Dubin's Method for For Reading EKG's. correct answers1. Rate
2. Rhythm
3. Axis
4. Hypertrophy
5. Infarction
Rate correct answers300, 150, 100... 75, 60, 50
But for brady= cycles/6 sec strip X 10
Rhythm correct answersIdentify the basic rhythm, then scan tracing for prematurity, pauses,
irregularity, and abnormal waves.
- Check for: P before each QRS
QRS after each P.
-Check: PR intervals (for AV Blocks).
QRS interval (for BBB).
-If access deviation, rule out Hemiblock.
Axis correct answers- QRS above or below the baseline for Axis Quadrant (for Normal vs. R or
L Axis Deviation).
For Axis in degrees, find isoelectric QRS in a limb lead of Axis Quadrant using the "Axis in
Degrees" chart.
-Axis rotation in the horizontal plane: (chest leads) find "transitional" (isoelectric) QRS.
Hypertrophy correct answersCHECK V1.
P wave for atrial hypertrophy.
R wave for right ventricular hypertrophy.
S wave depth in V1....
+ R wave height in V5 for Left Ventricular Hypertrophy
Infarction correct answersScan all leads for:
- Q waves
- Inverted T waves
- ST segment elevation or depression
Find the location of the pathology (in the Left ventricle), and then identify the occluded coronary
artery.
1mm (small square) correct answers= 0.04 sec
5mm (big square) correct answers=0.2 sec
QRS Morphology, narrow complex correct answerssinus, atrial, or junctional origin