Can you interpret an Electrocardiogram (EKG)?

From the Guidelines

I am not capable of reading an EKG as I am an AI language model without the ability to visually interpret electrocardiogram tracings. Reading an EKG requires specialized medical training to identify normal cardiac electrical patterns and recognize abnormalities such as arrhythmias, conduction blocks, myocardial infarction, electrolyte disturbances, and other cardiac conditions. Medical professionals who commonly interpret EKGs include cardiologists, emergency physicians, internists, and specially trained nurses or technicians. The skill involves understanding the relationship between the electrical tracings and underlying cardiac physiology, including the significance of P waves (atrial depolarization), QRS complexes (ventricular depolarization), T waves (ventricular repolarization), and various intervals and segments.

Key Points to Consider

• According to the American College of Physicians, proficiency in ECG interpretation requires a combination of knowledge, skill, and practical clinical experience 1.
• The American College of Cardiology (ACC) and American Heart Association (AHA) recommend interpretation of 500 ECGs under supervision to attain initial competency 1.
• To maintain competency in ECG interpretation, the ACC/AHA statement advised the reading of 100 ECGs yearly 1.
• Some studies suggest that noncardiologist physicians have more ECG interpretation errors than do cardiologists, but the rate of adverse patient outcomes from ECG interpretation errors is low 1.
• Computers may decrease the time needed to interpret ECGs and can reduce ECG interpretation errors, but they have shown less accuracy than physician interpreters and must be relied on only as an adjunct interpretation tool for a trained provider 1.
• For accurate EKG interpretation, healthcare providers typically complete formal training during medical education and often pursue additional specialized training or certification in cardiac diagnostics 1.
• The American Board of Internal Medicine does not require a minimum number of supervised ECG interpretations to take the internal medicine board certification examination 1.
• The Accreditation Council for Graduate Medical Education advises that the ideal results of a competency-based assessment should allow sound inferences about what learners know, believe, and can do in defined contexts 1.
• Some literature on invasive procedures suggests improved patient outcomes with more procedures, but there are insufficient data to recommend a yearly minimum number of ECG interpretations or continuing medical education hours to maintain competency 1.

From the Research

EKG Interpretation

• EKG interpretation is a crucial skill for healthcare professionals, but achieving and maintaining competency can be challenging 2.
• Studies have shown that healthcare professionals, including primary care physicians, cardiology fellows-in-training, resident physicians, medical students, advanced practice providers, nurses, and allied health professionals, have significant gaps in EKG interpretation proficiency 2.
• The average overall accuracy of EKG interpretation among healthcare professionals is around 56.4% ± 17.2%, with cardiology fellows-in-training demonstrating superior performance across all metrics 2.

Factors Affecting EKG Interpretation

• Length of time as a registered nurse and length of time in the current work environment are weakly correlated with EKG interpretation proficiency 3.
• Having a critical care background shows a positive relationship with nursing knowledge of EKG rhythm identification 3.
• Instructional modalities, such as computer-assisted instruction, can have a small but statistically significant effect on EKG interpretation training 4.
• Instructional methods, such as group training and peer-led instruction, can also improve EKG interpretation skills 4.

EKG Interpretation Approaches

• Systematic interpretation approaches can have a large and statistically significant effect on EKG interpretation skills 4.
• Complete ensemble empirical mode decomposition approach can be used for accurate QRS complex and P wave detection in EKG signals 5.
• This approach can eliminate the need for conventional filtering and can automatically identify P waves without prior information 5.

Nursing Knowledge of EKG Rhythm Identification

• Registered nurses have poor knowledge of EKG rhythm identification and interpretation, with an overall correct answer rate of 55% 3.
• Coronary care nurses scored the highest in identifying EKG rhythms, but still had difficulty identifying EKG abnormalities associated with electrolyte imbalances 3.
• Education and training associated with EKG recognition and morphology may need to be revamped to improve nursing knowledge of EKG rhythm identification 3.