The Elusive U Wave || EMS Cardiology

EMS students from the basic level to critical care level alike are taught the basics of the EKG including the P wave, QRS complex and T wave. But what comes next? The elusive U wave & its significance is certainly not talked about as often as the previously mentioned waves. This is likely due to the fact that it isn’t always present and it’s exact significance is unknown. So let’s talk about it!

🚨U Wave Characteristics🚨
The U wave can be upright or inverted, but it tends to follow what the T wave does. If the T wave is inverted due to ischemia or a previous injury, chances are the U wave (if present) will be inverted as well. They are usually most obvious in V1 & V2 and when the heart rate is slower. If the heart rate is more than 95 bpm, the chances of the U wave being present/obvious are very low.

🚨U Wave Causes🚨
The U wave is thought to be the final part of ventricular repolarization, specifically the repolarization of the purkinje fibers. It can be completely benign, however there are instances where it can indicate more serious medical conditions. Some of those conditions could be hypokalemia, CVAs, ischemia, LVH and bradycardia.

🚨U Wave Treatments🚨
There are no EMS treatments specifically for a U wave as it does not always clinically mean something, BUT as always treat your patient and their symptoms. Click the link in the bio for a video all about the U wave.

🚨 Disclaimer: This is not meant to be used as or in the place of professional medical advice. Remember to abide by your local protocol & stay within your scope of practice. 🚨

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