Follow-up question EKG negative values
January 23, 2015 | 15,00 EUR | answered by Dr. med. Ralf Berg
Dear Mr. Berg, I have a follow-up question for you regarding the ECG and the negative values. Somehow I am completely lost. Please correct me if I have misunderstood something.
+| - 0 would be the optimum on track 2 where no deviations can be detected or must be. For example, if there is + mm, one should consider a heart attack. And with negative values or -mm, one might think of oxygen deficiency in the heart (myocardial ischemia).
I actually think this somehow fits together. During my operation, there was actually oxygen deficiency (due to high SPA).
Is a so-called tidal volume (e.g. 500 ml) always administered or set on the ventilation monitor during general anesthesia or only in emergency situations?
Thank you in advance!
Hello,
I have already answered the question on Sunday, but it seems that the sending did not work.
You have understood it correctly. Deviation of the so-called ST segment by more than 2mm upwards can be a sign of a heart attack if this deviation also occurs in adjacent leads, and mirror-image changes can be seen in leads perpendicular to it (-90 degrees). In plain language: Not only one deviation indicates a heart attack, the adjacent leads and the opposite leads must also match.
If deviations of the ST segment by more than 2mm downwards = - lead deviation occur, this can indicate oxygen deficiency.
Conversely, ST deviations from -2 to +2 mm are okay.
In controlled volume-controlled ventilation, the frequency and the TV= Tidal volume= Breath volume are always adjusted.
So that ventilation can start immediately in emergency situations, both values, the number of breaths as well as the volume of the breath (TV volume), are pre-set to standard values.
e.g. f 12 x. TV 500ml = 6 liters of minute ventilation. (f= 10 and TV = 600 lead to the same result)
If indeed the spinal anesthesia had risen too high in you, the appropriate response to this event would have been assisted or controlled volume-controlled ventilation if spontaneous breathing no longer sufficed due to the spinal anesthesia.
So, are your questions answered?
With best regards, Dr. R. Berg
