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| 5 Steps to Rhythm Strip Interpretation |
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| Audience |
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EMS and Firefighters:
Cardiology
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| Authors |
Ed4Nurses Inc.
David W. Woodruff, MSN, RN, CNS, CCRN |
| Hours |
2.00 contact hours
Contact hours are awarded by CEU4U, Inc. on successful post test completion. CEU4U, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation |
| Expires |
EXPIRED |
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| Passing Grade |
70% |
| Test Retries |
Unlimited
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After completion of this course the participant should be able to:
- Describe the characteristics of a normal EKG complex.
- Identify the physiological characteristics of normal conduction.
- Use 5-steps to identify normal sinus rhythm.
- Compare and contrast EKG rhythms using a 5-step approach.
- Plan care for patients with abnormal EKG rhythms.
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To take just this course, test, and evaluation and get your certificate online, the cost is only $ 30.00!
| Hours |
Price |
p/Hour |
% FREE |
| 10 |
$ 142 |
$ 14.20 |
5% FREE! |
| 15 |
$ 203 |
$ 13.53 |
10% FREE! |
| 20 |
$ 257 |
$ 12.85 |
14% FREE! |
| 25 |
$ 302 |
$ 12.08 |
19% FREE! |
| 30 |
$ 339 |
$ 11.30 |
25% FREE! |
| 35 |
$ 367 |
$ 10.49 |
30% FREE! |
| 40 |
$ 386 |
$ 9.65 |
36% FREE! |
| 45 |
$ 405 |
$ 9.00 |
40% FREE! |
Hours purchased are good for an unlimited time, but only within the discipline they were purchased in.
(If located in Ohio state taxes will be applied before purchase)
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No Commercial Support or Sponsorship is accepted by CEU4U, Inc.
Products, drugs, and/or therapies discussed within this educational offering do NOT imply endorsement by CEU4U, Inc. or American Nurses Credentialing Center.
The author(s) and planning committee of this content declare that they have no real or perceived conflict of interest related to this presentation.
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Course Sample:
Program description:
Upon completion of this program, the learner will be able to rapidly identify common cardiac rhythms and be able to relate the appropriate treatment priorities for those rhythms.
Introduction
As patient acuity increases, more patients are being placed on telemetry and nurses are being expected to be able to read EKG rhythm strips. However, this skill need not be difficult to learn. It is best accomplished by a systematic method of analysis. The 5 Steps to Rhythm Strip Interpretation systematically reviews the major components of a rhythm strip to help determine the type of rhythm and the appropriate course of treatment. The 5 Steps are listed below:
Step 1. Is the speed of the rhythm between 60-100?
Step 2. Is it regular?
Step 3. Is the complex narrow?
Step 4. Is it preceded by a P-wave?
Step 5. Do all the complexes look the same?
Step 1 evaluates the speed of the rhythm to determine if it is normal, too slow or too fast. A speed between 60-100 maintains the best hemodynamic stability. Rates less than 60 or greater than 100, can lead to hemodynamic instability and become symptomatic.
Step 2 asks if the rhythm is regular. Rhythms originating from the normal pacemakers in the heart will be regular. Irregular rhythms indicate extra beats or abnormal rhythms.
Step 3 assesses the shape of the complex. A narrow complex is normal. A wide complex indicates conduction abnormalities.
Step 4 asks if a P-wave precedes the QRS complex. This represents normal conduction from the atria to the ventricles. If the P-wave is absent, the impulse is being generated from elsewhere in the heart.
Step 5 assesses whether all the complexes look the same. Normal conduction follows the same pathway with each beat. Different looking complexes indicate the some impulses are following alternative or aberrant pathways.
If the nurse can answer all of the questions asked by the 5-steps affirmatively, the patient has a sinus rhythm. The greater the number of questions answered negatively, then the greater the abnormal conduction through the heart. This usually indicates myocardial irritability.
Spend a few moments to reacquaint yourself with the normal EKG complex, and its components.
Normal conduction
Depolarization:
Impulses begin at the Sinoatrial (SA) node, generating a P-wave. The impulse travels through the electrical pathways to the Atrio-Ventricular (AV) node. The AV node delays the impulse, so that the atria and ventricles don't fire at the same time. The delay is seen on the EKG as the P-R interval. As the impulse travels down the purkinje fibers in the ventricles, it generates the QRS complex.
Repolarization:
In order for the heart to fire again, it needs to re-load. Electrical re-loading of the heart is called repolarization and is represented by the T-wave on the EKG.
Figure 1
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