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Digital Seminar

12-Lead EKG & Chest X-Ray Interpretation: Enhancing Assessment Skills for Improved Outcomes

Cheryl Herrmann
5 Hours 21 Minutes
Audio and Video
Copyright :
Jun 02, 2018
Product Code:
Media Type:
Digital Seminar


When to be concerned — 12-Lead EKG Pearls of Wisdom
In a cardiac event, the clock starts ticking as soon as the coronary artery becomes occluded. Are you ready to rapidly interpret STEMI (ST segment elevation myocardial infarction) changes with a 12-lead EKG and provide effective intervention to reduce the size of the AMI? The 12-lead EKG is one of the most frequently utilized cardiac assessment tools to assess chest pain. Yet, it provides us with so much more information that can help improve patient care. The purpose of this portion of the recording is to assist the health care professional in mastering 12-lead EKG assessment skills in order to identify the common and not-so-common changes. You will also examine subtle and high-risk signs on 12-Lead EKG that are of concern preoperatively, in the ED, or in the clinic.

As Easy as Black and White...
Chest X-rays are also a commonly ordered diagnostic test, yet viewing and interpreting them can be challenging. Chest X-rays can be as simple as black and white. The purpose of this portion of the recording is to provide clinicians with chest X-ray interpretation skills in order to help you easily assess changes in the patient’s condition. You will develop skills in line identification; differentiations among atelectasis, pneumonia, ARDS, pleural effusion, and pulmonary edema; and identification of pneumothorax, cardiac tamponade, and cardiomyopathy. You will view examples of numerous chest X-rays to reinforce the concepts presented. Clinicians will walk away from this session with practical skills for better, quicker patient assessment allowing for more effective intervention.



NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after completing and passing the on-line post-test evaluation). 

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of your profession.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your profession's standards.  

The planning committee and staff who controlled the content of this activity have no relevant financial relationships to disclose. For speaker disclosures, please see speaker bios.

Nurses, Nurse Practitioners, and Clinical Nurse Specialists

PESI, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses completing these self-study materials will earn 5.2 contact hours. Expires: 06/02/2021.

California Nurses

PESI, Inc. is a provider approved by the California Board of  Registered Nursing, Provider #: 17118 for 5.0 self-study contact hours. 

** You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses

PESI, Inc. is an approved provider by the Florida Board of  Nursing. Provider #: FBN2858. These materials qualify for 5.0 self-study contact hours.

CE Broker

Iowa Nurses

PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 5.2 self-study contact hours. Please email with your license number, include the title, speaker name and date. PESI must have this number on file in order for your hours to be valid.

Other Professions

This self-study activity qualifies for 5.25 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.



Cheryl Herrmann's Profile

Cheryl Herrmann Related seminars and products: 6


CHERYL HERRMANN, RN, MS, APRN, CCRN, CCNS-CSC/CMC, has 31 years of nursing experience—15 years as a bedside nurse in SICU, Neuro ICU, and CVICU, and 16 years as a cardiac clinical nurse specialist. As a cardiac CNS, she cares for patients in cardiac prep and recovery, cardiac catheterization, surgery, ICU, telemetry/progressive units, and at discharge. In addition, Ms. Herrmann is a Prehospital RN for the local ambulance service. She has a passion for cardiac nursing and is an advocate for heart health, particularly in raising awareness of heart disease in women.

Ms. Herrmann is a reviewer for a critical care textbook as well as several nursing journals, one of which, Critical Care Clinics, recently published her article "A Woman's Heart is Different." She is a popular presenter for local nursing colleges, church and service groups, and EMS groups, as well as national conferences such as the American Association of Critical Care Nurses NTI. In 23 years of volunteer work, she has provided vital medical supplies, services, and training to the poor and disadvantaged in Mexico, Ethiopia, Haiti, and Indonesia. She has been team leader of 40 medical-dental teams to Mexico and participated in a Critical Care Nursing Ambassador program to China.

In 2005, Ms. Herrmann was honored with the American Association of Critical-Care Nurses Circle of Excellence—Excellent Clinical Nurse Specialist Award and the Twenty-Five Women in Leadership Award in central Illinois. She is the recipient of the 2009 University of Illinois Alumni Award. Her nursing career has been profiled in Advance for Nurses. Ms. Herrmann believes that learning should be fun and stimulating. She has created numerous educational puzzles and games for nurses, three of which have been published in AACN News. She presents material in a way that all health professionals caring for the cardiac patient, regardless of where they are in the continuum, take home valuable knowledge and new skills. For more information about Ms. Herrmann, please visit

Speaker Disclosures:

Financial: Cheryl D. Herrmann has an employment relationship with UnityPoint Health Cardiology. She receives a speaking honorarium from PESI, Inc.

