Simplified ECG Guide for Emergency Situations

Want to Identify a Normal Sinus Rhythm? Watch as we break it down in minutes! 👌🏼

Follow these steps for interpreting ECGs in emergencies:

1. Heart Rate: Check for tachycardia or bradycardia

   
   

   The heart rate can be estimated using the number of large squares between successive R waves on an ECG. (This is based on the fact that the ECG paper runs at a standard speed of **25 mm/sec**, where each large square (5 mm) represents **0.2 seconds**).

   
   

   The formula to calculate heart rate is:

   Heart Rate (beats/min) = 300 ÷ Number of Large Squares Between R Waves

   
   

   Below is a table showing the relationship between the number of large squares and the heart rate:

   
   
   
   

R–R Interval (Large Squares)	Heart Rate (Beats/Min)
1	300
2	150
3	100
4	75
5	60
6	50

This method provides a quick estimation of heart rate. For irregular rhythms, it is better to calculate the average heart rate over a longer period.

In the fast-paced environment of emergency medicine, having a quick and reliable tool for interpreting ECGs can make all the difference in delivering prompt and accurate patient care.

See video below on how to use our ECG ruler in an emergency.

2. Rhythm: Assess the regularity and origin of the heartbeat.

   
   

   There should be one P wave for every QRS complex to indicate normal conduction- Sinus Rhythm.

   
   

   Use a 12-lead ECG to identify arrhythmias, as P waves are easier to spot compared to rhythm strips.

   
   

   Sinus Arrhythmia is normal in young people; the heart rate changes with breathing.

   
   

   Sinus Bradycardia common causes: Athletic training, fainting, hypothermia, myxoedema, or after a heart attack.

   
   

   Sinus Tachycardia common causes: Exercise, fear, pain, bleeding (haemorrhage), or thyrotoxicosis.

   
   

3. Conduction Intervals: Measure intervals such as PR, QRS, and QT to evaluate the electrical conduction system.

   Right Bundle Branch Block (RBBB) shows an RSR' pattern (a "rabbit ears" shape) in lead V1.Left Bundle Branch Block (LBBB) shows an M-shaped pattern in lead V6.

2. Cardiac Axis: Determine the heart's electrical axis to identify any Right and Left Axis Deviation (RAD and LAD):

   
   

Axis deviation is usually harmless on its own- RAD is common in tall, slim people. LAD is common in short, overweight people.

However, if axis deviation is seen, it’s important to check for:

• Enlarged heart chambers (right or left ventricular hypertrophy).

• Other features as a RAD may suggest a pulmonary embolism , and a LAD could mean a problem with heart conduction.

  
  
  
  

• QRS Complexes: Analyze the morphology of the QRS complexes for signs of ventricular abnormalities.

• ST Segments and T Waves: Examine these segments and waves for indications of ischemia or other cardiac conditions.

This user-friendly guide is tailored to meet the needs of doctors, nurses, and medical students, providing them with a simplified approach to understanding ECGs. Whether you are a seasoned healthcare professional or a student gaining your footing in the clinical world, this resource is designed to be your go-to companion in decoding ECG patterns efficiently. The website's layout is specifically crafted to ensure ease of navigation, allowing users to quickly access the information they need without unnecessary complexities. Each section of the guide is thoughtfully organized to cover the essentials of ECG interpretation, from understanding basic concepts to recognizing critical findings that require urgent attention. By breaking down complex concepts into digestible chunks, JMD Medical Education equips healthcare providers with the knowledge and confidence needed to make swift clinical decisions in emergency settings. With emphasis on simplicity and practicality, this guide empowers clinicians to interpret ECGs with proficiency, ultimately enhancing patient outcomes. Whether you are faced with a time-sensitive emergency or seeking to strengthen your ECG interpretation skills, JMD Medical Education's guide is a valuable resource that can help sharpen your clinical acumen. Stay tuned to this platform for insightful tips, case studies, and interactive tools that will further enrich your understanding of ECGs. In the realm of emergency medicine, every second counts. With JMD Medical Education's simplified ECG guide at your fingertips, you can navigate through cardiac rhythms with confidence and precision, ensuring that your patients receive the critical care they deserve. Visit the website today and embark on a journey towards mastering ECG interpretation in emergency situations.