Your FREE EKG Technician Flashcards 2026 – 200+ Cards

The Health Insurance Portability and Accountability Act — protects patients' protected health information (PHI).

Protected health information — individually identifiable health data that must be kept private and secure.

Access and share only the PHI needed for the task or the patient's care.

Looking up a patient's record out of curiosity, with no care reason — even a coworker or celebrity.

PHI overheard despite reasonable safeguards — permitted under HIPAA; deliberate snooping is not.

Secure tracings/screens, don't discuss patients in public, log off shared workstations, no personal-device copies.

Acquire and recognize EKGs and report findings — do NOT diagnose, interpret for the record, or treat.

Recognizing and escalating a dangerous rhythm is in scope; diagnosing it is not.

Decline and check with your supervisor rather than work beyond your scope.

The order in which concerns are escalated within a facility.

Verify at least two — typically full name and date of birth — before any EKG.

The room number or bed number — patients move between rooms.

Treat every patient's blood and body fluids as potentially infectious for every patient.

Hand hygiene — before and after every patient contact.

Disinfect reusable electrodes, cables, and the machine surface between patients per policy.

Federal rule (29 CFR 1910.1030) to protect workers from blood and body-fluid exposure.

Never recap a used needle by hand; drop it point-first into a puncture-proof sharps container.

Wash the area, report it immediately, and follow the facility's exposure-control plan.

Contact, droplet, and airborne precautions added to standard precautions for specific organisms.

Personal protective equipment — gloves, gowns, masks, and eye protection used as the situation requires.

Inspect cables for fraying, keep the unit grounded, and keep electrical devices away from oxygen and water.

Stay with the patient, call for help, and follow the facility's emergency response.

Introduce yourself, explain the procedure, provide privacy and comfort, and gain cooperation.

A relaxed, still patient produces a cleaner tracing with less artifact.

Use a qualified interpreter and adapt communication to the patient's needs.

Record the correct patient, date, and time so results match the right chart.

The provider explains the procedure's risks, benefits, and alternatives; the team verifies it as required.

Record findings and any incidents accurately and objectively in the medical record.

Working with the nurse and team so the right test reaches the right patient and results are reported.

Promptly alert the nurse or provider when a dangerous rhythm or alarm appears.

Keeping patient information private and shared only with those involved in care.

Sets national standards for protecting patients' medical records and other PHI.

Sets standards for protecting electronic protected health information (ePHI).

Confirm the requester's identity and authorization before releasing any PHI.

Before patient contact, after patient contact, and after contact with the environment or fluids.

A labeled, puncture-resistant container kept near point of use; replaced before it overfills.

Include privacy, informed consent, respectful care, and the right to refuse a procedure.

A competent patient may refuse the EKG; do not force it — document and notify the nurse/provider.

Maintain hygiene, identification, courtesy, and ethical behavior with patients and staff.

Clean technique that reduces the number and spread of microorganisms.

Proper lifting and positioning to protect yourself and the patient from injury.

Use latex-free supplies for an allergic patient and post appropriate signage.

Remove the device from use, label it, and report it; do not use faulty equipment on a patient.

Document and report errors, exposures, or unsafe conditions per facility policy.

Confirm a clean, artifact-free, correctly labeled tracing before submitting it.

Know your role and the facility's emergency codes; summon help and stay with the patient.

Give the tracing/findings to the nurse or provider responsible for the patient's care.

Out of scope — the technician does not enter a diagnosis or formal interpretation in the record.

A noninvasive measure of blood oxygen saturation, often monitored alongside the EKG.

Temperature, pulse, respirations, blood pressure, and often oxygen saturation.

An alert for rate or rhythm outside set limits; respond and report promptly, do not ignore.

10 electrodes — 4 limb + 6 precordial (chest). They produce 12 views (leads).

The sinoatrial node — the heart's natural pacemaker in the right atrium; fires 60–100/min and starts each beat.

The atrioventricular node; delays the impulse so atria empty before ventricles contract. Backup rate 40–60/min.

Carries the impulse from the AV node into the interventricular septum, then splits into the bundle branches.

Terminal fibers that spread the impulse rapidly through the ventricles → the QRS. Backup rate 20–40/min.

SA node → AV node → bundle of His → right/left bundle branches → Purkinje fibers.

60–100 beats per minute — the dominant pacemaker.

40–60 beats per minute (a backup pacemaker).

20–40 beats per minute (Purkinje/ventricular backup pacemaker).

The two upper chambers that receive blood and contract first (atrial depolarization = the P wave).

The two lower chambers that pump blood out; their depolarization is the QRS complex.

Right side pumps deoxygenated blood to the lungs; left side pumps oxygenated blood to the body.

One complete heartbeat — systole (contraction) and diastole (relaxation/filling).

The electrical activation of heart muscle that triggers contraction.

The recovery/resetting of heart muscle after contraction (ventricular repolarization = the T wave).

An electrode is a sensor on the skin; a lead is a calculated view of the heart. 10 electrodes → 12 leads.

