Intermediate 12-Lead ECG Exam Information

In order to prepare for the Intermediate 12-Lead ECG Board Certification Examination, the participant should be able to accomplish the following electrocardiographic interpretations and monitoring skills. 

       Identify monitoring protocols depending upon patient presentation and the differential diagnosis

       Demonstrate proper lead placement with three, five, and six wire systems for telemetry

       Demonstrate proper lead placement with a 12-lead ECG machine

       Demonstrate the 10-step analysis skill when interpreting ECG rhythm strips

       Identify the normal components of the cardiac cycle

       Identify the following: 

1. Sinus rhythms

       Sinus rhythm

       Sinus bradycardia

       Sinus tachycardia

       Sinus arrhythmia

       Sinus pause

       Sinus arrest

2.  Atrial rhythms

       Atrial premature beats conducted normally, aberrantly, or non-conducted (APB’s)

       Atrial tachycardia

       Atrial flutter

       Atrial fibrillation

3. Juncitonal rhythms

       Junctional premature beats (JPB’s)

       Junctional escape beat or rhythm with and without aberration

       Junctional rhythm

       Junctional tachycardia

     4.    Ventricular rhythms
 

       Ventricular premature beats (VPB’s from left and right ventricle)

       Ventricular escape beats

       Ventricular rhythm

       Accelerated idioventricular rhythm (AIVR)

       Ventricular tachycardia including Torsade de Pointes

      
      5.     AV blocks

       First degree AV block

       Second degree AV block type I

       Second degree AV block type II

       High grade AV block

       Complete or third degree AV block

      6.    Normal 12-lead ECG

      7.    Ischemia and injury seen in the 12-lead

       Inferior wall ischemia and injury

       Inferior-lateral wall ischemia and injury

       Anterior wall ischemia and injury

       Anterior and lateral wall ischemia and injury

       Posterior wall ischemia and injury

       Right ventricular wall ischemia and injury

       Global ischemia and injury

       Myocardial mimics 

       8.    Bundle branch blocks

       Right bundle branch block (incomplete and complete)

       Left bundle branch block (incomplete and complete)

       Supraventricular tachycardia with right bundle branch block

       Supraventricular tachycardia with left bundle branch block

       9.    Electrolyte disturbances (potassium and calcium)

       Hypokalemia

       Hyperkalemia

       Hypocalcaemia

       Hypercalcaemia

     10.   Bedside monitoring principles and practice

       Use of three wire telemetry systems in bedside monitoring

       Use of five wire telemetry systems (conventional) in bedside monitoring

       Use of six wire telemetry systems (conventional) in bedside monitoring

       When to use which lead for patient monitoring

       Monitoring wide-QRS patterns

       Monitoring the patient with ischemia and or injury

       Monitoring the patient during and after special diagnostics and procedures

       Monitoring the patient during cardiac surgery and interventional procedures

       Is one lead ever enough

       When to use the 12-lead for bedside monitoring

       Monitoring the patient in chest pain observation units

       Monitoring the patient being transported by emergency personnel

       Importance of getting the right point of view the first time