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Writer's pictureJoshua S. Farquharson

Measuring Electrocardiogram (ECG) Waveforms: Simple Techniques and Practice Activities to Improve Your Skills Quickly

Audience: Healthcare Students | Level: Beginner

healthcare worker pointing to cardiac waves on an ECG strip

1. Introduction

Are you curious about electrocardiograms (ECGs) and how they work? Maybe you're asking questions like:


  • What is a 12-lead ECG, and what information does it provide?

  • How do I arrange the strips when mounting an ECG?

  • What types of cardiac waves appear on an ECG?

  • How do I use the ECG grid to measure cardiac waves?


If so, this guide is for you.


Don't worry. This guide is not about learning the entire subject of electrocardiography. Instead, it focuses on one specific skill that many beginning students find challenging—using an ECG grid to measure cardiac waveforms.


1.1 Why ECG Measurement Skills Matter

An electrocardiogram (also known as an EKG or ECG) is a test that records the electrical activity of the heart. It helps healthcare providers detect and study heart problems such as heart attacks, arrhythmias, and heart failure. Knowing how to measure the waveforms of an ECG is an essential aspect of patient care. If you don't report your findings correctly, the patient can be misdiagnosed or end up with the wrong treatment plan.


In this guide, you will review the layout of a 12-lead electrocardiogram and learn how to use the ECG grid to measure the height, amplitude, width, and duration of the P waves, T waves, PR and QT intervals, and the QRS complex.


1.2 What You’ll Learn

Here are the new skills you’ll gain after completing this guide:

  • ECG Essentials: Discover the 12-lead ECG layout and learn how cardiac conduction relates to the specific waves you see on an ECG.

  • ECG Grid Fundamentals: Learn the values of the small and large boxes on an ECG grid and how they are used to measure cardiac waves.

  • Cardiac Wave Measurements: Analyze ECGs and measure the height, amplitude, width, and duration of P waves, T waves, PR and QT intervals, and the QRS complex.

1.3 Tips for Successfully Completing this Guide


  • Have a pencil and paper: Jot things down quickly if needed.

  • Find a quiet place: Free from distractions and turn off device notifications.

  • Take breaks: After each lesson, take a five-minute break. Stretch or walk to give your eyes a break from the screen.

  • Use a desktop computer or large display device: Access the content on a desktop or large display for the best experience.


Remember, go at your own pace and build your skills with the activities. Practice as often as necessary to master the skills. You are going to do great!


 

2. ECG Essentials


2.1 Exploring the 12-Lead ECG Layout

Let's start by exploring some common areas of a 12-lead electrocardiogram and its elements. Keep in mind that the ECG layout may differ depending on the manufacturer and healthcare provider preferences.


2.2 Review ECG Layout and Elements

Instructions: Use the interaction below to explore the 12-lead ECG. Once complete, continue to the next lesson.



 

2.3 Cardiac Conduction and ECG Waves

Now let's explore how the electrical conduction system of the heart relates to cardiac waveforms.


Review Cardiac Conduction and ECG Waves

Instructions: Watch the video explanation of the electrical conduction system of the heart and how it relates to the waveforms you see on an ECG.


 

3. Using the ECG Grid to Measure Cardiac Waveforms


3.1 Measuring Size (mm) on the ECG Grid

Now that you understand the basic structure of a cardiac waveform, let's focus on how the grid works for measurements.


Review Measuring Size (mm) on the ECG Grid

Instructions: Watch the video to learn how to use the ECG grid to measure height and width in millimeters (mm).


 


3.2 Examples of Size Measurements

Here you'll review examples of various size measurements on the ECG grid.

Review Examples of Size Measurements on the ECG Grid

Instructions: Use the interaction to review examples of various size measurements on the ECG grid.



 

3.3 Measuring Amplitude (mV) on the ECG Grid

Next, focus on measuring amplitude.

Review Measuring Amplitude (mV) on the ECG Grid

Instructions: Watch the video to learn how to use the ECG grid to measure amplitude in millivolts (mV).

