Check patient name, date, and calibration
Verify paper speed and voltage
Assess heart rate
Assess rhythm regularity
Identify P waves
Measure PR interval
Measure QRS duration
Determine axis
Evaluate QT interval
Check for atrial enlargement
Check for ventricular hypertrophy
Look for ST elevation or depression
Look for T wave abnormalities
Look for pathologic Q waves
Compare with prior EKGs
Correlate findings with symptoms and clinical context