CPEP strongly recommends that you complete this exam on a large, high resolution display to allow for enlargement of the ECG images. Using a desktop with a large high resolution display or using a laptop, connected to a large, high resolution accessory display should be sufficient. Using a laptop with built-in display only is not recommended, and you should not use a tablet, iPad or phone to complete this exercise.
PLEASE NOTE: these ECGs are presented with minimal clinical history. We understand that some participants are uncomfortable, reading the ECGs and providing plans for management without clinical history. Reading and following the instructions below will assist you in formulating your responses.
Instructions
You MAY use calipers and/or a calculator for this exercise, if you desire.
For the first ECG (ECG Tracing #1) only, please calculate the actual rate, duration, intervals, and axis.
For the remaining ECGs (ECG Tracings 2-11), please provide the following information:
Note: If there’s anything that you are unable to determine based on the quality of the tracing (e.g., rate, interval, or waveform), feel free to state that in your response.
Description: Describe what you see on the ECG. This is the same regardless of the history or setting. Describe the important findings as clearly as possible (as if you were talking on the telephone with a colleague or specialist who could not see the ECG).
Interpretations: Provide the breath of potential interpretations, (a differential diagnosis) for the ECG findings, regardless of the setting in which the patient presents.
Plan: Please presume that the patient is presenting to your usual practice setting (e.g., office, emergency room, or inpatient setting). Describe how you would actually manage the patient in this setting.
If you’re management recommendations would differ based on the patient history, please indicate so in your plan. For example, you might write: “if in the setting of chest pain, I would recommend a, B, and see if asymptomatic, I would recommend X, Y, NZ.”
If your plan would be to refer to another provider, please indicate the urgency and, if applicable, more of transport, (for example, “refer to cardiology to be seen non-urgently” versus “transfer to the emergency room via ambulance.”)
if your plan includes administration of medication to the patient, you do not need to indicate the dosage for any drug drugs you would administer.