Four — one on each arm and each leg (RA, LA, RL, LL).

Six — the chest electrodes V1 through V6.

The inverted triangle formed by the RA, LA, and LL electrodes; defines limb leads I, II, and III.

It is the ground/reference electrode; it does not form a recorded lead.

4th intercostal space, right sternal border.

4th intercostal space, left sternal border.

Midway between V2 and V4.

5th intercostal space, left midclavicular line.

Left anterior axillary line, level with V4.

Left midaxillary line, level with V4 and V5.

V1 and V2 (they anchor the rest); then V4, then fill in V3, V5, V6.

White — 'white on the right,' 'snow over grass.'

Black — 'smoke (black) over fire (red)' on the left.

Red — the left-leg ('fire') electrode.

Green — the right-leg ground electrode ('snow over grass').

Bipolar limb leads: I = LA − RA, II = LL − RA, III = LL − LA.

aVR, aVL, aVF — unipolar leads derived from the limb electrodes.

An upside-down P-QRS-T in lead I; recheck and correct placement, then re-record.

A chest electrode placed on the right side to look for right-ventricular involvement.

Clean and dry the skin, remove hair if it blocks an electrode, wipe off oils, and lightly abrade for firm contact.

Good electrode contact reduces artifact and produces a clean, accurate tracing.

25 mm per second.

A 1-mV signal must deflect the trace exactly 10 mm (two large boxes) vertically.

0.04 seconds, at 25 mm/s paper speed.

0.20 seconds (5 small boxes).

1 mm = 0.1 mV.

5 mm = 0.5 mV.

Used when complexes are too tall to fit the paper.

The square calibration pulse at the start of a strip confirming 10 mm = 1 mV.

Any signal on the tracing not produced by the heart — wandering baseline, muscle tremor, or AC interference.

A slow up-and-down drift of the whole tracing.

Patient movement, respiration, or loose/dried electrodes and skin oils.

Re-prep skin, replace electrodes, ensure firm contact, and have the patient lie still.

Fuzzy, erratic spikes on the tracing.

Shivering, tension, talking, or a Parkinsonian tremor.

Warm and relax the patient, reposition the arms, ensure comfort.

Uniform, thick fuzz laid evenly over the trace.

Nearby electrical equipment, crossed/frayed lead wires, or an ungrounded unit.

Unplug nearby devices, uncross lead wires, check grounding.

A broken wire or detached/dried electrode for that lead — reconnect or replace it.

A portable EKG worn 24–48 hours (or longer) recording continuously during daily activity.

The patient logs symptoms and activities so events can be matched to the tracing.

An EKG recorded while the patient walks a treadmill or pedals a bicycle under increasing exertion.

Monitor the patient and rhythm; stop for chest pain, distress, or ominous changes per protocol.

Continuous wireless EKG monitoring of an admitted patient, displayed at a central station.

A longer-term recorder the patient activates when symptoms occur, for infrequent events.

The muscular wall dividing the right and left ventricles; conduction travels through it via the bundle branches.

Conducts the impulse down the right side of the septum to the right ventricle.

Conducts the impulse down the left side of the septum to the left ventricle.

The tricuspid (right) and mitral (left) valves between the atria and ventricles.

The pulmonary and aortic valves at the exits of the ventricles.

Vessels that supply blood to the heart muscle itself; blockage causes ischemia/infarction.

The ability of cardiac cells to generate their own electrical impulse spontaneously.

The SA node — sets the heart's normal rate; lower sites take over only if it fails.

A 12-lead gives 12 views at one moment; a rhythm strip is a single lead recorded over time.

Twelve — six limb leads (I, II, III, aVR, aVL, aVF) and six chest leads (V1–V6).

II, III, and aVF — view the inferior (bottom) wall of the heart.

I, aVL, V5, V6 — view the lateral (side) wall of the heart.

V1–V4 — view the front and septal walls of the heart.

Remove only the hair that prevents firm electrode contact; clip rather than shave when possible.

Dry the skin and use stronger-adhesive electrodes; sweat causes poor contact and artifact.

Conductive gel on the electrode improves the electrical connection to the skin.

The electrode sticks to the skin; the lead wire clips/snaps to the electrode and connects to the machine.

Extra chest electrodes placed around the back to view the posterior wall.

Place the limb electrode on the nearest available area (e.g., the shoulder/torso) and document it.

Children have faster normal heart rates; use appropriately sized electrodes.

So amplitudes and intervals are accurate and comparable across machines and over time.

Verify the standardization mark prints as a 10-mm tall square before trusting the tracing.

Reduce some artifact, but proper skin prep and electrode contact remain the primary fix.

A single noisy or flat lead while the others look fine points to that electrode/wire.

The volume of blood the heart pumps per minute (heart rate × stroke volume).

The relaxation/filling phase of the cardiac cycle.

The contraction phase of the cardiac cycle when blood is ejected.

A limb lead that normally shows mostly negative deflections.

Six total — I, II, III, aVR, aVL, aVF — from the four limb electrodes.

