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EKGEKGPlain Plain and SimpleSimple
CHAPTER
Third Edition
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
EKG Plain and Simple, Third EditionKaren M. Ellis
Technical Aspects of the EKG
4
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
EKG Plain and Simple, Third EditionKaren M. Ellis
The EKG MachineThe EKG Machine
• Electrically speaking, the heart is a transmitter and the EKG machine is the receiver
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-1 Man Attached to EKG Machine
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EKG Plain and Simple, Third EditionKaren M. Ellis
Control FeaturesControl Features
• Chart speed: Regulates speed of EKG printout. Normal speed is 25 mm/second
• Gain: Regulates the amplitude of the EKG waves and complexes. Normal setting is 1
• Document any change in settings
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
EKG Plain and Simple, Third EditionKaren M. Ellis
Electrical SafetyElectrical Safety
• Macroshock: High-voltage shock that allows 110 volts to travel through skin– Caused by: Inadequate grounding of electrical
equipment (frayed/broken wires or cords, electrical outlet damage, or other)
– Results in: Burns, neurologic damage, fatality
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
EKG Plain and Simple, Third EditionKaren M. Ellis
Electrical SafetyElectrical Safety
• Microshock: Smaller shock that travels up a conduit into the heart (pacemaker, etc.)– Caused by: Frayed grounding wire or other– Results in: Burns, neurologic damage, fatality
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EKG Plain and Simple, Third EditionKaren M. Ellis
Electrical SafetyElectrical Safety
• ALWAYS CHECK FOR FRAYED WIRES OR COMPONENTS BEFORE DOING AN EKG
• NEVER USE A FAULTY MACHINE
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EKG Plain and Simple, Third EditionKaren M. Ellis
ArtifactArtifact
• Unwanted jitter or interference on the EKG tracing
• Four kinds– Somatic tremors– Baseline sway– 60-cycle interference– Broken recording
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EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-2 Somatic Tremors Artifact
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EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-3 Baseline Sway
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EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-4 60-Cycle Interference
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EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-5 Broken Recording
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EKG Plain and Simple, Third EditionKaren M. Ellis
TroubleshootingTroubleshooting
• Involves determining and alleviating the cause of artifact and recording errors
• Find the common limb of the affected leads and direct corrective efforts there
• May involve replacing electrode patches or reattaching loose or detached wires
• If artifact is on cardiac monitor in hospital, can change lead selector switch to monitor rhythm in another (clearer) lead
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EKG Plain and Simple, Third EditionKaren M. Ellis
Artifact Troubleshooting Artifact Troubleshooting Practice 1Practice 1
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EKG Plain and Simple, Third EditionKaren M. Ellis
Artifact Troubleshooting Artifact Troubleshooting Practice 2Practice 2
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EKG Plain and Simple, Third EditionKaren M. Ellis
Artifact Troubleshooting Artifact Troubleshooting Practice 3Practice 3
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EKG Plain and Simple, Third EditionKaren M. Ellis
Artifact Masquerading as Artifact Masquerading as AsystoleAsystole
• The rhythm looks like asystole (flat-line), but is artifact. Several monitor wires and patches were loose or disconnected. The patient was fine
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EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-7 Artifact Masquerading as Asystole (Flat-Line)
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EKG Plain and Simple, Third EditionKaren M. Ellis
True AsystoleTrue Asystole
• The next slide is true asystole. This patient has no pulse and is not breathing. It looks the same as the previous strip, doesn’t it?
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EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-8 True Asystole
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EKG Plain and Simple, Third EditionKaren M. Ellis
Toothbrush TachycardiaToothbrush Tachycardia
• The next slide is from a man who was brushing his teeth. The arm movements jiggled the EKG wires and created what appeared to be a dangerous rhythm
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-9 “Toothbrush Tachycardia” masquerading as a rhythm
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EKG Plain and Simple, Third EditionKaren M. Ellis
True Lethal RhythmTrue Lethal Rhythm
• The next slide is a true rhythm. Looks a lot like the previous strip, doesn’t it?
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EKG Plain and Simple, Third EditionKaren M. Ellis
Figure 4-10 Ventricular Tachycardia, a potentially lethal rhythm
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CPR ArtifactCPR Artifact
• Seen during CPR• Can resemble ventricular rhythms• May cause health care personnel to think
there is a rhythm when there is not