Bradycardia with a hump at the J point (the Osborn wave) in most leads, upright where the QRS is and down in aVR and V1, with long PR, QRS and QT.
Cold slows everything: the rate, the PR, the QRS and the QT. The signature is the Osborn (J) wave, a positive hump right where the QRS ends, upright in the leads facing the left ventricle and down in aVR and V1, and growing as the patient gets colder. Expect bradycardias, slow AF, AV blocks, and shivering artifact that fuzzes the baseline. As the core temperature drops further come VF and asystole, so handle the patient gently.
Each is a standard 12-lead: 2.5 seconds of each lead in four columns, with 10 seconds of lead II along the bottom, drawn to scale (25 mm a second, 10 mm a millivolt). The measurements are under each one.
Concave ST elevation in V2-V5 with a notched J point and tall, slightly lopsided T waves, no reciprocal depression, and a V6 ST under a quarter of its T wave's height. A normal variant, mostly in the young.
Everything normal sinus rhythm has, but under 60/min.
ST elevation in I, aVL, V5 and V6, with reciprocal depression in III and aVF.
In V1-V2, the ST rises over 2 mm at the J point and falls in a coved, convex curve straight into an inverted T wave.
The ECG tool in the app gives you a new 12-lead every time and walks you through reading it: rate, QRS, axis, then where the ST is up and down. It's part of the Paramedic level, and you can try 5 ECGs a day free.
Try the 12-lead drill
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