Log Book Ecg
Log Book Ecg
JAIPUR (RAJASTHAN)
Hospital Training
LOG BOOK2023
Diploma
Batch:-2019-20
DIPLOMA IN ECG TECHNOLOGY
DEPARTMENT Medicine
PERSONALDETAILS
1. Full Name
2. Date of Birth
3. Enrollment
number
4. Father’s
Name
5. Permanent
Address
6. Phone No.
7. E-mail ID
8. Date of
Joining
9. Date of
Completion
Nims University Medical College & Hospital
Rajasthan
SHOBHA NAGAR, JAIPUR-DELHI HIGHWAY, JAIPUR-303121
Certificate
This is to certify that Mr. -------------------------was registered as a under Diploma student for the Diploma in
the subject of Diploma in ECG Technology at Nims College of Paramedical Technology, Jaipur. The
procedures and the academic activities recorded in the log book have been checked and authenticated and are
as per the hospital records and have been carried out under the guidance of the faculty members of the Nims
College of Paramedical Technology, Jaipur
Principal
NIMS College of Paramedical Technology
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Principal
NIMS College of Paramedical Technology
Overallperformance
(To be filled Clinical Supervisor at the Completion of internship)
YES NO Comments
Comments :-
Principal
NIMS College of Paramedical Technology
Notes to supervisors Please date and initial and grade occasions where the
appropriate skill has been performed by the student
Gradings
I Independent The student is able to recall the associated facts and complete the skill
to a high standard with no assistance
SSupervised The student is able to recall essential facts and requires minimal
supervision to complete the skill to a high standard
MMarginal The student requires prompts and assistance to complete the skill to an
adequate standard
DDependant The student cannot recall essential facts or perform essential elements
of the skill
Examples
1. You attend a cardiac chest pain. The student suggests at the appropriate time
that an ECG is appropriate. You agree and Bob completes the skill, problem
solving as he goes. The finished product is good and you rate this skill as an I as
you were not required to prompt or give any assistance to the student to
achieve this standard
2. You ask the student to place an LMA in a cardiac arrest patient. The student
sets up and places the LMA and completes the safety checks. You note that the
student put the maximum amount of air into the LMA on the first opportunity
and later you discuss why this is not always the best practice. You rate the skill
attempt as S (supervised) as no safety issues were raised and the skill was
performed to a high standard.
3. The student is asked to place an intravenous cannula. You note that the aseptic
technique is good but the he hasn’t organised a sharps container at hand. You
supply this and the student goes on to complete the IVC with no further issues.
Because the student needed a prompt for a safety issue you grade this attempt
as M (marginal)
4. You ask the student to prepare some Morphine for IV administration. The
student is unable to identify the correct amounts of morphine and saline for
this task and when you ask the student later to identify this they are unable to.
You mark this
attempt as D (dependant) because the student could not recall essential or complete the skill
without direct intervention
ECG Basics
Introduction to ECG
An electrocardiogram is a picture of the electrical conduction of the heart. By examining changes from normal on
the ECG, clinicians can identify a multitude of cardiac disease processes.
There are two ways to learn ECG interpretation — pattern recognition (the most common) and understanding the
exact electrical vectors recorded by an ECG as they relate to cardiac electrophysiology — and most people learn a
combination of both. This tutorial pairs the approaches, as basing ECG interpretation on pattern recognition alone is
often not sufficient.
Parts of an ECG
The standard ECG has 12 leads. Six of the leads are considered “limb leads” because they are placed on the arms
and/or legs of the individual. The other six leads are considered “precordial leads” because they are placed on the
torso (precordium).
The six limb leads are called lead I, II, III, aVL, aVR and aVF. The letter “a” stands for “augmented,” as these leads
are calculated as a combination of leads I, II and III.
The six precordial leads are called leads V1, V2, V3, V4, V5 and V6.
Below is a normal 12-lead ECG tracing. The different parts of the ECG will be described in the following sections.
E
A junctional rhythm occurs when the electrical activation of the heart originates near or within the
atrioventricular node, rather than from the sinoatrial node.Because the normal ventricular conduction
system (His-Purkinje) is used, the QRS complex is frequently narrow. A junctional rhythm is normally slow —
less than 60 beats per minute. When faster, it is referred to as an accelerated junctional rhythm.Because the
electrical activation originates at or near the AV node, the P wave is frequently not seen; it can be buried
within the QRS complex, slightly before the QRS complex or slightly after the QRS complex. The morphology
of the P wave will not be similar to the sinus P wave, which is normally upright in lead II and biphasic in lead
V1. Often, the P wave is inverted in lead II, if it can be seen at all. A pacemaker may be needed to relieve
symptoms when no reversible cause — i.e. AV blocking medications or electrolyte disturbances — is
found.The strip below shows a junctional rhythm with retrograde P waves seen just before the QRS complex.
The second rhythm strip shows retrograde P waves just after the QRS complex.
ENLARGE
ECG Findings:
1. Atrial Fibrillation with a rapid ventricular response (RVR)
2. Premature Ventricular Contraction (PVC)
CARDIOLOGY
The common anatomical site/s where diseases occur are listed in a box and so are the common
etiologies of disease and the pathophysiological syndromes encounter
SYNDROMES OF
SITE OF DISEASE DYSFUNCTION
When the heart is not working pro
Pericardium
Congestive Heart Failure
Myocardium
Cardiac Asthma
Endocardium: Valvular
Low output Syndrome or Shock
Pancardium: Rheumatic
Arrhythmia
Fever, Trauma
Bacterial Endocarditis supervening
Vascular: Artery
CARDIOLOGY – THE COMMON PLAN
Most of the above symptoms occur because of the effects of primary disease on circulation. The
symptoms of the disease per se may be few or none and the symptoms due to the consequent
pathophysiological changes predominate or even predate.
CAUSE OF DISEASE
One has to consider the onset, course duration and the response to treatment in totality to reach
the probable cause of disease. A chart depicting these will help as a guideline in the history. It needs to be
re- emphasized that all these points have to be taken together to arrive at a decision.
Rapidly
VASCULAR Sudden Progressive or Few days Good/ Bad
regressive
Episodes of
RHEUMATIC Acute fever + Years Variable
Prophylaxis
Good with
TUBERCULAR Sub- Acute Progressive Months treatment
CARDIOMYOPA - Slowly
Sub- Acute Progressive Months/ years Bad
THY
Good in
CONGENITAL Since birth Progressive Variable milder forms
Slowly Acute
JOINT DISEASE Sub- Acute Progressive Years exacerbation
problematic
A. 4BACKGROUND HISTORY: NATURE OF DISEASE CAN BE ELUCIDATED
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Dept:-ECG
NIMS Hospital, Jaipur Principal
NIMS College of Paramedical Technology
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Dept:-ECG
NIMS Hospital, Jaipur Principal
NIMS College of Paramedical Technology