Atrial depolarization (the atria contracting). Normally upright in lead II.

Ventricular depolarization; tall and narrow. Normal duration < 0.12 s.

Ventricular repolarization (the ventricles recovering/resetting).

A small wave sometimes after the T wave; may be seen with low potassium (hypokalemia).

From the start of the P wave to the start of the QRS; reflects AV conduction.

0.12–0.20 seconds (3–5 small boxes).

Less than 0.12 seconds (under 3 small boxes).

Suggests a ventricular origin (e.g., PVC, VT) or a bundle branch block.

From the start of the QRS to the end of the T wave; a prolonged QT raises arrhythmia risk.

The flat line between the QRS and the T wave; elevation/depression suggests injury or ischemia.

The flat baseline of the tracing — no positive or negative deflection.

Rate = 300 ÷ number of large boxes between two R waves. Memorize 300, 150, 100, 75, 60, 50.

Rate = 1500 ÷ number of small boxes between two R waves (most precise for regular rhythms).

Count the QRS complexes in a 6-second strip and multiply by 10 — used for irregular rhythms.

The 6-second method (count QRS in 6 s × 10).

Regular, 60–100/min, with one upright P wave before every QRS and normal intervals.

A sinus rhythm with a rate under 60/min.

A sinus rhythm with a rate over 100/min.

A sinus rhythm that speeds up and slows with breathing; usually benign.

Premature atrial contraction — an early beat with an abnormal P wave, arising in the atria.

Organized 'sawtooth' flutter (F) waves; atrial rate ~250–350/min.

Irregularly irregular rhythm with no true P waves — only a chaotic baseline; atria quiver.

An 'irregularly irregular' R-R rhythm with no discernible P waves.

A fast, narrow-complex rhythm originating above the ventricles.

Originates at the AV junction; P wave inverted, hidden, or after the QRS; ~40–60/min.

Premature ventricular contraction — an early, wide, bizarre QRS with no preceding P wave.

PVCs of differing shapes from more than one ventricular site — more concerning.

A pattern of one normal beat alternating with one PVC.

Three or more PVCs in a row at a fast rate — a life-threatening, wide-complex rhythm.

A chaotic, quivering baseline with no organized QRS — life-threatening and shockable.

A flat line with no electrical activity — cardiac standstill.

A consistently long PR interval (> 0.20 s); every P is still followed by a QRS.

The PR interval lengthens progressively until a QRS is dropped (Wenckebach).

Intermittent dropped QRS complexes without progressive PR lengthening.

P waves and QRS complexes are completely dissociated — they march independently.

Shows pacemaker spikes before the P wave and/or the QRS.

Rate → rhythm (regularity) → P waves → PR interval → QRS duration.

Ventricular tachycardia, ventricular fibrillation, and asystole — alert the nurse/provider at once.

Ventricular fibrillation and pulseless ventricular tachycardia.

Asystole and pulseless electrical activity (PEA) — treat with CPR and medications.

The time between two consecutive R waves; used to judge regularity and rate.

March out the R-R intervals; equal spacing = regular, varying = irregular.

A heart rate slower than 60 beats per minute.

A heart rate faster than 100 beats per minute.

The SA node — producing an upright P wave in lead II before each QRS.

Suggests a rhythm not originating in the SA node (e.g., atrial fibrillation or a junctional rhythm).

Suggests a junctional or low-atrial origin, or reversed arm electrodes.

Narrow (< 0.12 s) = supraventricular origin; wide (≥ 0.12 s) = ventricular origin or bundle branch block.

ST segment above baseline; may indicate acute myocardial injury — escalate.

ST segment below baseline; may indicate ischemia.

Predisposes to a dangerous ventricular arrhythmia (torsades de pointes).

A polymorphic ventricular tachycardia with a twisting appearance, linked to a long QT.

Two PVCs in a row = couplet; three = triplet (a short run toward VT).

Three or more consecutive ventricular beats; sustained VT lasts > 30 seconds.

A slow ventricular escape rhythm (20–40/min) with wide QRS and no P waves.

Progressively lengthening PR intervals, then a dropped QRS, repeating.

The classic flutter (F) waves of atrial flutter.

The chaotic, undulating baseline with no true P waves seen in atrial fibrillation.

An organized rhythm on the monitor but no pulse — treat with CPR, not a shock.

1 large box apart = 300, 2 = 150, 3 = 100, 4 = 75, 5 = 60, 6 = 50.

Because the R-R spacing varies, so the box methods (which assume regularity) are inaccurate.

Check the patient and lead contact — artifact often disappears when contact is fixed; a true rhythm persists.

A beat that comes earlier than expected (atrial, junctional, or ventricular in origin).

A late beat from a lower pacemaker when the SA node fails to fire on time.

The heartbeat heard/counted at the apex of the heart with a stethoscope.

It usually shows clear, upright P waves, making it the go-to rhythm-strip lead.

A tool used to measure intervals and R-R distances precisely on the tracing.