• 300 method – 300, 150, 100, 75, 60 Rate • 10 second method • Each EKG is 10 seconds • Count total QRS complexes • Multiply by 6 Rate • Normal 60 – 100 • Bradycardia < 60 • Tachycardia > 100 Rhythm • Sinus •Atrial • Supraventricular • Junctional • VentricularExpressed in beats per minute (BPM) Determining Heart Rate 3step approach (1) Locate R wave that falls on or near thick line (2) Count # of thick lines until next R wave (3) Use "" rule Memorize the following sequence of numbers as stated in the ECG Strip Ease Book, "300, 150, 100, 75, 60,50 4" Start with the pwave or rwave (according to which rate you are measuring) closest to a heavy line on the EKG paper Assign the next series of heavy lines the six numbers respectively
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Ecg 300 150 100 75- Use the sequence Count from the first QRS complex, the first thick line is 300, the next thick line 150 etc Stop the sequence at the next QRS complex When the second QRS complex is between two lines, take the mean of the two numbers from the sequence or use the finetuning method listed belowTwo large squares, 150 bpm, three large squares, 100 bpm, four 75 bpm
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Use the following numbers to indicate what the heart rate is between two successive R waves 300, 150, 100, 75, 60, 50, 43, 37, 33, 30 Method # 2 The Six Second Tracing Method Obtain a six second tracing (30 five mm boxes) and count the number of R waves that appear within that 6 second period and multiply by 10 to obtain the HR/minFor example if there is 1 large square between R waves, the heart rate is 300 bpm;The mnemonic "" to estimate the rate in beats per minute (BPM) In other words if you pass 2 lines before the next QRS, the heart rate (HR) would be less than 150 Remember that this is merely an estimate
Normal ECG Standard 12 Lead ECG 12 Lead ECG record Role of Conduction System 12 lead ECG Limb leads I a VR II III Precordial leads V 1 V 4 a VL V 2 V 5 a VF V 3 V 6 Rhythm strip 300 150 100 75 6050 43 Standard 12 lead ECG 25 mm/sec 1 mv/10 mm 10 sec !!Using the method 300 150 100 75 60 in the above example, 3 large boxes noted between two Rwaves, followed by roughly 25 small boxes would represent a ventricular rate of 85/min Another method is to divide 1500 by the number of small squares between two Rwaves The rule of 300 No of big boxes Rate (apprx) 1 300 2 150 3 100 4 75 5 60 6 50 10 second rule • As most ECG record 10 seconds of rhythm per page, one can simply count the number of beats present on the ECG and multiply by 6 to get the number of beats per seconds
심박동 계산법 빨간 구름이 1개씩 늘어날 때마다 300, 150, 100, 75, 60 4Axis Lead I, aVF 의 R 파를 벡터로 보고 벡터의 합으로 축을 확인 합니다 아래 그림에서 심장의 축이 The HR may be counted by simply dividing 300 by the number of the large squares between two heart beats (RR) If the interval between two beats is one large square, the HR is 300 beat/min, 2 squares →150, 3 squares →100, 4 squares → 75, 5 squares → 60, 6 squares → 50 beat/min Figure 1 Calculating heart rate on EKG sheet, HR ~ 1 2EKG Intermediate Tips, tricks, tools Brian Gober, MAT, ATC, NRP, CSCS sequence Count from the first QRS the first thick line is 300, the next thick line 150 etc Count the number of QRS complexes that fit into 3 seconds Rate ECG Rate Ruler Regularity Determining regularity is the second step of analyzing
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Vertical axis is electrical HQHUJ\ (mV) 43 Normal Sinus Rhythm What is the heart rate?Divide the number of large boxes into 300 This method is only recommended for regular rhythms 300, Select one 60 75 Movement 50 150 Tremors , 100, Select one 60 75 Movement 50 150 Tremors , 60, Select one 60 75 Movement 50 150 Tremors1st R 300 150 100 75 60 50/min Heartrate measure 2 cardiac cycles 0 1 86 67 55 Maximal QTc per given heart rate what QT value at what heart rate results in a QTc of 450ms?
