What is the first step in identifying an arrhythmia on an EKG?

Identifying an arrhythmia on an EKG begins with assessing the heart rate and rhythm for regularity. This step is crucial because it establishes a baseline for what the normal rhythm should look like. By evaluating the heart rate and rhythm, the technician can distinguish between normal sinus rhythms and various types of arrhythmias. Regularities in rate and rhythm provide critical insights; for instance, an irregular rhythm might suggest atrial fibrillation or other types of arrhythmias that warrant further investigation.

Following this initial assessment, other steps, such as checking for ST segment changes or evaluating the patient's symptoms, can provide additional context and information, but they rely on having already determined the baseline heart rate and rhythm. Therefore, starting with the assessment of heart rate and rhythm lays a foundational understanding necessary for interpreting the rest of the EKG.