ECG Workshop: The ABC of Pediatric ECG M. Hamdan, MD Normal Values 2 3 GOLDEN RULE..! 4 Forget Internal Medicine 5 14-Lead EKG 6 Nomenclature Right leads  aVR, V , V R, V R  1 3 4 Left Leads  I, aVL, V  6 Inferior Leads  II, III, aVF  Transitional Leads  V -V IGNORE  2 5 7 Practical Approach A) Age/ Calibration/ Speed B) LIMB LEADS C) CHEST LEADS 1. Rate 1. T waves (V & V ) 1 6 2. Axis (P& QRS) 2. R & S (V & V ) 1 6 3. NSR 3. RSR’ (V ) 1 4. P waves & PR 4. ST Segments interval (II) 5. Q waves (III) 5. QTc 8 A) Age/ Calibration/ Speed A.1) Speed:  25 mm/sec   1 small box = 0.04 sec (or 40 msec)  1 large box = 0.2 sec (or 200 msec) A.2) Calibration:  1 mV = 10 mm   1 small box = 1 mm (0.1 mV) ½ standard: 1 mV = 5 mm   1 small box = 0.2 mV (voltages x 2) 9 Full Standard Calibration 10