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EKG interpretation checklists

Here are the EKG Club's recommended steps for interpreting cardiac rhythms and 12-lead EKGs


For cardiac rhythm strip evaluation the EKG Club expert panel recommends paramedics, EMTs and students follow a repeatable pattern or process. Although not diagnostic, in many case examining each of these characteristics can help direct appropriate prehospital patient treatment:

  1. Heart rate
  2. P wave (Normal shape? Present? Followed by QRS?)
  3. PR interval (Normal? Short? Long? Irregular?)
  4. QRS interval (Normal? Short? Long? Irregular?)
  5. ST segment (Generally a normal shape?)
  6. T wave (Normally shaped? Tall? Short? Wide?)
  7. U wave (Present?)

Read more about EKG interpretation from Kevin Grange, Paramedic and EMS1 columnist. Grange describes the process he follows on every EKG to correctly identify the cardiac ryhthym

12-lead EKG interpretation steps

It is just as important to follow a repeatable pattern or checklist when interpreting a 12-lead EKG. In each lead examine the following:

  1. Rate and rhythm
  2. P wave
  3. PR interval
  4. QRS interval
  5. QRS complex and mean axis
  6. ST segment
  7. T wave
  8. U wave
  9. QT interval

Use each of these checklists as you review 12-lead EKG cases from the EKG club, ECG Guru and EMS 12-Lead.

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