ECG Course for Nurses

Lesson 1 • Hemodynamic Correlation with Electrical Events

Connects electrical cardiac events to mechanical contraction and blood flow. Nurses understand why rhythm disturbances produce hemodynamic consequences.

Lesson 2 • Cardiac Cell Electrophysiology

Explains action potentials, depolarisation, and repolarisation at the cellular level. Provides the physiological basis for understanding waveform morphology.

Lesson 3 • Heart Anatomy Relevant to ECG

Covers cardiac chambers, valves, and coronary vessels as ECG reference points. Establishes the anatomical basis for interpreting electrical signals.

Lesson 1 • Precordial Lead Electrode Placement

Details V1–V6 anatomical landmarks using ribs, intercostal spaces, and sternal borders. Consistent precordial placement is critical for serial ECG comparison.

Lesson 2 • Artifact Recognition and Elimination

Identifies somatic tremor, AC interference, baseline wander, and poor contact artifacts. Nurses apply corrective techniques before repeating the recording.

Lesson 3 • Patient Preparation and Safety

Covers patient positioning, privacy, skin preparation, and electrical safety during ECG acquisition. Proper preparation improves signal quality and patient comfort.

Lesson 4 • ECG Machine Components and Settings

Identifies ECG machine hardware, paper speed, and gain settings. Correct configuration prevents recording errors that distort clinical interpretation.

Lesson 1 • ST Segment and T Wave Analysis

Evaluates ST elevation, depression, and T wave polarity relative to the isoelectric line. These findings are central to ischaemia and infarction identification.

Lesson 2 • PR Interval and Segment Analysis

Measures PR interval from P wave onset to QRS onset and identifies normal vs. prolonged values. PR changes indicate conduction delays or pre-excitation.

Lesson 3 • ECG Grid Measurements

Explains small and large box dimensions in time and voltage. Accurate grid reading is the foundation for all interval and amplitude measurements.

Lesson 4 • QRS Complex Measurement

Quantifies QRS duration, amplitude, and morphology including Q, R, and S wave components. QRS abnormalities reflect bundle branch blocks or ventricular hypertrophy.

Lesson 1 • Sinus Node Rhythm Variations

Identifies sinus bradycardia, sinus tachycardia, sinus arrhythmia, and sinus pause. Each variant retains sinus P wave morphology but differs in rate or regularity.

Lesson 2 • Normal Sinus Rhythm Criteria

Defines all five criteria for normal sinus rhythm including rate, P wave, PR interval, QRS, and regularity. This standard is the reference for all rhythm comparisons.

Lesson 3 • Rhythm Regularity Assessment

Uses calipers and systematic R-R interval comparison to classify rhythm as regular, regularly irregular, or irregularly irregular. Regularity guides dysrhythmia classification.

Lesson 1 • Junctional Rhythms

Identifies junctional escape, accelerated junctional, and junctional tachycardia by P wave location relative to QRS. Junctional rhythms indicate SA node suppression or AV node acceleration.

Lesson 2 • Atrial Fibrillation Recognition

Defines the hallmarks of atrial fibrillation: absent P waves, fibrillatory baseline, and irregularly irregular ventricular response. AF is the most clinically prevalent dysrhythmia.

Lesson 3 • Premature Atrial Complexes

Identifies PAC morphology including early P wave, altered P axis, and compensatory pause. PACs are common triggers for sustained supraventricular tachycardias.

Lesson 4 • Atrial Tachycardia and Flutter

Distinguishes atrial tachycardia from atrial flutter using rate, P wave morphology, and flutter wave patterns. Correct identification guides rate control vs. rhythm control decisions.

Lesson 1 • First and Second Degree AV Blocks

Measures PR prolongation in first-degree block and identifies Mobitz I and Mobitz II patterns in second-degree block. Each type carries distinct progression risk.

Lesson 2 • Premature Ventricular Complexes

Identifies PVC morphology: wide QRS, no preceding P wave, and full compensatory pause. Recognises unifocal, multifocal, bigeminy, trigeminy, and couplet patterns.

Lesson 3 • Ventricular Tachycardia

Defines monomorphic and polymorphic VT criteria including rate, QRS width, and AV dissociation. Distinguishes sustained from non-sustained VT and assesses haemodynamic stability.

Lesson 4 • Ventricular Fibrillation and Asystole

Identifies coarse and fine VF waveforms and distinguishes asystole from artifact. Both rhythms require immediate resuscitation and cannot be managed with medication alone.

Lesson 1 • Left Bundle Branch Block

Identifies LBBB by broad notched R in I and V6, absent septal Q waves, and QRS ≥ 0.12 s. New LBBB in chest pain context is treated as a STEMI equivalent.

Lesson 2 • Ventricular Hypertrophy Patterns

Applies voltage criteria and repolarisation changes to identify left and right ventricular hypertrophy. Hypertrophy patterns affect ST-T interpretation and increase false-positive ischaemia findings.

Lesson 3 • Right Bundle Branch Block

Identifies RBBB by QRS ≥ 0.12 s, RSR' in V1, and wide S in I and V6. Distinguishes complete from incomplete RBBB and notes common clinical associations.

Lesson 4 • Electrical Axis Determination

Uses leads I and aVF quadrant method and the isoelectric lead technique to determine QRS axis. Axis deviation indicates ventricular hypertrophy, fascicular block, or ectopic origin.

Lesson 1 • Systematic 12-Lead Interpretation Approach

Establishes a consistent step-by-step method: rate, rhythm, axis, intervals, and ST-T changes. A structured approach prevents missed findings in time-critical situations.

Lesson 2 • STEMI Equivalents and Mimics

Identifies Wellens syndrome, de Winter T waves, and left main occlusion patterns as STEMI equivalents requiring urgent intervention. Distinguishes early repolarisation and pericarditis mimics.

Lesson 3 • Ischaemia and Injury Pattern Recognition

Differentiates ST depression and T wave inversion of ischaemia from ST elevation of acute injury. Recognises hyperacute T waves as the earliest infarction indicator.

Lesson 4 • Right Ventricular and Posterior MI

Teaches right-sided lead acquisition and posterior lead placement for non-standard infarction territories. RV infarction complicates inferior MI and alters management significantly.