Step one
The first step in analyzing a cardiac rhythm strip is determination of the heart rate. The heart rate indicated at the top of the rhythm strip printout must be verified by the nurse. Cardiac monitors have been known to double the heart rate incorrectly in rhythms with a very elevated T-wave. In addition,moscardiac monitors will include premature ventricular contractions (PVCs) or other abnormal beats when calculating heart rate. The quickest way to verify the heart rate is by counting the number of QRS complexes occurring in a 6-second strip and multiplying this number by ten. A more accurate but time-consuming way to calculate heart rate is to count the number of small boxes between two consecutive R waves and divide that number into 1,500 (Huff,2006). Lf there are two rhythms on the same strip (e.g., sinus rhythm and an episode of ventricular tachycardia), the rate of each rhythm should be determined independently.