterized by erratic, irregular waveforms with no identifiable P waves, QRS complexes, or T waves.
• Asystole: Absence of electrical activity in the heart, appearing as a flat line on the ECG.
• Pulseless Electrical Activity (PEA): Electrical activity is present on the ECG, but there is no palpable pulse.

ECG INTERPRETATION IN ACLS ALGORITHMS

ECG interpretation plays a crucial role in the ACLS algorithms:

• Cardiac Arrest Algorithm: Distinguishes between shockable rhythms (VF/pVT) and non-shockable rhythms (asystole/PEA), guiding appropriate interventions.
• Bradycardia Algorithm: Helps determine the presence and severity of bradycardia.
• Tachycardia Algorithm: Helps differentiate between stable and unstable tachycardia and narrow and wide QRS complex tachycardias, guiding treatment decisions.

KEY CONSIDERATIONS

• ECG interpretation should always be correlated with the patient’s clinical presentation.
• Continuous ECG monitoring is essential during resuscitation efforts.

This lesson provided an overview of key ECG rhythms relevant to ACLS. It is essential for healthcare providers to be proficient in ECG interpretation to effectively manage cardiac emergencies.