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Use that as the start Rwave and then count success big boxes from the start as 300, 150, 100, 75, 60, 50 Below 50, use the formula given in method #2 This method is good for regular rhythms Method #2 300 divided by the number ofThe 300, 150, 100, 75, 60, 50 method can be used to determine the ventricular heart rate but not the atrial rateRate, rhythm and axis from an ECG 1)Rate The ECG paper runs at 25 mm/sec through the ECG printer Use the sequence Count from the first QRS complex, the first thick line is 300 bpm, the next thick line 150 etc Stop the sequence at the next QRS complex
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300 150 100 75 60 250 214 187 167 136 125 115 107 94 79 71 68 65 62 START Rapid Interpretation of EKG's by Dale Dubin, MD COVER Publishing Co, 300, 150, 100, 75, 60, 50, 43, 37, 33 The heart rate irregular rhythm If the heart rate is irregular, count the number of QRS complexes on the ECG and multiply by 6 to obtain the average heart rate The ECG paper will show a period of 10 seconds300 150 100 75 60 250 214 187 167 136 125 115 107 94 79 71 68 65 62 START "300" "150" "100 Rapid Interpretation of EKG's by Dale Dubin, MD COVER Publishing Co, PO Box , Fort Myers, FL , USA 1
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One of the most important parts of EKG interpretation is comparing the current EKG with any previous EKGs available "300, 150, 100, 75, 60, 50300 150 100 75 60 50 43 2 Rate greater than 100 bpm ECG Criteria Rate greater than Sinus tachycardiaSinus tachycardia • มกเัป นการสสสนองตอบทางสรระของรางกายตามี ปกติไมจาเ ํป นตองรกษา ัจาเพาะํThe dark vertical lines correspond to 300, 150, 100, 75, 60, and 50 bpm For example, if there are three large boxes between R waves, the patient's heart rate is 100 bpm There are more accurate ways to determine heart rate from ECG, but in lifesaving scenarios, this method provides a
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View ECG Cheat Sheetpdf from PSYC MISC at University of Texas, Arlington RATE 300 150 100 AXIS DEVIATION Normal Left Right 75 60 50 Lead I QRS 43 NORMAL SINUS RHYTHM • Is there a P wave for ECG Rate The Cardiac Ruler or Sequence Method Count the number of big boxes between R waves and count using the following numbers The Six Second Method Get 6 seconds of ECG tracing (ie 30 big boxes) and count the number of R waves that appear within that 6 second period and multiply by 10 On the EKG, locate a R wave that matches a thick line, count the number of large squares to the next R wave Heart rate is 300 divided by the number of large squares, and that's it!
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Use the sequence Count from the first QRS complex, the first thick line is 300, the next thick line 150 etc Stop the sequence at the next QRS complex When the second QRS complex is between two lines, take the mean of the two numbers from the sequence or use the finetuning method listed belowView Cheat Sheet CV ECGpdf from PSYC MISC at Texas A&M University RATE 300 150 100 AXIS DEVIATION Normal Left Right 75 60 50 Lead I QRS 43 NORMAL SINUS RHYTHM •Interpretation of ECG Rhythm Normal heart rhythm has consistent RR interval Mild variations due to breathing also normal cycle At standard paper speed, divide 1500 by distance between R to R waves Find R wave on heavy line Count off 300, 150, 100, 75, 60 for each following line Where next R lands is quick estimate Multiply number
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Regular rhythms (constant RR interval) 300, 150, 100, 75, 60, 50, 43, 37, 33 Atrial rate (bpm) = 300/# of large boxes between P waves Ventricular rate (bpm) = 300/# of large boxes between R waves If not a whole number, estimate it or calculate as 1500/# of small Heart rates associated with each of the large boxes in the following order are 300, 150, 100, 75, 60, 50, 43, 37, 33 beats per minute (bpm) 3 large blocks 100 2 large blocks 150 1 large block 300 We know the "normal" heart rate is (although some would argue that 5090 is more accurate) Using the normal heart rate should have 35 large blocks between Rwaves More than 5 large blocks is a bradycardia and fewer than 3 blocks is a tachycardia
