57. Module 4 Reducing Artifact Unless you have a clear ECG to analyze, all you interruptive skills are of little use
58. Module 4 Reducing Artifact Stress labs obtain clear ECG’s while the Patient is running on a treadmill We should be able to obtain a 12 lead while the Patient is laying still
59. Module 4 Reducing Artifact As the heart depolarizes, an electrode on the Pt’s skin picks up the electrical activity
60. Module 4 Reducing Artifact It can also pick up other electrical signals
61. Module 4 Reducing Artifact To reduce artifact, we have to increase the heart’s signal and reduce the other electrical activity
62. Module 4 Reducing Artifact Artifact Reduction Strategy: Helping the electrode gel to better penetrate the skin will increase the signal strength from the heart and reduce the signal strength from other sources.
69. Module 5Tips and Techniques Supine is the proper position, if the Pt will tollerate
70. Module 5Tips and Techniques When the Pt changes position, the heart moves within the chest. This can cause ECG changes similar to a misplaced electrode.
71. Module 5Tips and Techniques Do your best to maintain the modesty of a female Pt
73. Module 5Tips and Techniques A folded blanket or towel may help hold the electrodes in place
74.
75. When ECG cables are looped around IV lines, O2 tubing, BP cuff tubing, or dangling between squad bench and stretcher you will have more artifact
76. Make sure the Pt isn’t twiddling the ECG cables
77. If unable to lay supine for ECG, place them semi-fowlers and breathing normally
78.
79. Module 5Tips and Techniques For some Pt’s obtaining a clear ECG will be difficult (e.g. respiratory distress Pt, sitting up) However, in most cases it is possible to a 12 Lead ECG with excellent, or at least acceptable data quality It just takes effort. A desire to obtain a clean 12 Lead and the knowledge to trouble shoot problems
80. Module 5Tips and Techniques Myocardial Infarctions are not like broken bones, and therefore, ECG’s are not like X-rays. If you’re treating a Pt with a broken hip. That x-ray could be taken now, 10 min’s from now, an hour from now and what would you see? A broken hip. With MI the events in the coronary artery can be changing moment by moment. The ECG can be very dynamic as well. There is a value to obtaining repeat ECG’s when you suspect MI. Making a habit of doing early and repeat ECG’s will help you identify a STEMI that could easily be missed.
83. Module 5Tips and Techniques This short course provides you with what you need to know in order to rapidly obtain a 12 Lead ECG that’s both clear and accurate Just as the case with ECG interpretation, acquisition also requires practice. After you’ve done this 20 or 30 times, you’ll become comfortable and confident FIN