EKG Interp. and Axis

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How many CCU nurses out there know how to determine the electrical axis of an EKG? Do you feel like this is an important part of EKG interpretation?

If you feel like it's a good skill to have, do you have any tips/ways of understanding it that you could pass along?

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Specializes in Cardiothoracic ICU.

I am a student hoping to do some cvicu but i know EKG pretty well. You need to understand the frontal plane and where all the leads are on the frontal plane. lead I is 0 degrees lead AVF is 90 degrees. Anyways once you have a 12 lead you can determine axis by the mean direction of the QRS either up or down. You can be clued in to hypertrophy and myocardial damage by finding the axis. I would recommend reading a 12 lead EKG book

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Specializes in ER/ICU/Flight.

Determining axis deviation is important because of bi- and tri-fascicular blocks. A patient with an extreme right axis deviation is at a higher risk of developing a complete heart block, regardless of the underlying rhythm.

Also like brandon2011 said, it helps identify hypertrophy and ischemic patterns. You could get a 12 lead book, the "poor man's" way of determining axis deviation is by looking at leads I, II and III. they should all have upright qrs complexes. If any are downward, then you have a left axis. If they are all downward, then you have a right axis deviation. that's the quickest and easiest way of determining deviation.

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Specializes in ICU/ER/Flight.

If you're interested in learning how to determine axis and the what it means, the best reference I've studied is Bob Page's "12-Lead ECG for Acute and Critical Care Providers". He also has a website with course hand-outs that "may" help you out.

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I'll have to check out the book. I had a slow night last night (only one patient), and spent a great deal of time on learntheheart.com. Awesome site. I went through every EKG on the floor, did a few of their case studies, it was good.

Just like with basic EKG interpretation, I think I just need to see more of these patterns before it becomes second nature.

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Specializes in CTICU.

Most useful in deciding on VT -v- SVT with aberrancy for me.

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