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ECG Paper Systematic Approach to Reading an ECG Lead Placement Hexaxial System •300 big boxes = 60 sec •Rate = 300/# big boxes 300 150 100 75 60 50 The RateThis study aimed to examine the effect of different LPF on pacemaker spike detection in remote and bedside electrocardiogram (ECG) Methods Patients with permanent pacemaker implantation were included during routine followup Standard 12lead ECGs at 6 different upperfrequency cutoff (40, 100, 150, 0, 300, and 400 Hz) were collected12Lead EKG Interpretation • I work for Virginia Garcia Memorial Health Center, Beaverton, Oregon 300 150 100 75 60 6 seconds Horizontal axis is WLPH (mS);
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The EKG is a summary of electrical events in the heart that includes depolarization and repolarization The EKG consists of five main parts • , each small block = 30 bpm • , each small block = 10 bpm • , each small block = 5 bpm • 75QRS complexes found in a 6second portion of the ECG tracing • The 300, 150, 100, 75, 60, 50 method involves locating an R wave on a bold line on the ECG paper, then finding the next consecutive R wave and using the 300, 150, 100, 75, 60, 50 values for subsequent bold lines to determine the rate50/min QT 493ms 60/min QT 450ms 70/min QT 417ms 80/min QT 390ms 90/min QT 367ms 100/min QT 349ms QTc= QT RR(in sec)
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300 150 100 75 60 50 43 Count number of complexes x 6 (standard ECG = 10sec) LAE RAE LVH RVH AXIS DEVIATION Normal (30 to 90º) Left Right Lead I QRS Lead II/aVF QRS NORMAL Q WAVES • Small (septal) q waves normal in leads aVL, I, II, V5, V6About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How works Test new features Press Copyright Contact us Creators6 seconds 44 I II
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Multiply complex count by 10 for Heart Rate per minute Interval between complexes Count large boxes (02 seconds) between complexes Divide 300 by box count 300, 150, 100, 75, 60, 50 1 large box (0 ms or 02 seconds) 300 bpm 2 large boxes (400 ms or 04 seconds) 150 bpm 3 large box (600 ms or 06 seconds) 100 bpm300/1 = 300 per minute 2 large squares 300/2 = 150 per minute 3 large squares 300/3 = 100 per minute 4 large squares 300/4 = 75 per minute 5 large squares 300/5 = 60 per minute 6 large squares 300/6 = 50 per minuteHeart rate (HR) measure of the frequency of cardiac cycles;
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300, el número mágico de la frecuencia cardiaca En un electrocardiograma normal por cada segundo hay cinco cuadros grandes, por tanto en un minuto hay 300 cuadros grandes (ver características del papel de EKG) Sabiendo esto, podemos calcular la frecuencia cardiaca midiendo el intervalo RR, siempre que el ritmo sea regular 1 The Cardiac Ruler or Sequence Method Count the number of big boxes between R waves and count using the following numbers This can only be used on regular rhythms and not on irregular rhythms 정상적인 ekg, ecg, 비정상적인 ekg,ecg(부정맥)에 대해서 알아보도록 하겠습니다 가장 쉽게 알수있는 법으로 봤을 때, 5060회/분정도 되는 것을 알 수 있습니다 그렇다면!!
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Confirm the heart rate interpreted by the ECG machine, as it can be wrong!300 150 100 75 60 50 43 LVH RVH LAE RAE AXIS DEVIATION Normal Left Right Lead I QRS Lead II/aVF QRS Q WAVES • Can be normal in leads aVL, I, II, V5, V6 • Can be normal on expiration in lead III PATHOLOGICAL Q WAVES • > 2 small squares deep • >25% of height of following R wave in depthCuente "300, 150, 100" para las tres líneas gruesas que le siguen a la línea inicial y consecutivamente para las que le siguen a las primeras tres iniciales Donde la siguiente onda R cae, eso determina la frecuencia
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Subsequent dark thick lines each have an associated HR In order, the HRs are 300, 150, 100, 75, 60, 50, 44, and 38 beats per minute (bpm) There is no need to go any lower than 38!The 300, 150, 100, 75, 60, 50 Method This involves locating an Rwave on a bold line on the ECG paper then finding the next consecutive R wave and counting down from 300 on the subsequent bold lines to determine the rateFind the next R wave (Figure 44a))
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