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Introduction/Abstract: The purpose of this
presentation is to help the learner to identify acute changes on the 12
lead EKG seen in Acute Myocardial Infarction (AMI) and coronary ischemia.
There are
three sections to this presentation. The first includes a review of
cardiac anatomy, lead placement and differentiating between myocardial
infarct, injury and ischemia. We will review a 12 step process
that will help to differentiate acute infarct versus ischemia. The 12
step method involves assessing the EKG for:
1. Regularity
2. Rate
3. Complexes
4. Rhythm changes
5. ST elevation
6. ST depression
7. T wave inversion
8. Pathological Q’s
9. R-wave progression
10. Right sided chest lead
11. Imposters
12. Interpretation
The second section involves the grouping of leads
to specify location using the location assistant table. This identifies
which leads are involved in anterior, septal, inferior, lateral, and
posterior. We will also expand on the imposter rhythms that can
camouflage findings and review differential diagnosis and treatment
options for each.
The final section will consolidate the participants
knowledge as they practice their interpretation skills while reviewing
example 12 lead EKG’s. We will use the 12 step process and the location
assistant tool to interpret the EKG findings and determine if acute
infarct, injury or ischemia are present.
The
presentation is targeted towards healthcare professionals including
physicians, advanced practice nurses or physician assistants, and nurses
who would like to further their understanding of 12 lead EKG’s.
Background knowledge of basic telemetry/rhythm recognition is required.
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