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Hey, what's up? 
Everyone? 

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Doctor zeeshan here. 
So before you listen to this 

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lecture on EKGs, or at least an 
intro to EKGs, I highly suggest 

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you watch this on YouTube first.
We put this exact lecture on 

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YouTube. 
So it gives you a sense of 

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actually visualizing what I'm 
going to talk about. 

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All right, so let's get started 
with EKGs. 

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So again. 
With EKGs on the boards. 

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I want you to understand that 
there's a few things that 

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they're going to ask you and 
they want you to focus on. 

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Don't make it more complicated 
than it is. 

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I know it's very daunting and 
intimidating subject but think 

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of it from a board perspective 
and the way that I think the way

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that I would ask questions. 
What I want you to know is 

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they're going to try to make you
identify strips and the more 

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common ones. 
Ones that I cover here are the 

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ones I want you to worry about. 
Okay, they're going to want you 

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to know, potentially what the 
causes are potentially and I'll 

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tell you for the ones that 
they'll want you to know, but 

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definitely what you're going to 
do about it. 

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So, how are you going to treat 
that Rhythm and the progression 

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of? 
How are you going to treat that 

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rhythm? 
so, if it's Procedure wise, 

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cool. 
If it's medication, wise know, 

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the side effects, things of that
nature. 

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You're going to want to pay 
attention to what I'm providing 

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you with these notes with these 
notes and just focus on that, 

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just focus on that. 
But let's also understand. 

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Let's understand what EKGs are 
showing us. 

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So, the first thing that we have
to do, is we have to look at The

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different portions of it. 
We've got a p-wave A Q wave and 

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are wave and S Wave and the T. 
Wave P Q R S. 

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T. 
The p. 

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Is what? 
Part of the heart? 

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What part of the heart is the P 
showing us? 

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It's showing us. 
The atrium. it's showing us the 

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atrium when a p-wave happens, 
that means that the atrium has 

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contracted which means the qrst 
is going to be what The 

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ventricle good. 
The ventricles. 

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So when the qrst happens, now, 
we've got the ventricles 

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Contracting. 
What electrolyte predominantly 

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controls the atrium? 
Calcium calcium. 

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What? 
Electrolyte predominantly 

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controls the ventricles. 
Potassium. 

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So now you ask yourself as you 
go back to day one, when I talk 

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about ask graph and why changes 
in potassium or so important, 

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it's because they predominantly 
control the ventricles. 

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If they predominately control 
the ventricles and we've got 

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changes in potassium, low or 
high. 

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We can go into a dysrhythmias. 
The ventricles can go into a 

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disparate Mia. 
And what dysrhythmia are we 

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freaking out about v-fib? 
We will get into v-fib when I 

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get into the ventricles. 
Okay, and we'll talk about what 

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we're going to do and how to 
identify it. 

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But this is the basics. 
Of how I want you to understand 

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the different portions of an 
EKG. 

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The second thing I want you to 
know, is how to approximate. 

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A heart rate. 
As quickly as possible. 

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Now, is this the only way to 
approximate a heart rate? 

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Know if you have your own way of
knowing how to read and find the

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heart rate, stick to it. 
If you don't have a way, this is

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a method that I use that ends up
being quick and fast for me 

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because the boards are going to 
make things quick. 

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They're going to make things 
simple. 

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What I want you to do is I want 
you to look at your RR interval.

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So between your are and your 
are. 

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And in between those two ours, 
those two little Peaks are going

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to be big boxes. 
And all you have to do is count 

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the number of big boxes. 
And divide 300 by it. so, in 

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this situation, I've got how 
many big boxes are in between my

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are and my arm are two peaks. 
There are four. 

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Right? 
My drawings. 

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Not that great. 
But yeah, there's four there. 

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Right? 
So, one, two, three, four, so 

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what would I take? 
I would take 300 and divide it 

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by 4, which would give me a 
heart rate of what? 

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Approximately 75. 
The boards are not going to 

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overly complicate it, they're 
going to make it simple. 

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So understanding understanding. 
That you can glance at a strip. 

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And look at your Peaks, your are
in your art count. 

