Difficulty
Tap two points on the strip to measure an interval; the marks march out across the strip.
Read it systematically
Answer each step from the strip, then name the rhythm. Each step is graded so you can see exactly where a miss came from.What is this rhythm?
Keys 1–9 pick a choice · N next · R new exampleEach QRS carries the cardiologist's beat label from the database (PVC, PAC, paced, LBBB…)Blocked P waves marked ×PBracket shows the first R–R
The 6-step read on this strip
How to read any strip
Same five questions every time, in the same order. The rhythm name is the conclusion, never the starting point.- Rate. Count QRS complexes in 6 seconds and multiply by 10. For a regular rhythm, 300 ÷ (big boxes between two R waves) is quicker. Slow <60, normal 60–100, fast >100.
- Regularity. March out the R–R with calipers. Regular, irregular with no pattern (irregularly irregular), or irregular with a repeating pattern (regularly irregular).
- P waves. Is there one upright P before every QRS, and do they all look alike? Absent, inverted, variable, sawtooth, or more Ps than QRSs each point somewhere specific.
- PR interval. Start of P to start of QRS. Normal 0.12–0.20 s (3–5 small boxes). Constant and long, growing, or random each mean a different block.
- QRS width. Narrow (<0.12 s, under 3 small boxes) means the impulse came through the normal conduction system. Wide means ventricular origin or a conduction problem.
- Name it, then treat the patient. Pulse, pressure, mentation, chest pain. The strip is one data point; the patient decides the treatment.