Telemetry: Help with rhythm interpretation

Nurses General Nursing

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Ok, I'll admit it. I'm a med/surg-telemetry nurse and I SUCK at interpreting rhythms. Help! Anyone have any resources, tips, advice to get me up to speed?

I've tried some websites. However, I end up just being able to identify the one example of a rhythm. I still can't figure it out if I see any deviation from that one.

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Specializes in critical care, ER,ICU, CVSURG, CCU.

Keep at it

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I go step by step:

1. Any p waves? Will be sinus or not

2. Regular/ regular

3. Fast/ too slow

4. Narrow or wide qrs

5. Any st elevation or depression

Understanding the pathophysiology begins the rhythms will help you identify what the rhythm is vs. Trying to memorize the pattern.

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

Buy Dale Dubins book on interpreting EKGs!

Rapid Interpretation of EKG's, Sixth Edition: Dale Dubin: 978

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Specializes in Private Duty Pediatrics.

The thing that helped me the most was getting bifocals. And I was only 24.

Those tiny squares were almost impossible to count!

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skillstat.com -> free EKG simulator, there is a good review section. Also, sometimes I just ask the cardiologist what they think of a rhythm when they are rounding on patients.

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You can't learn EKG rhythm analysis by looking at a bunch of rhythm strips and trying to memorize what each of the individual rhythms look like. Rather, you need to learn the criteria for each rhythm, and then apply those criteria in a systematic approach.

When I analyze an ECG rhythm strip I use the following mnemonic: RRPPQS.

Rate: What is the rate? Less than 60 or greater then 100?

Regularity: Is the rhythm regular? If irregular, Is there a pattern to the irregularity?

P wave: Are P waves present? Is each P wave followed by a QRS complex?

PR interval: 0.12 – 0.2 seconds.

QRS complex: 0.06 – 0.1 seconds, although you will find some variation to these values.

ST segment

You might find the following sites helpful. Although the latter two include 12 lead ECG information, the basic information concerning rhythm identification, wave analysis, etc. is appropriate.

Life in the Fastlane ECG Library

ECG Learning Center Characteristics of the Normal ECG

Analysis and Interpretation of the Electrocardiogram

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Specializes in Critical care.

Practice. When there's a weird rhythm print a strip md evaluate it- even if it's not your own patient's. Pick the brain of those more experienced than you- nurses and doctors.

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Do you have places in the area where you live that offer certifications. Sometimes they have instrctors who will meet with you one-to-one for small fee that will help you perfect that skill.

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