![]() ![]() This will identify the average number of complexes in one minute.Īfter determining this, next decide if your rhythm is fast or slow, irregular or regular (more on this in the next section). Count the number of complexes on the rhythm strip.Instead, a different method will need to be used, If the heart rhythm is irregular, then you will not be able to use the aforementioned method. Divide 300 by this number to calculate heart rate.Count the number of large squares present within one R-R interval.If a patient has a regular heart rhythm, determine their heart rate by, Next, determine whether your rhythm is regular or irregular you can use calipers if you have them or use a simple piece of paper and track your P waves and QRS complexes with a pencil mark and see if they march along or have gaps. Use a Systematic ApproachĪpproach your analysis to a 12 lead EKG/ECG the same way every time.įirst, determine the rate, and if any tachycardia (more than 100 beats/minute) or bradycardia is present (less than 60 beats/minute). Keeping this in mind will help you to interpret what you are seeing and identify which areas of the heart may be “hurting” or have damage. V5: 5th ICS, at the anterior axillary line (same level as V4).V6: 5th ICS, mid-axillary line (same level as V4).V4: 5th ICS, at the mid-clavicular line.V2: 4th ICS, along the left sternal border.V1: at the 4th intercostal space (ICS), on the right sternal border.The limb leads look at the heart from a vertical perspective the V leads show a horizontal perspective. There are six limb (I, II, III, AVR, AVL, AVF) leads and six precordial (V1-V6) leads. Think of each lead as a different snapshot of the heart you are trying to interpret. The twelve leads show the electrical current through the heart from different planes. Right atrium and cavity of left ventricle Normal 12-Lead EKG/ECG Values Wave/IntervalĪmplitude: 2-2.5 mm high (Or 2.5 squares) Deflection: + in I, II, AVF, V2-V6 Duration: 0.06 - 0.12 secĪmplitude: 5-30 mm high Deflection: + in I, II, III, AVL, AVF, V4-V6 Duration: 0.06 - 0.10 secĪmplitude: 0.5 mm in limb leads Deflection: I, II, V3-V6 Duration: 0.1 - 0.25 sec (Or greater) Duration: How long it is, as measured by squares going horizontal⁴.Deflection: Which lead on the patient it’s coming from.Amplitude: This measures the voltage of the beat and is determined by how high the wave reaches, as measured by each square vertically on the chart.A normal heart rhythm contains a P wave, a QRS, and a T wave.³ Knowing the normal amplitude, deflection, and duration of each component is essential to accurate rhythm and EKG/ECG interpretation. Know Your Normalsĭon’t sweat all the complex details when you are first beginning to read and interpret EKGs. A heart rate of 38 can be normal in an athlete.¹ But it also can require an immediate pacemaker insertion if accompanied by chest pain, shortness of breath, and an EKG/ECG interpretation of third-degree heart block.² 2. ![]() Looking at a sheet of paper with a tracing on it does not provide enough information.
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