Tag Archives: axis determination

QRS AXIS DETERMINATION

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During ECG interpretation, cardiac Axis, or direction of electrical impulses, may be normal (physiologic) or abnormal (pathologic), suggesting abnormal cardiac conductivity. Although every deflection obtained on the ECG will have an axis, we will focus on the ventricular axis. When we think of our cardiac monitoring lead placement, we have to understand cardiac Vectors, which is the […]

90 year old female CC: Seizure – Conclusion

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This is the conclusion to 90 year old female CC: Seizure. Be sure to start there first! When we left off, we had completed our initial assessment of a 90 year old patient who, based on bystander accounts, had a seizure. She is pale, cold to the touch, and feels lethargic. During our assessment she […]

64 year old male CC: Indigestion – Discussion

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This is the discussion to 64 year old male CC: Indigestion. If you recall, we had a stubborn gentleman complaining of indigestion with a significant cardiac history. Considering the symptoms kept our patient awake, are highly suggestive of a coronary event, and we have uncompensated hypotension, we should have a keen interest on any ECG […]

Video: Axis Determination

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So you’ve read our blog, followed us on Facebook, submitted your own case studies, but you’re looking for more. You’re looking for the next big thing in EMS 12-Lead education. As a test run I’ve put together a video,shotKahn Academystyle using a pen and tablet, covering rapid axis determination. When I learned 12-Lead interpretation in […]

Why learn axis?

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A few weeks ago on JEMS Connect there was a thread called Vectors, Axis and Cardiology. In it, Dave M. asked: I truly enjoy learning and studying the heart, how it works and why it works that way. I had the privilege of teaching a paramedic class today and going over the vectors and axis […]

Axis Determination – Part VI

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By now you can predict the QRS axis in the frontal plane within 15 degrees as long as you have an equiphasic (or isoelectric) lead in the frontal plane. So what constitutes a normal QRS axis? What is a left axis deviation? A right axis deviation? If you don’t have a copy of the hexaxial […]

Axis Determination – Part V

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In Part IV, I promised that I’d show you a fascinating relationship between the standard 12 lead ECG and the hexaxial reference system. You will recall that to use the hexaxial reference system, you find the most equiphasic (or isoelectric) lead in the frontal plane (first 6 leads of the 12 lead ECG) and look […]

Axis Determination – Part IV

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By now you should have a fairly good grasp of how the hexaxial reference system is derived from the first 6 leads of the 12 lead ECG. Before we break down the finished diagram, let’s look at the hexaxial reference system laying on top of the patient’s anterior chest, with the arrows and leads in […]

Axis Determination – Part III

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In Part II, we discussed the heart’s mean electrical vector and how Einthoven’s Triangle (leads I, II, and III) can be redrawn to form the first 3 spokes of the hexaxial reference system. Essentially, we ended up with a shape like the one on the right. When leads I, II, and III are drawn this […]

Axis Determination – Part II

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In Part I, we looked at Einthoven’s Equilateral Triangle and Einthoven’s Law, and I told you that it was the key to understanding the formation of the hexaxial reference system. But before we delve further into the hexaxial reference system (the instrument we’ll be using to calculate the heart’s QRS axis) we need to address […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Alex
100 yof CC: Rib pain and intermittent spasms
>>Too perfectly lined up with the T-waves, while the isoelectric line is relatively stable, to be strictly movement artifact. Can these spasms be sync-d with (or caused by) mechanical movement of the heart walls?
2014-11-25 23:20:19
Erich
What it Looks Like: Cardiac Arrest
Fantastic post, must see stuff for junior paramedics, medical students, residents and nurses that could potentially see cardiac arrest on a regular basis.
2014-11-25 16:22:28
LITFL Review 156
83 Year Old Male: Shortness of Breath
[…] ischaemia? Check out this case from the EMS 12 Lead blog. For more effective learning, read the original case first. […]
2014-11-25 09:09:03
ECG Axis Interpretation
The 360 Degree Heart – Part I
[…] http://www.ems12lead.com/2014/09/11/the-360-degree-heart-part-i/ […]
2014-11-25 09:01:37
LITFL Review 152 - LITFL
The 360 Degree Heart – Part I
[…] you understand axis as well as you’d like? The EMS 12-Lead blog gives us the first in a new series on understanding axis on the ECG. […]
2014-11-25 08:55:15
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