Non-financial: Cheryl D. Herrmann is a member of the Illinois Society of Advanced Practice Nurses and National Association of Clinical Nurse Specialists.

Additional Info

Program Information

Access for Self-Study (Non-Interactive)

Access never expires for this product.


  1. Review normal 12-Lead EKG and the polarity of each lead
  2. Identify axis deviation and implication in clinical practice
  3. Discuss the criteria, causes, and significance of left and right bundle branch blocks
  4. Analyze EKG changes associated with ischemia, injury, and infarction patterns
  5. Develop a quick approach to diagnosis of STEMI on 12-lead EKG
  6. Analyze EKGs for subtle and high-risk signs
  7. Develop a systematic approach to chest X-ray interpretation
  8. Identify correct placement of common invasive lines on chest X-rays
  9. Differentiate between common cardiac and pulmonary disorders on chest X-rays
  10. Discover the clinical pearls of EKG and chest X-rays in challenging case studies



12-Lead EKG 101

  • Cardiac electrical conduction system
  • Electrical vectors
    • Introduction to the 12-leads
      • Limb leads
      • Augmented leads
      • Chest leads
  • Normal polarity and P-QRS-T configuration of each lead

Ace the Axis

  • Left and right axis deviation
  • Causes and criteria of axis deviation
  • Methods to determine axis deviation
  • Case presentations, analysis, and clinical application

Beat the Bundles

  • Right and left bundle branch blocks (BBB)
  • Criteria for right vs. left BBB
  • Causes and complications of right and left BBB
  • Left anterior and left posterior hemiblocks
  • Case presentations, analysis, and clinical application

Correlate the Coronary Anatomy

  • Coronary arteries
    • Right coronary artery (RCA)
    • Left coronary artery (LCA)
    • Left anterior descending artery (LAD)
    • Circumflex artery (CX)
  • Posterior descending artery (PDA)
  • Left ventricular walls
    • Inferior
    • Anterior
    • Septal
    • Lateral
    • Posterior
  • Relationship of coronary arteries and ventricular walls to the 12-leads
    • Inferior—RCA—leads II, III, AVF
    • Anterior/septal—LAD—leads V1–V4
    • Lateral—circumflex—leads I, AVL, V5, V6
    • Posterior—PDA—reciprocal changes V1–V4

Differential Diagnosis: 12-Lead EKG in Acute Coronary Syndrome

  • Ischemia pattern
  • Injury pattern
  • Infarction pattern
  • Reciprocal changes
  • ST segment elevation myocardial infarction (STEMI)
  • Non-ST segment elevation myocardial infarction (NSTEMI)
  • Coronary spasm
  • Takotsubo cardiomyopathy (broken heart syndrome)

Example and Analysis Time - Piecing It All Together

  • 30-second diagnosis of STEMI on 12-lead EKG
  • Coronary angiographic correlation to 12-lead EKG
  • Case presentations, analysis, and clinical application

Advanced 12-Lead: Challenging Clinical Presentations

  • Atrial and ventricular hypertrophy
  • Wolff-Parkinson-White syndrome
  • Prolonged QT intervals


Note: Most chest X-ray examples will be AP films

Chest X-ray basics

  • Technique
  • Black and white principles
  • Projections
    • Anterior-posterior (AP)
    • Posterior-anterior (PA)
    • Lateral

Systematic Approach

  • Bone structures
  • Intercostal spaces
  • Soft tissues
  • Lungs/trachea/pulmonary vasculature
  • Pleural surfaces
  • Diaphragm
  • Mediastinum
  • Heart and great vessels
  • Invasive lines

As Easy as Black

  • Pneumothorax
  • Subcutaneous emphysema
  • Clinical application and treatment

As Easy as White

  • Pleural effusion
  • Pulmonary edema
  • Pneumonia
  • Atelectasis
  • Acute respiratory distress syndrome (ARDS)
  • Cardiomyopathy
  • Pericardial effusion
  • Cardiac tamponade
  • Clinical application and treatment

Beyond the Basics

  • Aortic aneurysm
  • Post-op changes with pneumonectomy
  • Hydropneumothorax
  • Esophagogastrectomy
  • Dextrocardia
  • Clinical application and treatment


Target Audience

  • Acute Care and Family Nurse Practitioners
  • Registered Nurses in:
    • Critical and Intensive Care
    • Acute Care
    • Cardiac Care
    • Emergency Department
    • Physician Offices, Physician Assistants
    • Clinical Nurse Specialists
    • Medical Assistants
    • Emergency Medical Technicians
    • Paramedics
    • Respiratory Therapists



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Total Reviews: 19

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