EKG interpretation

[kingjames06]

Hello! I’m starting a new job in a trauma unit and my biggest problem right now is reading ekg strips. I dont have any exposure to this and I’m trying to learn the basics. The director told me they cluster the pt’s that recquire ekg and they usually put nurses there after a year working in the unit but you never know there might be a call out and they just throw me in to the wolves.

I did my acls already and I’m reading the Dubin book but im still totally confused. I can read heart rates and probably like 3 rhythm but the rest to be honest i dont know what to do.

Any study guides, links or anything that I can study on? Thanks!

[herring_RN, ASN, BSN]

Maybe this will help:

http://www.columbia.edu/~ss45/EKG.PDF

[chare]

If you aren't familiar with ECG interpretation, you might find the Life in the Fastlane ECG Library helpful.

[Susie2310]

Did you take a basic EKG rhythm interpretation course prior to taking ACLS?

[Serhilda, ADN, RN]

Can you volunteer to shadow telemetry technicians? I did that prior to working on a cardiac telemetry floor and found it helpful. There are also websites that let you practice identifying EKG strips too that may help.

[10GaugeNeedles, BSN]

Sounds to me like you need a foundation. It’s incredibly easy to get lost in the weeds with those comprehensive study guides. I’d say know the ACLS categories. Organized vs disorganized, tachy vs Brady vs nsr, STABLE vs UNSTABLE, etc. know how to look at an ecg and immediately recognize “organized vs disorganized, Brady or tachy, are all the waves present in each complex (pqrst)”. It’s not necessary to identify all the details. It is necessary to recognize a problem. you’ve taken the acls class. Look at the algorithm and look at the treatable categories. Don’t worry about what you have to do to treat the rhythm. JUST differentiate each rhythm category. And most important, understand the difference between stable and unstable. One you treat and one you don’t and that’s extremely important to understand. The above should give you a good foundation to expand your toolbox from there. Good luck.

[kingjames06]

16 minutes ago, 10GaugeNeedles said:

Sounds to me like you need a foundation. It’s incredibly easy to get lost in the weeds with those comprehensive study guides. I’d say know the ACLS categories. Organized vs disorganized, tachy vs Brady vs nsr, STABLE vs UNSTABLE, etc. know how to look at an ecg and immediately recognize “organized vs disorganized, Brady or tachy, are all the waves present in each complex (pqrst)”. It’s not necessary to identify all the details. It is necessary to recognize a problem. you’ve taken the acls class. Look at the algorithm and look at the treatable categories. Don’t worry about what you have to do to treat the rhythm. JUST differentiate each rhythm category. And most important, understand the difference between stable and unstable. One you treat and one you don’t and that’s extremely important to understand. The above should give you a good foundation to expand your toolbox from there. Good luck.

yeah, it looks like I dont have any foundation. I just started reading and trying to memorize strips and how they look like.

[nursej22, MSN, RN]

A quick, down and dirty, 5 step method I learned when I first started is:

1. Look at the patient. Symptomatic or assymptomatic. If symptomatic, get help, assymptomatic you got some time to think.

2. Look at the rate. Too fast (tachy) too slow (brady) not at all (asystole)

3. Look at the rhythm. Regular? Irregular: irregularly irregular-most likely afib. Regularly irregular-look for blocks.

4. Look at the QRS. Is it wide? could be VT or aberrancy.

5. Look at the patient. Stable: think drugs. Unstable: think electricity.