← Chapter 9
Medical-Surgical Nursing · Chapter 9

The Six-Step Strip Bench

Students who guess at strips get them wrong; students who run the same six steps every time get them right. Work each strip through rate, rhythm, P waves, P-to-QRS relationship, PR interval and QRS width, then answer the only sorting question that matters — stable or unstable — and see which first intervention that unlocks. The lower bench screens a QT-prolonging drug before you hang it.
Pick a 6-second strip
Six-second rhythm strip
1 small box = 0.04 s1 large box = 0.20 s30 large boxes = 6 scount QRS × 10 = rate
Run the six steps
Now the only sorting question that matters
No strips scored yet.
Before you hang a QT-prolonging drug
Drugs already ordered or hanging
Analyse the strip
Choose a strip, answer all six steps, set the patient’s stability, then press Check my analysis.
Why six steps and not a glance
Naming a strip from its overall “look” is how students confuse junctional escape with idioventricular rhythm, or supraventricular tachycardia with ventricular tachycardia. The six steps force you to measure instead of recognise, and measurement is what survives an exam and a night shift.
Electricity is not perfusion
A monitor can show a textbook rhythm while the patient has no pulse at all — that is pulseless electrical activity. The first response to any alarming rhythm is to look at the patient, touch the patient, and check a central pulse and a blood pressure. Treat the person, not the screen.