Capstone Practice: 30 Mixed Tracings
Review the 60-second interpretation protocol, the 30-tracing set design, scoring rubric, and debrief method for mastering EKG reading under time pressure.
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Questions Covered in This Set
12 cards to master
What are the 8 steps of the 60-Second Protocol?
1) Patient & technical check, 2) Rate, 3) Rhythm, 4) Axis, 5) Intervals, 6) Chambers, 7) QRST morphology lead by lead, 8) Synthesize into a one-sentence impression plus urgency call.
What technical items do you verify in the first 5 seconds?
Name, age, date, calibration box (10 mm/mV), paper speed (25 mm/s), plausible lead placement, and artifact.
Why write your interpretation down before checking the answer?
Writing forces commitment, and commitment makes your errors visible so they can be corrected.
What are the normal interval values checked in step 5?
PR 120–200 ms, QRS <120 ms, QTc via Bazett (QT/√RR).
What is the Sokolow–Lyon criterion for LVH?
S wave in V1 + R wave in V5 or V6 greater than 35 mm.
How is the 30-tracing set weighted, and why?
6 normals, 5 atrial rhythms, 5 blocks, 6 ischemia/infarct, 4 wide-and-dangerous, 4 systemic/miscellaneous — mostly normal, punctuated by danger, mirroring real practice.
What is the three-round timing plan?
Round 1: 90 s each focused on completeness; Round 2 next day shuffled at 60 s; Round 3 one week later at 30 s to force pattern recognition.
Why shuffle (interleave) the tracings between rounds?
Studying blocks together teaches block features, but interleaving teaches discrimination between diagnoses — which is what real practice tests.
How is each tracing scored out of 5 points?
1 point each for correct rate, rhythm, intervals/conduction, morphology findings, and a safe disposition call; below 4 is a miss requiring a debrief note.
Which misses are an automatic zero, and how are false alarms scored?
Missing STEMI, complete heart block, VT, or hyperkalemia is an automatic zero; a false alarm costs only half a point — train toward safe pessimism.
What three lines go in the error log after every miss?
(1) What I said, (2) What it was, (3) The single distinguishing feature/lesson that would have caught it.
Which leads correspond to inferior, anterior, and lateral territories?
Inferior: II, III, aVF; Anterior: V1–V4; Lateral: I, aVL, V5–V6.
