[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-571870-105":3,"detail-sidebar-cat-1-en-105":80,"doc-detail-571870-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","critical-thinking-tip-sheets-12-lead-ekg-review","Critical Thinking Tip Sheets - 12 Lead EKG Review","","Quick-reference clinical tip sheets focused on cardiac electrophysiology and respiratory acid-base interpretation. Covers 12-lead EKG myocardial territory mapping and lead patterns, normal depolarization and axis ranges, bundle-branch and hemiblock markers, and recognition features for hypertrophy and conduction syndromes. Includes arterial blood gas fundamentals (pH, pCO2, pO2, HCO3, base excess), causes of respiratory and metabolic disorders, compensation patterns, and supportive hemodynamics and medication classification concepts.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/presentations/","Presentations",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/critical-thinking-tip-sheets-12-lead-ekg-review/571870/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/critical-thinking-tip-sheets-12-lead-ekg-review/571870.png","ImageObject",442,249,{"name":42,"@type":43},"Riley West","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-10-13",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"How are myocardial territories mapped to coronary arteries and EKG leads in a 12-lead review?","Question",{"text":62,"@type":63},"The sheet matches each territory (inferior, septal, anterior, lateral) to a coronary artery (e.g., RCA, LAD, circumflex) and lists the specific leads that are affected for each pattern.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What EKG and criteria features help identify LBBB, RBBB, and hemiblocks?",{"text":67,"@type":63},"LBBB is listed with a widened QRS criterion and negative QRS in V1, while RBBB uses a widened QRS criterion and positive QRS in V1. Hemiblocks are summarized using LAH and LPH patterns with lead I/II/III axis effects.",{"name":69,"@type":60,"acceptedAnswer":70},"How does the sheet distinguish respiratory vs metabolic acid-base disorders using ABG values?",{"text":71,"@type":63},"Respiratory acidosis uses decreased pH with increased pCO2, while respiratory alkalosis uses increased pH with decreased pCO2. Metabolic acidosis shows decreased pH and decreased pCO2, and metabolic alkalosis shows increased pH with increased pCO2, with base excess and compensation discussed in tables.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},571870,1792338211,{"code":4,"msg":81,"data":82},"success",[83,87,92,97,102,107,112,117,122],{"id":84,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":85,"slug":86},11,90,"presentations",{"id":88,"doc_module":22,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},12,"Resumes",80,"resumes",{"id":93,"doc_module":22,"doc_module_name":25,"category_name":94,"show_sort_weight":95,"slug":96},14,"Invoices",70,"invoices",{"id":98,"doc_module":22,"doc_module_name":25,"category_name":99,"show_sort_weight":100,"slug":101},15,"Posters",60,"posters",{"id":103,"doc_module":22,"doc_module_name":25,"category_name":104,"show_sort_weight":105,"slug":106},16,"Social Media",50,"social-media",{"id":108,"doc_module":22,"doc_module_name":25,"category_name":109,"show_sort_weight":110,"slug":111},17,"Forms",40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":81,"data":127},{"doc_id":78,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":84,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":135,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":33},1099523885074,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Critical Thinking Tip Sheets  \n12 Lead EKG Review  \n\n|  | Area of\u003Cbr>myocardium | Coronary artery involved | \u003Cbr>Leads affected |\n| --- | --- | --- | --- |\n| INFERIOR |  | RCA | II, III, AVF |\n| SEPTAL |  | LAD | V1 & V2 |\n| ANTERIOR |  | LAD | V3 & V4 |\n| LATERAL |  | Circumflex | I, AVL, V5, V6\u003Cbr>|\n\nNormal EKG Depolarization  \n\n| I\u003Cbr>↑ | AVR\u003Cbr>↓ | V1\u003Cbr>↓ | V4\u003Cbr>Biphasic |\n| --- | --- | --- | --- |\n| II\u003Cbr>↑ | AVL\u003Cbr>↑ or ↓ | V2\u003Cbr>↓ | V5\u003Cbr>↑ |\n| III\u003Cbr>↑ | AVF\u003Cbr>↑ | V3\u003Cbr>Biphasic | V6\u003Cbr>↑ |\n\n\n| Axis | Normal\u003Cbr>-30 to +90 | Left\u003Cbr>-30 to-90 | Right\u003Cbr>+90 to + 180 | Extreme\u003Cbr>-90 to + 180 |\n| --- | --- | --- | --- | --- |\n| Lead I | 􀀁 | 􀀁 | 􀀂 | 􀀂 |\n| AVF | 􀀁 | 􀀂 | 􀀁 | 􀀂 |\n\n\n| Hemiblocks | LAH | LPH |\n| --- | --- | --- |\n| Lead I | 􀀁 | 􀀂 |\n| Lead II | 􀀂 | 􀀁 |\n| Lead III | 􀀂 | 􀀁 |\n| Axis | Left | Right |\n\nLBBB = QRS  >  0.12, Negative QRS in V1 (carrot) RBBB = QRS  >  0.12; Positive QRS in V1 (rabbit ears)  \nCHerrmann 2015 [www.cherylherrmman.com](www.cherylherrmman.com)  \nAdvanced 12 Lead EKG  \n\n| Left Atrial Enlargment P-mitrale | • Notched p wave > 0.12 second in limb leads\u003Cbr>• Causes prolonged conduction times required to travel through enlarged LA\u003Cbr>• Produces a double hump (camel hump) |\n| --- | --- |\n| Right Atrial Enlargment P-pulmonale | • Right Atrial Enlargement\u003Cbr>• Peaked P wave taller than 2.5 mm in the limb leads\u003Cbr>• P-pulmonale = teepee |\n| Left Ventricular Hypertrophy | • S in V1 or V2 + R in V5 or V6 > 35 mm.