ECG and Rhythms Need Help!

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Hi,

We are going over this for two 4 hour days and after the first day I am totally lost. I get what they are saying find the rate then rhythm are there PR interval and all this, its just I can figure all that out I just can figure out what the interpretation is.

Is this the hardest I have found in nursing school and I cant seem to wrap my mind around it.

Our test on this is 9-22. Is there any book I will buy now or anything at all that will help me with this.

I am desperate, I studied about 6 hours today and am still clueless.

Thanks

Stacy

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Specializes in Burn, Ortho, Trauma.

I'm sure there are sources on this site, but I haven't found them yet. I found these sites helpful and our professor sent us there.

http://www.rnceus.com/course_frame.asp?exam_id=16&directory=ekg

http://davidge2.umaryland.edu/~emig/ekgtu01.html

http://www.medi-smart.com/ecg14.htm

I agree, its difficult material!

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I was in your position about two years ago when I was in nursing school, so I know where you're coming from. It's hard to learn to interpret EKG's quickly, as you need to do in nursing school. Do you need to learn what the interventions are for each life threatening rhythm too? That was the worst part for me. I work on a tele floor now, so I'm looking at them every day and it's much easier. Here are some sites I bookmarked when I was learning them.

http://www.gwc.maricopa.edu/class/bio202/cyberheart/cardio.htm

http://www.skillstat.com/Flash/ECGSim531.html

http://www.angelfire.com/ab/cardiosv/arrhythmia.html#normal

http://davidge2.umaryland.edu/~emig/ekgtu04.html

http://www.mf.uni-lj.si/mmd/cardio-a/eng/at/vent_ar.html

Also consider searching this site, I'm sure there are more resources on various threads that would be helpful.

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Yes we need to know interventions signs and symptoms and all. I am just worried at first of how to firgue out what is what. I have never heard anyone one mention this or how hard this was going to be.

Thanks for all the help msfb and fusster!!!

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Specializes in Peri-op/Sub-Acute ANP.

The only book that made it understandable to me was "Rapid Interpretation of EKG's" by Dale Dubin, MD.

It seems like quite a large book, but it is actually a very fast read. Everything is broken down, and there are exercises and fill in the blank things that keep you fresh on what you really need to take away from the reading.

Before this book, I had done enough to tell you what was the Dx on a given strip, but I really didn't UNDERSTAND what I was parroting. It's been out for ever, so you can probably find a cheap copy on the Internet and have it read by the 22nd (or at least enough of it so that you can get by).

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Specializes in Critical Care.
The only book that made it understandable to me was "Rapid Interpretation of EKG's" by Dale Dubin, MD.

It seems like quite a large book, but it is actually a very fast read. Everything is broken down, and there are exercises and fill in the blank things that keep you fresh on what you really need to take away from the reading.

Before this book, I had done enough to tell you what was the Dx on a given strip, but I really didn't UNDERSTAND what I was parroting. It's been out for ever, so you can probably find a cheap copy on the Internet and have it read by the 22nd (or at least enough of it so that you can get by).

I second this book entirely. Buy a used copy if you can- there's some ethical "issues" surrounding the author, and you may not feel it's appropriate to create more royalties for him.

That said, the book is excellent.

I will also suggest finding time to do part of a shift with a monitor tech so that you can absorb yourself in the rhythms and ask questions as needed.

They bringing the nursing students to me at work for 4 hours during their telemetry rotation so that they can get an understanding of EKGs.

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Specializes in Peri-op/Sub-Acute ANP.

Er, yes. I too heard the story. I guess that gives him a lot of time to perfect his text!!!!

Honestly though, if you need to know this stuff really well I would put that aside and just get the book. He won't get royalties on a used copy anyway.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Here's a sticky thread (contains most, if not all of the links above:wink2:) of great info: Helpful Information for the CCU and other Critical Care Units

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Specializes in med/surg, telemetry, IV therapy, mgmt.

there is enough free information on the internet that you shouldn't have to buy anything. like any disease process you need to know what is normal so you recognize what is abnormal. there is pathophysiology to arrhythmias. the main concept to keep in mind is that is this:

  • the heart is a muscle
  • most muscles require a nerve impulse in order to do their thing
  • heart muscle requires an electrical impulse, not a nerve impulse, in order to do its thing
    • this electrical impulse business proceeds in a specific manner if everything is going normally as it should (sa node to av node to bundle of his, etc.)
    • what you see on the cardiac monitor or rhythm strip is this electrical activity--not the muscle activity of the heart. if you want to assess the muscular activity of the heart you have to take pulses and listen with stethoscopes and dopplers.
    • heart muscle cells are dumb. they do what any electrical signal coming along tells them to do.
    • when electrical impulses take the wrong path is when you get all kinds of different arrhythmias. the dumb heart muscle cells just respond to the lost/straying electrical impulses coming at them and arrhythmias results.
    • arrhythmias are based on where the electrical signal was strayed from the normal cycle.

when i first learned to read ekg monitors my head nurse sat with me for about a half hour and basically explained what i just said above. she so de-mystified it. just because something looked funny on an ekg monitor didn't necessarily mean that was what the heart was actually doing either. we had to get up and physically assess the patient. the ekg is merely a tracing of the electrical impulse. the pulse we take is an assessment of the actual beating of the person's heart. i have actually been at code blues where the ekg monitor showed electrical activity of the heart but the heart muscle itself wasn't doing anything (it's called disassociation--the muscle not responding to the electrical impulses) and the person's heart was, for all intents and purposes, not working.

https://allnurses.com/forums/f15/helpful-information-ccu-other-critical-care-units-140706.html - helpful information for the ccu and other critical care units has all kinds of wonderful ekg weblinks listed on it. one that i think you'll find helpful is:

the other website that is listed there that i like because it has online flashcards is the online textbook companion to introduction to 12-lead ecg, the art of interpretation. if you don't want to monkey around digging through the various chapters playing around with flashcards just pull up the glossary. you can also see rhythm strips of all the arrhythmias on this site. http://www.12leadecg.com/intro/

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hi,

we are going over this for two 4 hour days and after the first day i am totally lost. i get what they are saying find the rate then rhythm are there pr interval and all this, its just i can figure all that out i just can figure out what the interpretation is.

is this the hardest i have found in nursing school and i cant seem to wrap my mind around it.

our test on this is 9-22. is there any book i will buy now or anything at all that will help me with this.

i am desperate, i studied about 6 hours today and am still clueless.

thanks

stacy

hi stacy2009:

a couple of people mentioned dale dubin's book, i personally have never read his book and don't know much about him, but i do have a file on ekg's that may be of help. the file is work by him, but i think it's a great study tool. i am posting the link below, i hope it helps along with the information everyone else has posted. best of luck to you. cardio was the toughest most difficult subject for me and still is. you can print this file if you like also.

from cardiac monitors.com and dr. dale dubin:

a file on ekg interpretation and more:

http://www.cardiacmonitors.com/reference_sheets.pdf

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Here are two sites that helped me get through Paramedic school - the first one is informative, while the second link gives you some great visual examples and there is a fun game once you master the rhythms! http://students.med.nyu.edu/erclub/ekghome.html

http://www.skillstat.com/Flash/ECG_Sim_022505.html

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Hey thanks for this post and thanks to the person who contributed this website because it is literally the only thing that has gotten through to me! http://www.rnceus.com/course_frame.asp?exam_id=16&directory=ekg

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