 

3.4 Examples of Amplitude Measurements

Here you'll review examples of various amplitude measurements on the ECG grid.

Review Examples of Amplitude Measurements on the ECG Grid

Instructions: Use the interaction to review examples of various amplitude measurements on the ECG grid.



 


3.5 Measuring Time or Duration (sec) on the ECG Grid

Next, focus on measuring time.

Review Measuring Time or Duration (sec) on the ECG Grid

Instructions: Watch the video to learn how to use the ECG grid to measure the time in seconds (sec).

 

3.6 Examples of Time or Duration Measurements

Here you'll review examples of various time measurements on the ECG grid.

Review Examples of Time or Duration Measurements on the ECG Grid

Instructions: Use the interaction to review examples of various time measurements on the ECG grid.



 

3.7 Measuring with the ECG Grid

Here you'll practice the concept of measuring with the ECG Grid.

Practice Activity: Measuring with the ECG Grid

Instructions: Complete each question and select SUBMIT to confirm your answer.



 

4. Measuring ECG Waves: P and T Waves


4.1 How to Measure P and T Waves

Now that you know how the grid works for measurements, you are ready to begin measuring waves.


Review Measuring P and T Waves

Instructions: Watch a video to learn how to measure the height, width, amplitude, and duration of the waves.

 

4.2 Measuring P Waves

Here you'll practice measuring the height, width, amplitude, and duration of the P waves.

Practice Activity: Measuring P Waves

Instructions: Complete each question and select SUBMIT to confirm your answer.



 

4.3 Measuring T Waves

Here you'll practice measuring the height, width, amplitude, and duration of the T waves.

Practice Activity: Measuring T Waves

Instructions: Complete each question and select SUBMIT to confirm your answer.



 

5. Measuring ECG Intervals: PR and QT Intervals


5.1 How to Measure PR Intervals

Let's explore how to measure PR intervals.


Review Measuring PR Intervals

Instructions: Watch a video to learn how to measure the width and duration of PR intervals.

 

5.2 Measuring PR Intervals

Here you'll practice measuring the width and duration of PR intervals.

Practice Activity: Measuring PR Intervals

Instructions: Complete each question and select SUBMIT to confirm your answer.



 

5.3 How to Measure QT Intervals

Let's explore how to measure QT intervals.


Review Measuring QT Intervals

Instructions: Watch a video to learn how to measure the width and duration of QT intervals.


 

5.4 Measuring QT Intervals

Here you'll practice measuring the width and duration of QT intervals.

Practice Activity: Measuring QT Intervals

Instructions: Complete each question and select SUBMIT to confirm your answer.



 

6. Measuring the QRS Complex


6.1 How to Measure the QRS Complex

Let's explore how to measure QRS Complex.


Review Measuring the QRS Complex

Instructions: Watch a video to learn how to measure the width and duration of the QRS complex.

 

6.2 Measuring the QRS Complex

Here you'll practice measuring the width and duration of the QRS complex.

Practice Activity: Measuring the QRS Complex

Instructions: Complete each question and select SUBMIT to confirm your answer.



 

7. Bonus Activity: Sarah's ECG Challenge


7.1 Sarah's ECG Challenge

Sarah's ECG Challenge presents a fun way for you to confirm your ability to use the ECG grid to measure cardiac waveforms.


7.2 Review Sarah's ECG Challenge Scenario

Instructions: Watch a brief video for the context, then complete the activity.


7.3 Practice Activity: Play Sarah's ECG Challenge

Instructions: Complete each question in the interaction.



 
7.4 Skills Assessment for Measuring Electrocardiogram Waveforms

Now you're ready to test your skills! Be confident. You're going to do great!


Instructions: Complete each question and select SUBMIT to confirm your answer.



 

Conclusion

Congratulations! You've completed the guide and gained valuable skills in measuring ECG waveforms. Thank you for participating!

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