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Rapid Rhythm Identification


Rapid Rhythm Identification Library

ACLS providers must have the ability to rapidly identify and treat all of the most common rhythms that occur during emergency situations. The videos provided in the Rapid Rhythm Identification Library are practice tools to help you become comfortable with identifying all of the major rhythms that are treated using the ACLS protocol. Each video contains rhythms that you must identify and random questions about ECG rhythms and their treatment. These videos are designed to prepare you for ACLS certification and also for real world situations.

Before watching a rapid rhythm identification video, you may want to prepare by reviewing the pages on ECG rhythm interpretation.

Video 1: Rapid Rhythm Identification

Video 2: Rapid Rhythm Identification

Video 3: Rapid Rhythm Identification

  50 Responses to “Rapid Rhythm Identification

  1. Jeff,
    I’m up for re-cert tomorrow. Class 1st day then test 2nd day. I wish I had found this before yesterday. It is so helpful and user friendly. Boosted my confidence way up. I do need to boost up on strip identication and measurements. Is there a site I can go to that reviews basic strip measurements and test strips?
    Again, thank you. You have done such a great job with this site. I wish you were my instructor!
    Thanks, Gaby

  2. Jeff,

    What actually is happening in the heart during depolarization and repolarization? Im a bit confuse about it .
    V/ R Phil

    • When you look at an ECG strip or a monitor with the ECG displayed. You see the following P-wave, PR-interval, QRS Complex, ST-segment, and T-wave:

      First, the p-wave which represents electrical depolarization of the SA node and consequent atrial contraction.

      Second the PR-interval is a critical delay in the conduction system at the AV node that allows the atria to fully contract before the electrical impulse proceeds to make the ventricles contract;

      Third, the QRS Complex represents electrical depolarization of the ventricles and consequent contraction of the ventricular muscle.

      Fourth the ST-segment and the T-wave which represent repolarization of the ventricles. Repolarization restores the ventricles to negative charge which readies the myocardium for another depolarization and subsequent contraction.

      If you are a visual learner, these two videos will help clarify:
      Electrical System of the Heart (9min 43 seconds long)

      Depolarization of the Heart (11min 44 seconds long)
      Kind regards,

  3. could you explain wide and narrow complexes?

    • Wide QRS Complex usually means that the electrical impulses are usually ventricular in origin. This is true for both bradycardia and tachycardia. With bradycardia it occurs as an ventricular escape rhythm because of a blocked electrical conduction. With tachycardia the wide QRS complex is usually related to an arrhythmia that is producing an electrical conduction that is generated in the ventricles.
      Narrow QRS Complex usually means that the electrical conduction was generated above the level of the AV node.

      Kind regards,

  4. Excellent ! Highly recommended. Thanks.

  5. with a first degree heart block, and a second degree type II block, should atropine be used if the Pt. has bradycardia?

    • If the patient has symptomatic bradycardia then atropine can be used. With 2nd degree block type 2, you would want to use it cautiously due to the fact that MI can cause 2nd degree block type 2. In the case of MI the use of atropine could worsen the ischemia. In this case TCP or the use of a titrated epinephrine or dopamine drip would be a better choice.
      Kind regards,

  6. Hi Jeff,
    I would like a more in depth explanation of the heart blocks like how to recognize 1st, 2nd and 3rd degree heart blocks and what to do for each of them. Also, is defebrillation the same as shock? One one thing, thanks to your site I passed my ACLS but there weren’t any questions from my ACLS test on the actual ACLS test. I really would benefit from what I call the KISS (keep it simple stupid) format. I would like a more dummy done version of what to do for the more lethal rhythms. I’d really appreciate your help…you already have been a great resource. Keep up the great work!

  7. Hey Jeff, should atropine still be given (while preparing transcutaneous pacing) in symptomatic third degree heart block if you suspect it to be caused by ischemic heart disease? Or should you skip straight to TP? Thanks!

    • If you suspect ischemia, it would be wise to skip atropine and go to TCP. Keep the pacing at around 50-60/min. You do not want to increase myocardial oxygen consumption. When you give atropine, this can increase the heart rate to the point of myocardial oxygen demand which can worsen ischemia. —-Kind regards, Jeff

  8. hello jeff, I got confuse with atrial flutter and atrial fibrilation. Is there any thing that are so distinct between the two? that I could tell right away the difference? thanks

    • Yes. For atrial flutter will often have a sawtooth pattern and you will see very distinct extra P-waves on the tracing between the QRS waveform.

      For atrial fibrillation remember: no p-waves at all and an irregular heart rate. (irregular heart rate is indicated by changing distances between each QRS waveform.

      I hope this makes sense. Kind regards, Jeff

      • I think of it like this. The “Flutter” looks like a shark fin. You flutter kick in the water and sharks are in the water (normally). So sharkfin=flutter.

  9. Awesome site. The practice tests were very helpful. I did the ACLS exam Yesterday and passed with flying colors! Some of the questions found here were VERY similar to those on the actual test. The videos and megacode simulations were excellent too. Very helpful. A MILLION THANKS!!!
    I, to appreciate all the work and time you put into making this such a great learning tool. Perfect !
    Best regards Mr. Jeff

  10. Jeff & Chris
    I feel very prepared for my ACLS recert tomorrow thanks to the practice scenarios, test questions and videos you’ve provided. This site is a great adjunct to the AHA material provided by my employer. Thank you for this site- I’ve been recommending it to my co-workers who will be re-certifying in the coming months.

  11. good review. Great questions.

  12. This site has been very helpful tonight, it has pointed out areas I need to spend more time on .

  13. Good learning tool !!!

  14. Love this site!!! Thank you so much for putting all the work into this!!!

  15. I loved this site as well. It is nice to have a review of rhythm identification “on the fly.” Thanks for putting it together.

  16. I too loved the music but learned so much from this site. I appreciate all the work that went into making this the great learning tool. Perfect !

  17. This website is excellent for the visual learner! i have learned more the past few hours by viewing this website then a whole day of just reading out of an ACLS book. It is interactive and actually makes learning more fun then just a bunch of words on pages! Thank you:)

  18. I really like this site especially the music with the rapid rhythm identification!!

  19. Really enjoy learning with this site. I agree with Lindsey, It’s so much easier to understand than the book. :)

  20. Great job on the rhythm interpetations.
    this helped a lot. Thanks for the music/audio

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