ekg reading

can25rn · Mar 25, 2005

I am a recent grad about 2 yrs and work on a tele/critcal care stepdown unit and I read an EKG made easy book. It really helped and I also took several classes that my facility offered. I would advise taking any and all classes that are education and especially regarding cardiac rhythms. Don't get discouraged....it takes time to get it right and to know what you are doing. I think that name of the book that I bought was "EKG Interpretation Made Easy." Hope this helps. )

TMPaul · Mar 25, 2005

Hi guys
I am a new grad also on a telemetry unit.I need some advise about ekg readings.Can you recomend a really good book to learn.I can recognize some rythms but I am not very good yet and I need a lot of practice.Any advise from the cardiac nurses?I want to become a cardiac nurse when I get my experience and I have to start right now right?
DyeRN

"Rapid Interpretation of EKG's" by Dale Dubin, MD. Easy to understand book. :)

Jami RN, BSN, RN · Mar 25, 2005

I totally agree with this -- the old orange Dubin book has been the ekg bible and "ender of all arguments" on every tele unit that I've ever worked. You can even prove an errant cardiologist wrong if you can back your theory up with Dubin. :rolleyes:

RNKPCE · Mar 26, 2005

Dubin's was the recommended book when I started on Tele. There was another book but I don't think it is in print anymore called something like Coronary Care by author of last name Vicente. It was the text for the basic coronary care class we all had to take when we started. It was a great general cardiac text geared for nurses. Not too advanced.

Do you have a tele tech where you work? If so ask your manager if you can spend a couple shifts, the quieter shifts, sitting with tele tech, ananlyzing strips, measuring etc.

When I started we only had a tele tech 4 days a week, the other 3 days the RN's rotated sitting there for a shift. That is how I got even better at rhythms.

Practice, Practice, Practice

angelique777 · Mar 31, 2005

hi again

i emailed you some power point presentations but they did not go through to you. so i posted my notes from lecture for you. i hope they help out.

unfortunately the rhythms are not attached but you can see the rhythms in your own book.......we used basic dysrhythmias from robert huszar third edition

below are my notes to help distingish between the rhythms just in case something from this helps you distinguish between them

here is analogy some one told me about how to remember the blocks

1st degree block

is like 1yr of marriage the couple goes every where together so the p wave is always coupled to the qrs (like newlyweds) with a prolonged pri interval

p for every qrs

rhythm is regular

pri prolonged

2ndblock type i winkyblock (that is how it sounds not how its spelled)

well this block is like five yrs of marriage some times they are together but with time they take longer and longer breaks from each other

so pri interval progressively are getting more longer............

now note that between mobitz type i you can tell cause the

pri interval becomes more and more prolonged sort of like

this ____ ______ ____________

this rhythm is irregular

pri progressively prolonged

if you can visualize that those are pri intervals and put in the missing pieces such as the p wave and the qrs complexs that go there you can see the pri interval is progressively getting longer cause of the block that is occurring

2nd degree block type ii this is a more serious block.

it is like ten yrs marriage they are together but some times they go to the party alone

so you have p wave showing up more often by themselves with missing qrs complexes

note that the distinguishing feature is that the pri is consistent in this block and can either be regular or irregular rhythm (atrial rate regular with ventricular rate irregular)

pri consistent

more p's than qrs (p waves showing up without a qrs complex)

___ ___ ___ ___ pri is consistent

3rd degree block

is like a 15yr marriage now the couple tends to go places sepeartely not together and are now dissociated from each other

(gosh even though this makes a good analogy to help remember.......i pray marriage is not really like that hope real people get closer not further apart...... knew a little old couple like that still held hands and cuddled so sweet....ok that's off topic)

so in this rhythm you see that the p and qrs are dissociated

so if you measure the distance from each p it should be equal and regular and

the distance from r to r in each qrs is equal and regular

so r to r regular (measure with a rhythm strip and see they are equi distant) and

p to p regular (measure with a piece of rhythm strip to see they are equi distant)

pri will vary and they are not consistent in distance

now there may be more detail to these blocks but these are the basics that help me distinguish between the blocks and those with more experience can post any errors or more detail that you may need to know but this is how i understand them and is how i get to know the difference between these blocks.

now if you get a few strips and apply these concepts see if that helps you distinguish between the blocks

hope that helps let me know if it did or not or if i just confused you more lol

sincerely angela

DyeRN · Apr 1, 2005

Hi there:

That was great.!!It will totally help me with the blocks.Thanks a lot for the great imput.

DyeRN