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The number of big boxes. 
Take the number 300 divided by 

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the number of big boxes. 
And now all you've got is your 

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approximate heart rate. 
They're not going to make it 

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unclear or ambiguous. 
It's going to either be 

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blatantly low, blatantly normal,
or blatantly. 

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Hi. 
Okay, so don't overthink it. 

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Don't overthink it. 
So let's get started with normal

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sinus rhythm. 
So normal sinus rhythm. 

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It's got the word sinus in 
there. 

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And what does that mean? 
Well. 

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We've got two nodes in our 
heart. 

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We've got the sinoatrial node, 
which is also known. 

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As the pacemaker. 
Of the heart. 

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And then we've got the atrial, 
ventricular node. 

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So, let's think about this. 
This sinoatrial node is the 

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pacemaker of the heart. 
Meaning, it's going to start the

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heart off. 
And what's the first part of the

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heart that's going to contract' 
the first part of the heart 

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that's going to contract is now 
the atrium. 

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And as the sinoatrial node 
fires, The Atrium will contract,

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we will develop a p-wave. 
Now the atrium is going to have 

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a signal that is going to hit 
the atrioventricular node, which

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is a signal, is coming from The 
Atrium. 

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And now it's going to cause The 
ventricle to contract. 

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And now we have a q r s t. 
So let's go through that one 

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more time. 
There is a node in the heart 

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called the sinoatrial node or 
that SA node. 

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It is the pacemaker of the 
heart. 

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It's what starts everything off.
When the sinoatrial node starts,

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and it fires it will contract 
The Atrium. 

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And now we've got a P wave. 
That impulse that signal will 

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now, travel through the atrium, 
get to the AV node. 

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And now the eight AV node will 
fire. 

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So now that signal from The 
Atrium is not going to make the 

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ventricle contract through the 
AV node. 

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And now we've got a q r s. 
T. 

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So, a normal sinus rhythm. 
Okay, so let's just break that 

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up. 
Let's take out the word normal. 

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Let's just worry. 
Let's work. 

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Let's focus on the word. 
Sinus rhythm. 

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How about that? 
Okay, sinus rhythm means what 

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the sinoatrial node is firing 
correctly? 

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If the sinoatrial node is firing
correctly, The Atrium is going 

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to contract. 
So we will have a p-wave. 

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That signal will now hit the AV 
node. 

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And now the AV node will fire 
and The ventricle will 

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Contracting lava qrst. 
So in every sinus rhythm in 

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every sinus rhythm. 
What are we going to see a p q r

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s t who just signed his shortest
just so weird sinus rhythm. 

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How about that? 
So now tell me the difference 

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between normal sinus rhythm. 
Sinus, bradycardia and sinus 

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tachycardia. 
Just by the words itself, normal

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is going to be a heart rate of 
what? 

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60 to 100. 
Okay? 

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For the board to remember normal
is normal. 

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There is no ambiguity. 100 is 
now borderline 16 out 

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borderline. 
It's normal. 

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So, in normal sinus rhythm will 
be see a pqrst. 

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Absolutely, and when we go to 
check the heart rate with that 

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RR interval. 
Just like we did previously and 

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we solve for big boxes, it fell 
between 60 and 100. 

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So we have a normal sinus 
rhythm. 

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In sinus bradycardia. 
Are we going to have a pqrst? 

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Yes, because it's a sinus 
rhythm. 

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But the heart rate is going to 
be where? 

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Below. 60 in sinus. 
Tachycardia. 

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Are we going to have a pqrst? 
Yes, because the sinoatrial node

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is firing. 
So we got that P wave then it 

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hits the AV node and we get our 
qrst. 

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So yes, but the difference in 
tachycardia is it's going to be 

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where? 
It's going to be above 100. 

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Okay, so understand what sinus 
rhythm means is just 

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understanding that art pacemaker
or sinoatrial node is firing. 

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Our Atrium is Contracting. 
We got a p-wave. 

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That signal hits the AV node. 
And now the ventricle contracts.

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You gotta qrst that is sinus. 
Rhythm normal is going to be 

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between 60 and 100. 
Brady is going to be below 60 

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and tacky is going to be above 
100.