How do you read EKG?

Answer 1

Reading an EKG is done by careful viewing of the EKG strip. This includes assessment of rhythm regularity, calculating heart rate, observing the form of various parts of the EKG and their timing.

Answer 2

A person who reads an EMG has extensive training in anatomy, physiology, pathology, neurology, and electrodiagnosis that allows him/her to be able to interpret the waveforms presented. This is generally read by someone with a doctoral education like a neurologist, physiatrist, or chiropractor. The person reading an EMG looks at several characteristics including non-volitional activity that occurs at rest, activity that occurs while the needle moves (insertional activity), activity that occurs while the muscle is contracting, and activity that occurs while the muscle is at full contraction. Certain activity at certain times can be considered abnormal, such as motor unit potentials occurring when the muscle is at rest. The doctor looks at the presenting waveforms at each of these different stages of activity and evaluates those waveforms for their morphology. Certain waveforms can be considered abnormal, such as polyphasic waveforms during a contraction, positive sharp waves during rest, or fibrilation potentials during rest.

Answer 3

To keep this answer simple and not to mention shorter, I'll answer the question discussing only the basics of EKG interpretation (may come back and add a little bit to this ha ha).

6 Second EKG/ECG Strip Interpretation Basics

1. Determine the heart rate.

   Determining heart rate involves measuring the distance between 2 consecutive R waves, aka R-R interval or 2 consecutive P waves (P-P interval). There are a few different methods you can use for doing this.

   - a. six-second method, which involves counting how many completel QRS complexes there are on the entire 6 second strip (multiply result by 10). This can be used for regular or irregular rhythms.

   - b. large box method, which involves counting how many large boxes there are between 2 consecutive R waves, then dividing the result into 300. This can also be done for 2 consecutive P waves to determine atrial rate atrial rate. Use this method for regular rhythms only.

   300/# large boxes

   - c. small box method, which involves counting how many small boxes are between 2 consecutive R waves and dividing into 1500. Like the large box method, this method is only for regular rhythms.

   1500/# small boxes

   * Remember that each large box [equal to 0.2 sec] = 5 small boxes [each equal to 0.04 sec]

   d. sequence method, which is considered to be a variation of the large box method, as it involves using the "dark lines" (borders of the large boxes). Each of the dark lines are assigned a rate except for the very first dark line that the wave falls on (next is assigned a rate of 300, the next 150, 100, 75, 60, 50, 43, 38, etc.). Select a R wave that falls on a dark line and count how many "dark lines" are between 2 R waves (assign each dark line its respective value as mentioned earlier). Estimate the rate if the next R waves lands inbetween dark lines. This method is useful for regular rhythms (not very accurate however), particularly those at very high heart rates.

2. Determine whether or not the OVERALL rhythm is regular

   Determine the overall regularity (or irregularity) of a rhythm by measuring the distances between 2 select QRS complexes (or 2 P waves). Take the measured distance and see if the R-R interval between 2 consecutive R waves if consistent across the strip. If it is consistent or within 10% variance, it is considered to be regular. If there is over 10% variance in the R-R intervals throughout the strip, the rhythm is irregular.

   * Remember that some variation is normal (within about 10%). For example, if there are 10 small boxes inbetween 2 R waves, then any variation within 1 small box is considered normal; anything above 1 small box and it's considered irregular.

   Also keep in mind that some "events", such as sinus blocks, heart blocks, sinus arrests, premature atrial contractions (PACs), etc., can cause temporary irregularity in the rhythm strip.

3. Assess the P wave (if present)- represents atrial depolarization

   Are the distances between the P waves normal? How long are the P waves (P waves are no more than 0.11 sec [just under 3 small boxes])? How tall are the P waves (are no more than 2.5 small boxes or 2.5 mm tall)? In Lead II, P waves are normally smooth, rounded, and positive (go "up). Also check if the P waves are uniform in shape and size across the strip.

4. Look at the PR Interval (if present)- represents atrial depolarization, activation of AV node to the start of the bundle branches

   This is measured from the start of the P wave to the start of the QRS (P wave + PR segment). If no P waves are present, then you can skip this step. The normal PR interval is between 0.12-0.2 seconds (3-5 small boxes); this distance will shorten as the heart rate increases.

5. Analyze the QRS Complex- represents depolarization of the ventricles

   How wide are the QRS complexes? Are they positive (upward) or negative (downward)? Do they all go in the same direction? Normal QRS complexes are 0.10 seconds or less. 0.11-0.12 seconds and an incomplete bundle branch block is present. Anything over 0.12 seconds and a complete bundle branch block is present. Abnormally tall R waves indicate right ventricular enlargement, while an abnormally deep S wave is a result of left ventricular enlargement.

Answer 4

Listen to the lecture on the related link below, if you are interested.

Answer 5

It's not that simple, u must know the normal waves, durations, deflections.. etc. and how to calculate the rhythm,if regular or not ... In fact, that's why there r ' cardiologists ' !

Answer 6

on a monitor