ABSTRACT
ECGs are the most commonly conducted cardiovascular diagnostic procedure (Kligfield et al., 2007) used to diagnose, or exclude, cardiac dysrhythmias and cardiac disease. Acutely ill patients may have chronic dysrhythmias, or develop acute dysrhythmias in response to disease or treatments. For example, about 7 per cent of general surgical patients develop new dysrhythmias post-operatively (Walsh et al., 2007). Level 2 patients may need continuous ECG monitoring or 12-lead ECGs. Although primarily used for medical diagnoses, nurses in acute care should be able to recognise most dysrhythmias, and know what, if any, treatments are likely to benefit their patients to enable earlier and optimal intervention. Monitoring, without staff able to interpret monitoring, induces a dangerous false sense of security. The appendix lists some commonly used drugs to treat dysrhythmias. The chapter begins with ‘basics’; if these are unfamiliar, further descriptions can be found in texts such as Hampton (2008a). All qualified nurses should be able to record a 12-lead ECG and attach bedside monitors. Yet simple errors, such as lead misplacement, can cause erroneous diagnosis. 12-lead ECGs should be reviewed by doctors, but nurses should summon help for urgent problems. Nurses should be able to interpret common rhythms and problems. This chapter, therefore, provides a framework for ECG interpretation, describes common dysrhythmias and key interventions/treatments. Drugs listed are those commonly used; other drugs may also be effective. Like any skill, ECG interpretation needs repeated practice.
