Are these printable EKG practice strips free?

Yes. Paper A is a free PDF: 20 strips, a cover sheet with the rules, and an answer key. There is no account to create and nothing to pay. It may be printed and copied for a class.

Do the strips print at true size?

Yes, when the PDF is printed at 100% (“actual size”). Each strip is 150 mm long for 6 seconds, so one small square is 1 mm and 0.04 seconds, and one large square is 5 mm and 0.20 seconds. A ruler and calipers work on the paper exactly as on a monitor printout.

Does the PDF come with answers?

Yes. The last page is an answer key. For each strip it gives the interpretation, the rate, PR interval and QRS measured on that strip, and the feature that decides the answer. The lethal rhythms are marked, because most hospital exams require every one of them to be right.

Which rhythms are on the paper?

The questions are shared out the way Relias publishes for its Dysrhythmia (Basic) assessment: sinus rhythms and atrial rhythms make up more than half, then the lethal rhythms, the AV blocks, ventricular ectopy, a paced rhythm and a junctional rhythm.

Can I get a different paper?

Yes, with a plan. A new paper is set each time you ask, from 492,000 different strips, in 20, 35 or 50 questions, with its own answer key. Paper A stays the same so that a class can sit it together.

Where do the strips come from?

Each strip is drawn by our own engine from the published criteria for its rhythm, on standard paper at 25 mm a second and 10 mm a millivolt. A separate program then measures the finished trace and has to arrive at the same rhythm, rate and intervals. 552,000 strips have been through that check.

Printable · PDF · Answer key

Printable EKG practice strips, with answers

A 20-strip dysrhythmia practice test to print and sit with a pencil: set out like a hospital exam, drawn at true scale so that calipers work on the paper, with an answer key at the back. Free, and no account is needed.

Open the free PDF: 20 strips with answers Download it8 pages · US Letter · prints in black and white too

The first two strips of Paper A

As they are on the paper: 6 seconds of lead II at 25 mm/s, one question and four whole interpretations to choose from. The other eighteen, and the answers, are in the PDF.

1.What is the interpretation of this strip?
- A.Normal sinus rhythm
- B.Sinus rhythm with first-degree AV block
- C.Second-degree type I (Wenckebach)
- D.Atrial fibrillation
2.What is the interpretation of this strip?
- A.Ventricular tachycardia
- B.Atrial fibrillation
- C.Asystole
- D.Ventricular fibrillation

What is in the PDF

True to scaleon screen and on paper: Every strip is 6 seconds of lead II at 25 mm/s and 10 mm/mV. One small square is 0.04 s, so intervals can be counted and measured with calipers.
Relias Basicoutline built in: One setting shares the questions out as Relias publishes for its Dysrhythmia (Basic) assessment: 31% sinus, 26% atrial, 17% lethal.
552,000strips measured before release: A separate program that sees only the finished trace reads every strip back. It has to find the rhythm, the rate and the intervals we report.

A cover sheet with the rules: 16 of 20 to pass, every lethal rhythm required, 30 minutes, and the five-step read to keep beside you.
Twenty strips, four to a page, each with four whole interpretations: 6 sinus rhythms, 5 atrial rhythms, 3 lethal rhythms, 2 AV blocks, 2 ventricular ectopy, 1 paced rhythm, 1 junctional rhythm. That is the balance Relias publishes for its Dysrhythmia (Basic) assessment.
An answer key with the interpretation of each strip, its measured rate, PR interval and QRS, the feature that decides it, and the lethal rhythms marked.
A score line for the total and for the lethal rhythms, the way the exam counts them.

How to print it at true size

Open the PDF and choose Print.
Set the scale to 100% or “Actual size”. “Fit to page” shrinks the squares.
Use US Letter paper. On A4 the strips still fit at 100%.
Check one strip with a ruler: it is 150 mm long, and five large squares are 25 mm, which is one second.

For instructors and educators

Paper A is the same for everyone, so a class or a unit can sit it together and go through the key afterwards. Print and copy as many as you need for teaching. The strips are large enough to project, and the measurements in the key give you numbers to point at.

For a different paper for each sitting, a plan sets a new one whenever you ask. For the same questions on screen, the online practice test times the paper and writes the report.

A new paper every time

Sit Paper A once and you know it. With a plan, each paper is set new from 492,000 different strips, 12,000 of each rhythm, with its own answer key: print one for tonight and another for the morning of the exam.

New papers come with a plan

Unlimited strips, every one explained, the caliper trainer and timed practice tests. $19.99 for 30 days. One payment, no subscription, and a refund within 24 hours if it is not for you.

Already have a plan? Log in

Get 30 days: $19.99 See both plans

Questions about the printable strips

Are these printable EKG practice strips free?: Yes. Paper A is a free PDF: 20 strips, a cover sheet with the rules, and an answer key. There is no account to create and nothing to pay. It may be printed and copied for a class.
Do the strips print at true size?: Yes, when the PDF is printed at 100% (“actual size”). Each strip is 150 mm long for 6 seconds, so one small square is 1 mm and 0.04 seconds, and one large square is 5 mm and 0.20 seconds. A ruler and calipers work on the paper exactly as on a monitor printout.
Does the PDF come with answers?: Yes. The last page is an answer key. For each strip it gives the interpretation, the rate, PR interval and QRS measured on that strip, and the feature that decides the answer. The lethal rhythms are marked, because most hospital exams require every one of them to be right.
Which rhythms are on the paper?: The questions are shared out the way Relias publishes for its Dysrhythmia (Basic) assessment: sinus rhythms and atrial rhythms make up more than half, then the lethal rhythms, the AV blocks, ventricular ectopy, a paced rhythm and a junctional rhythm.
Can I get a different paper?: Yes, with a plan. A new paper is set each time you ask, from 492,000 different strips, in 20, 35 or 50 questions, with its own answer key. Paper A stays the same so that a class can sit it together.
Where do the strips come from?: Each strip is drawn by our own engine from the published criteria for its rhythm, on standard paper at 25 mm a second and 10 mm a millivolt. A separate program then measures the finished trace and has to arrive at the same rhythm, rate and intervals. 552,000 strips have been through that check.

To practise on screen with each strip explained as you go, use the practice page; for a quick check, the 10-question EKG quiz; to read about a rhythm, the rhythm library. Simulated strips, for education and practice only.

Where this comes from

The criteria and rules on this page are taken from published sources, and every strip is drawn to them and then measured by a separate program before it is shown. How the strips are made and checked

American Heart Association. CPR and Emergency Cardiovascular Care guidelines: adult cardiac arrest, bradycardia and tachycardia algorithms. Which rhythms are shockable, and the first actions for the arrest rhythms, slow rhythms and fast rhythms.
American Heart Association, American College of Cardiology and Heart Rhythm Society. Recommendations for the standardization and interpretation of the electrocardiogram, part I (Circulation, 2007). The paper every strip is drawn on: 25 mm per second and 10 mm per millivolt.
University of Arkansas. How to Interpret Rhythm Strips, in the open EKG Interpretation manual. The five-step read and the normal ranges for rate, PR interval and QRS.
Relias. Dysrhythmia (Basic) Exam Content Outline (2021). The share of each rhythm category in the “Relias Basic outline” practice test and in the printable paper.