There are two different ways to establish the heart rate:
Method 1
Here we divide 300 by 3 (number of big squares between the QRS peaks).
This gives a rate of 100bpm
NOTE: you can only use this method if the rhythm is regular and it only gives an estimated bpm
Method 2
Here we count off 30 large squares and count how many QRS peaks fit in this. Then we multiply that number by 10.
In this case there are 9 peaks in 30 squares and so the rate is 9 x 10 = 90 bpm.
NOTE: you need to use the rhythm strip to count off the squares
NOTE: it doesn't matter if the rhythm is irregular you can still use this method
NOTE: see how we get a slightly different and more accurate rate using this method than the last