Systematic Approach to Interpretation

Rate

  • What is the rate?
  • Is the atrial rate the same as the ventricular rate?

Rhythm (also called regularity)

  • Is it regular?
  • Is it irregular?
  • Any pattern to any irregularity?
  • Any ectopic beats? If there are, are they early or late?

P Waves

  • Are the P waves regular?
  • Is there one P wave for every QRS?
  • Is the P wave in front of the the QRS or after it?
  • Is the P wave normal and upright in Lead II?
  • Are there more P waves than QRS complexes?
  • Do all the P waves look alike?
  • Are any irregular P waves associated with ectopic beats?

P - R Interval

  • Are all the PRIs constant?
  • Is the PRI measurement within normal limits?
  • If the PRI varies, is there a pattern to the changing measurements ("regularly irregular")?

QRS Complex

  • What is the measurement of the QRS complex?
  • Is the QRS measurement within normal limits?
  • Do all the QRS complexes look the same?
  • Are any unusual QRS complexes associated with ectopic beats?

S-T Segment

  • Is it elevated? Or Depressed?
  • Do you know where the "J Point" is?

T Wave

  • What is the morphology of the T wave? Is it inverted, peaked or flattened?

Click on the links below for the rules (for each rhythm)

Normal Sinus Rhythm

Sinus Bradycardia

Sinus Tachycardia

Sinus Arrhythmia

Wandering Atrial Pacemaker

Premature Atrial Contraction

Atrial Tachycardia

Atrial Flutter

Atrial Fibrillation

Premature Junctional Contraction

Junctional Escape Rhythm

Accelerated Junctional Rhythm

Junctional Tachycardia

1st Degree Heart Block

Second Degree Type II

Second Degree Type I

3rd Degree (Complete Heart Block)

Premature Ventricular Contractions

Ventricular Tachycardia

Ventricular Fibrillation

Ideoventricular

Asystole


Have a look at these 12 - lead EKGs. These are basic tracings and you should not have much trouble figuring them out. Except perhaps for #7. It's a bit tricky.


EKG #1

Click here for EKG #1interpretation


EKG #2

Click here for EKG #2 interpretation


EKG #3

Click here for EKG #3 interpretation


EKG #4

Click here for EKG #4 interpretation


EKG #5

Click here for EKG #5 interpretation


EKG #6

Click here for EKG #6 interpretation


EKG #7

Click here for EKG #7 interpretation


EKG #8

Click here for EKG #8 Interpretation


EKG #9

Click here for EKG #9 Interpretation


EKG #10

Click Here For EKG #10 Interpretation


These quizzes are 6 - 10 questions in length. They consist of multiple choice, true/false, and fill-in-the-blank questions. Please note, the fill-in-the-blank questions require only one word. All questions are taken directly from the "Paramedic Textbook" (Mosby's) and the "Basic Arrhythmias" (Walraven) book.

Take the Normal Sinus Rhythm (NSR) Quiz

Take the Bradycardia Quiz

Take the Sinus Tachycardia Quiz

Take the 1st Degree Heart Block Quiz

Take 3rd Degree Heart Block Quiz

Take the PVC Quiz

Take the A-Fib Quiz

Take the 2nd Degree Type II Quiz

Take the 2nd Degree Type I (Wenkebach) Quiz



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