\u003Cbr>Or\u003Cbr>• Any precordial lead is > 45 mm\u003Cbr>• The R wave in AVL is > 11mm\u003Cbr>• The R wave in Lead I is > 12 mm\u003Cbr>• The R wave in lead AVF is > 20 mm |\n| Right Ventricular Hypertrophy | • R:S ratio is > 1 in leads V1 and/or V2\u003Cbr>• R is bigger than S |\n| Wolff-Parkinson-White | • Shortened PR interval \u003C 0.12 sec with a normal p wave • Wide QRS complex > 0.11 sec\u003Cbr>• The presence of a delta wave\u003Cbr>• ST-T wave changes or abnormalities\u003Cbr>• Association with paroxysmal tachycardias – can be fatal |\n| Pericarditis | • Diffuse ST elevation\u003Cbr>• Scooping upwardly concave ST segment elevation in almost all leads except AVR\u003Cbr>• No reciprocal ST depression except in AVR\u003Cbr>• PR depression |\n| Early Repolarization | • Elevated take-off of ST segment at the j point\u003Cbr>• Concave upward ST elevation ending with a symmetrical upright T wave – often of large amplitude\u003Cbr>• Gently upsloping and curving downward or sagging of the ST segment , producing the so called “smiley face”\u003Cbr>• Contrasted with the junctional elevation and horizontal or straight ST segment & the curving upward of “sad face” of the STEMI examples\u003Cbr>• No reciprocal ST segment depression |\n| Pulmonary Embolus (not diagnostic … may see these changes) | • S1, Q3 or S1,Q3, T3 (inverted T)\u003Cbr>• RBBB\u003Cbr>• Inverted T waves secondary to RV strain may be seen in the right precordial leads and can last for months\u003Cbr>or\u003Cbr>• R axis deviation noted by Lead I negative or S wave Lead I and AVR positive\u003Cbr>• V1 has tall R wave\u003Cbr>• Large p waves II, III, AVF\u003Cbr>• Inverted T wave Lead III |\n\nCHerrmann 2015 [www.cherylherrmman.com](www.cherylherrmman.com)  \nArterial Blood Gas  \nNormal pH 7.35 – 7.45 Resp Acidosis pH ↓ pCO2 ↑  \nNormal pCO2 35 – 45 Resp Alkalosis pH ↑ pCO2 ↓  \nNormal pO2 80-90 Metabolic Acidosis pH ↓ pCO2 ↓  \nNormal HCO3 23 – 27 Metabolic Alkalosis pH ↑ pCO2 ↑  \nBase Excess – 2 - + 2  \nRespiratory Acidosis Respiratory Alkalosis  \nCause: Hypoventalation Cause: Hyperventalation  \nGuillain Barre Pain  \nSpinal Cord Injury Anxiety  \nOversedation Spinal Cord Injury  \nMetabolic Acidosis Metabolic Alkalosis  \nCause: Retention of Acid Cause: Body Taking on Base  \nDiarrhea Eliminating Acid  \nRenal Failure Continuous NG Suction  \nDKA Diuretic Use  \nTissue Hypoxia  \nHypoperfusion  \n\n|  | Uncompensated |  |  | Partially Compensated |  |  | Fully Compensated |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| Fluid and Potassium Replacement | pH | pCO2 | tCO2 | pH | pCO2 | tCO2 | pH | pCO2 | tCO2 |\n| Resp. Acidosis | ↓ | ↑ | − |","cbCaidywpfSbKZ9I","https://ap.wps.com/l/cbCaidywpfSbKZ9I","pdf",141397,10,"English","# 12 Lead EKG Review\n## Myocardial territories and affected leads\n## Normal EKG depolarization and axis\n## Hemiblocks, LBBB/RBBB, and conduction criteria\n## Advanced EKG patterns (LAE, RAE, hypertrophy, WPW, pericarditis, early repolarization, PE)\n# Arterial Blood Gas (ABG)\n## Normal values and disorder patterns\n## Respiratory vs metabolic causes\n## Compensation tables\n# Cardiac output and hemodynamics\n## Basic hemodynamic parameters\n## Medication effects and cardiovascular actions","[{\"question\":\"How are myocardial territories mapped to coronary arteries and EKG leads in a 12-lead review?\",\"answer\":\"The sheet matches each territory (inferior, septal, anterior, lateral) to a coronary artery (e.g., RCA, LAD, circumflex) and lists the specific leads that are affected for each pattern.\"},{\"question\":\"What EKG and criteria features help identify LBBB, RBBB, and hemiblocks?\",\"answer\":\"LBBB is listed with a widened QRS criterion and negative QRS in V1, while RBBB uses a widened QRS criterion and positive QRS in V1. Hemiblocks are summarized using LAH and LPH patterns with lead I/II/III axis effects.\"},{\"question\":\"How does the sheet distinguish respiratory vs metabolic acid-base disorders using ABG values?\",\"answer\":\"Respiratory acidosis uses decreased pH with increased pCO2, while respiratory alkalosis uses increased pH with decreased pCO2. Metabolic acidosis shows decreased pH and decreased pCO2, and metabolic alkalosis shows increased pH with increased pCO2, with base excess and compensation discussed in tables.\"}]","Critical Thinking Tip Sheets - 12 Lead EKG Review | PDF",1791924143]