EKG help

Specialties NP


Specializes in Plastic Surgery, ER.

I am about to graduate from an FNP program. Strongly interested in urgent care. Even with my ED background, I feel one of my weaknesses is reading 12 lead EKGs. I've taken classes, got the books, and it still just does not click very well. Any suggestions?


Specializes in allergy and asthma, urgent care.

If you have an iPhone or IPod touch there's a decent app called Instant ECG. I believe it's free or else really cheap. It goes over basics and then quizzes you. I've found it helpful, although I'm still pretty lame when it comes to reading real ones.

Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.

What exactly are you having trouble with? One thing you have to consider is to always treat the patient and their symptoms, then bring the EKG into play. I work in PAT so we are frequently doing EKGs on patients and I look at them first before they are confirmed by a cardiologist the next day. One thing I always do if I get a crappy-looking EKG (and I don't mean one showing an acute MI - but maybe an old MI, poor R-wave progression, BBB, etc. and the patient does not have a previous cardiac hx. to support the current EKG tracing) is I call their doc's office to see if they have one on file there. It only takes a matter of minutes to have one faxed over to compare the two. Unfortunately, this might not be so easy if it's off-hours.

Can you shadow a cardiologist? You say ED is your background - could you look at a bunch of them with one of the ED docs and see what they do/how they treat with various EKGs? I would say that in an urgent care setting - if you get a person c/o chest discomfort, SOB, syncope, or any other various possible cardiac symptoms, etc. and the EKG is not obviously completely normal, then your best decision would be to transfer to a higher level of care - ie - the ED. Remember, even normal EKGs do not absolutely r/o a cardiac entity, so if there is any doubt, you do have that option to send to the ED. IMHO, it's always better to err on the side of caution.

Specializes in Plastic Surgery, ER.


I think I'm just not a 'picture' person. I don't like tables and graphs and such. Sometimes I will ask a MD questions, but most of the time we are just too busy. I think it just intimidates me...kind of like math LOL

I have an NP friend who worked cardio who will work with me. Once again, a matter of time, and coordinating schedules.

I used to work in PAT as an RN in an outpatient surgery center. What setting are you in? Definately something I would consider as an NP.

Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.

I work in a hospital setting. I do PAT as well as see patients in the same-day surgical unit who may not have come in for PAT prior to their procedure. I also do the H&Ps on patients who are admitted for emergency surgery like chole's and appy's.

I thoroughly enjoy it, but we are BUSY! Also, it can become a game of phone tag with the patients' PCPs when you have lab/X-ray/EKG results that are abnormal and medical clearance is warranted.

Good luck with the EKGs!

Specializes in ER, HH, CTICU, corrections, cardiology, hospice.

If it is something you will use often I highly suggest Necessary Workshops from Marye Dorsey Kellermann

Her cardiac review. I went in knowing buptkis, when I walked out I felt confident that I could correctly read a 12 lead and come up with a diagnosis. Unfortunately for me it was a very perishable skill.

Check it out.

I hope it helps. Good luck.

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