rhythm recognition


  • Specializes in Med Surg, ICU, Tele. Has 2 years experience.

having some trouble with rhythm recognition. any of you seasoned nurses have advice? seems like rhythms always look different.

Specializes in Telemetry, CCU.

Have you taken a dysrhymia course? If so, can you review some of your old books and brush up? Sometimes when I'm not sure of a rhythm I ask the monitor tech or another nurse what it is, usually saying what I think it is and just confirming. See if you can print out some strips to take home and study; get a variety and write down what they are so you can compare them. Real life strips don't always look textbook, so maybe that would help. It does take some practice, but if you are looking at strips all the time it will start to stick.

Also, don't get too caught up in some of the really uncommon ones, just focus on learning the most common rhythms (sinus rhythm, including sinus brady and sinus tach; atrial fib, and paced are what I see most) and also know the really bad ones, mainly V tach and V fib, and asystole of course. You can always learn more about the others one later, just focus on what's most common on your floor for now.

And yes, a lot of times they will all look different. You can have 5 strips of normal sinus rhythm all look a little different; it depends on lead placement, patient history and the gain of the reading. A good dysrhythmia course will teach you the proper steps to reading a strip, if you can remember these steps it will help you a great deal. Good luck!

(oh and I'm not too seasoned, just love working on my tele floor!)

the actual rhythm strips on monitors really look hard to recognize sometimes especially if you're new.where's the p? how wide is QRS? is there a u wave? it was all so confusing. my acls course had a ECG rhythm course as well and that's where I learned to differentiate the different rhythms. Try taking up an ACLS course or ECG course

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