![]() ![]() In order to determine if a rhythm is regular, mark out several consecutive R-R intervals on a piece of paper, then move them along the rhythm strip to check if the subsequent intervals are the same. A regular heart rhythm has all of the aspects previously discussed. It is important to determine if a heart rate is regular or irregular. Many heart medications have beta-adrenergic effects, which correlate to slower heart rates, such as beta-blockers. Rhythms conducted below the atria are slower and tend to be unstable when the rate is irregular (heart blocks).Īnother comment about rate: know what medications your patient is taking. Rhythms conducted above the atria are usually above 60 and tend to be abnormal when the rate is fast (atrial flutter, atrial fibrillation, supraventricular tachycardia). Rate is usually determined by which electrical circuit is “conducting” the heart. Slow or fast can be “good” or “bad” depending on the patient presentation and corresponding rhythm. A stable rhythm often correlates with a stable patient. The pace at which a rhythm is conducting can help determine the stability of the rhythm. Look at the EKG/ECG to see if the rate is regular and how fast the heart is beating both are important for rhythm interpretation. If you can tell elevation or depression without the help of paper, be prepared to act and inform the provider immediately. Lastly, examine the ST segments for any elevation or depression again, you can use a sheet of paper to help you evaluate this. This will identify the average number of complexes in one minute.Īfter determining this, next decide if your rhythm is fast or slow, irregular or regular (more on this in the next section). Count the number of complexes on the rhythm strip.Instead, a different method will need to be used, If the heart rhythm is irregular, then you will not be able to use the aforementioned method. Divide 300 by this number to calculate heart rate.Count the number of large squares present within one R-R interval.If a patient has a regular heart rhythm, determine their heart rate by, Next, determine whether your rhythm is regular or irregular you can use calipers if you have them or use a simple piece of paper and track your P waves and QRS complexes with a pencil mark and see if they march along or have gaps. Use a Systematic ApproachĪpproach your analysis to a 12 lead EKG/ECG the same way every time.įirst, determine the rate, and if any tachycardia (more than 100 beats/minute) or bradycardia is present (less than 60 beats/minute). Bradycardia > Related: How to Become an EKG Technician 3.Duration: How long it is, as measured by squares going horizontal⁴.Deflection: Which lead on the patient it’s coming from.Amplitude: This measures the voltage of the beat and is determined by how high the wave reaches, as measured by each square vertically on the chart.A normal heart rhythm contains a P wave, a QRS, and a T wave.³ Knowing the normal amplitude, deflection, and duration of each component is essential to accurate rhythm and EKG/ECG interpretation. ![]() Know Your Normalsĭon’t sweat all the complex details when you are first beginning to read and interpret EKGs. Metabolic Acidosis & Alkalosis study guide 2. Get 5 FREE study guides from - fill out the form for instant access! 1. A heart rate of 38 can be normal in an athlete.¹ But it also can require an immediate pacemaker insertion if accompanied by chest pain, shortness of breath, and an EKG/ECG interpretation of third-degree heart block.² Looking at a sheet of paper with a tracing on it does not provide enough information. Are you feeling nauseous, dizzy, lightheaded, or tired?.Have they ever been diagnosed with a heart condition?.What is their baseline physical activity?.Do they have underlying heart conditions?.Is your patient talking to you, or are they struggling to catch their breath?.Do you smoke, or have you ever smoked? If so, how many packs per day?.Would you describe it as more of a dull pressure or squeezing or more of a sharp, stabbing, or.When does the pain usually occur – morning, afternoon, or night?.Are they having chest or referred (arm) pain?.Is the patient’s skin warm and dry, or is it damp and clammy?.This must come first! There are many clues you can learn when obtaining the EKG that will help you analyze and act on what you see. How do you know when you need to act immediately or can wait for expert consultation? Here are seven tips to help you gain confidence in interpreting what you see. ![]()
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