.png)
ECG ANALYSIS
How to read an ECG
Follow a system so you will never miss anything:
Patient details
Situation details
Rate
Rhthm
Axis
P-wave and P-R interval
Q-wave and QRS complex
ST segment
QT interval
T-wave
Follow a system so you will never miss anything:
Patient details
Situation details
Rate
Rhthm
Axis
P-wave and P-R interval
Q-wave and QRS complex
ST segment
QT interval
T-wave
TIME / PLACE / PERSON
When/where? was the ecg done
on the basis of the ecg is your patient in the correct place of care
Community / a+e / resus / coronary care
Why was it done?
Person?
Patient’s name, date of birth and hospital numberSequential ecg's
The number of the ECG if it is one of a series
If you are concerned that there are dynamic changes in an ECG it is helpful to ask for serial ECGs (usually three ECGs recorded 10 minutes apart) so they can be compared.
These should always be labelled 1, 2 and 3.
3. Measuring the rate on an ECG
Rate can be calculated in a number of ways:
Count the number of QRSs on one line of the ECG (usually lead II – running along the bottom)
and multiply by six.
Count the number of large squares between R waves and divide 300 by this number
(if the patient is in atrial fibrillation
it is more accurate to report a rate range rather than a single value).
4. Assessing the rhythm on an ECG
Is the rhythm regular or irregular? If it is irregular is it regularly or irregularly irregular?
Rhythm can be difficult to assess especially in bradycardia or tachycardia. It may be helpful to use the ‘paper test’.
To do this place a piece of scrap paper over the ECG and mark a dot next to the top of a QRS complex, draw another dot next to the top of the next QRS then slide the paper along the ECG. If the rhythm is regular you should see that your two dots match to the tops of the QRS complexes throughout the ECG.
Is the rhythm regular or irregular? If it is irregular is it regularly or irregularly irregular?
Rhythm can be difficult to assess especially in bradycardia or tachycardia. It may be helpful to use the ‘paper test’.
To do this place a piece of scrap paper over the ECG and mark a dot next to the top of a QRS complex, draw another dot next to the top of the next QRS then slide the paper along the ECG. If the rhythm is regular you should see that your two dots match to the tops of the QRS complexes throughout the ECG.