You often hear that learning how to read an electrocardiogram (ECG or EKG) is like learning a new language. Interpreting ECGs is an essential skill for emergency physicians who frequently treat patients with acute cardiac conditions. As a medical student, it is crucial to practice as much as possible because it takes time to develop this skill and become comfortable with it. The International Federation of Emergency Medicine (IFEM) lists basic electrocardiographic analysis as an essential component of undergraduate education for medical students including recognition of acute myocardial infarction and life-threatening arrhythmias.
As I went through my emergency medicine rotation during my clerkship, I found that this skill took a lot of practice to learn. Along the way, I discovered some excellent resources that helped me get better at it. I wanted to share these Free Open Access to Medical Education (FOAMed) resources to help other medical students looking to strengthen their ECG skills and apply their knowledge on a shift in the emergency department.
Analysis and Interpretation of the Electrocardiogram from Queen’s University
This self-directed online module was where I started. Reading ECGs requires a systematic approach and I really liked how this module presents a step-by-step breakdown. It includes clearly labeled overview diagrams of the different intervals and segments as well as expected values for a normal ECG. The “Approach to the ECG” section is very helpful with examples provided to help you master each step. Check out the ECG index section for examples of different ECG rhythms including some details about each arrhythmia, ECG criteria and associated clinical presentations.
Practical Clinical Skills
This is a very comprehensive website that is useful for anyone from beginners to more advanced medical learners. The ECG basics was a great introduction to the different parts of tracing and how each part relates to cardiac physiology. There’s a concise reference guide of arrhythmias for quick review. What I liked most about this resource was the opportunity to check your knowledge with the ECG Quiz. There’s also an excellent ECG Tutor section, which allows you to customize the quiz and practice the types of rhythms you are having most difficulty with. This website also features ECG content in Spanish!
Life in the FAST Lane
Life in the Fast Lane is a great all-around resource for students interested in emergency medicine. Even beyond ECGs, they have excellent clinical cases for practicing chest x-ray and ultrasound interpretation as well as other common clinical presentations (see the Top 100 tab). They also have a toxicology section that features illustrated flashcards. Check it out!
For ECGs, I found Life in the Fast Lane to be a very comprehensive resource. From a review of the basics to a comprehensive library of examples by an arrhythmia – this FOAMed resource has a lot to offer anyone looking to brush up on their ECG skills. I used this resource later in my studies when I already had some basic knowledge. I found the Top 100 ECG Clinical Cases section very useful. This section allows you to practice ECG interpretation, check your answers, and many are contextualized with a clinical scenario. The clinical outcome section of these ECG cases was great in helping to link an arrhythmia to clinical management. It was a great review of what you are going to do for the patient once you interpret their ECG. There were also often additional commentary and resources provided for more in-depth reading about the arrhythmia if desired. I found it very useful in my EM rotation.
Free ECG Simulator
This is a well-designed, sleek resource that I discovered only after my EM rotation. Some of my colleagues have found it very helpful and highly recommend it. The “learn” mode is great for review, and you can check your knowledge afterward with the game mode. Pro tip: you can change the settings from ‘dynamic’ to ‘static’ mode when you are still learning. The ‘dynamic’ mode can be a little stressful, but it makes for a great added challenge when you are more comfortable with ECG interpretation!
These are some of the resources I found useful when learning how to read ECGs. Everyone has their own learning style. Hopefully, one of these resources works well for you too. I am sure there are many other excellent resources out there. If you have enjoyed any other great FOAMed resources on ECG interpretation, please share them with us in the comments.