How to use an ECG machine
Enter the patientТs demographic information when prompted by the ECG machine, for quality assurance. This information prints out on the telemetry strip and is used in discerning one patientТs readings from another. The amount of leads you are using will now be identified. There are three types: 3-lead, 5-lead and lead. Set the machine to read the right amount of leads (either 12 . Jul 27, †Ј The machine has a turn dial that designates the type of lead input being used. Each lead type relays different information to the monitor, which is then printed out on the strip. Apply the leads as directed by your machine's literature. The lead ECG is the preferred type of monitoring, giving the best electrical activity picture.
An ECG also known as EKG or electrocardiography machine is used to identify what kind of electrical activity rhythm the heart is producing.
With this information a doctor can make the right decision on how to treat the patient's cardiac issues. Although ECG machines vary in look, set up 3 lead up to 12 lead styles and operation, all perform the same way by capturing a picture of the electrical current your body naturally produces through heart function.
ECG's come with how do i upgrade windows 7 to 64 bit manufacturer's manual to aid in using specific machines, but the basic steps of usage are universal. Ensure ECG is plugged in for a steady power supply most machines have a battery operated backup, but it is not good practice to rely on the battery first in case it dies during operation.
Check the connection between the ECG machine and the monitor. Enter the patient's demographic information when prompted by the ECG machine, for quality assurance. This information prints out on the telemetry strip and is used in discerning one patient's readings from another. The amount of leads you are using will now be identified. There are three types: 3-lead, 5-lead and lead. Set the machine to read the right amount of leads either lead, 5-lead or 3-lead.
The machine has a turn dial that designates the type of lead input being used. Each lead type relays different information to the monitor, which is then printed out on the strip. Apply the leads as directed by your machine's literature.
The lead ECG is the preferred type of monitoring, giving the best electrical activity picture. The name "lead ECG" can be misleading there are only 10 cords and is the most difficult to set up. With this set up you will use the patient's arms, a leg and chest, applying one lead to each arm, one lead to a single leg and one lead to the right clavicular line. All other leads go into a triangular pattern on the left chest area. The 3-lead type is used primarily in field transport by emergency medical responders to get a quick readout for the transfer to the hospital emergency room.
The 3-lead is easier and only takes a few seconds, by applying one lead to the right clavicular line, another to the left clavicular line; the third is the ground, to be placed anywhere in between the other two. The 5-lead type, which is rarely used, is a little more time consuming than the 3-lead, and just as effective. Based in Arlington, Texas, David Malec began writing what is a gamma seal lid in how to use an ecg machine He specializes in health, fitness, martial arts and military life.
Malec's work has appeared in military publications and in various online publications. He is a year veteran of the military. Malec has also graduated from nursing school, trained in the martial arts and become a Certified Personal Trainer.
By: David H. Malec Jr. Published: 27 July, More Articles. Home Fitness Cardio. References Utah School of Medicine.
How to use the machine
IntroductionThe electrocardiogram (ECG) can assist monitoring of a wide range of cases, such as emergencies, those undergoing anaesthesia and for critically ill patients. While being a valuable diagnostic tool in veterinary practice, many nurses are apprehensive about using the ECG machine, either due to uncertainty or unfamiliarity of the machine, or being unsure about what to look out for. Apr 29, †Ј This is an overview of the GE MAC EKG machine: onlinenicedating.com Medical is .
Charlotte Pace Tuesday, February 2, IntroductionThe electrocardiogram ECG can assist monitoring of a wide range of cases, such as emergencies, those undergoing anaesthesia and for critically ill patients.
While being a valuable diagnostic tool in veterinary practice, many nurses are apprehensive about using the ECG machine, either due to uncertainty or unfamiliarity of the machine, or being unsure about what to look out for, when in use. This practical and illustrated article gives explanations on how to use the machine and provides examples of the common rhythms and arrhythmias seen in practice.
An electrocardiogram ECG is a useful diagnostic tool in veterinary practice to assess heart rate and rhythm, but anecdotally, veterinary nurses seem reluctant to use the machine, citing two distinct challenges. First, knowing how to set up and use the machine correctly, and second, knowing what to look for when it is working. This practical article will explore both these issues, and suggest cases that might benefit from ECG monitoring. Cardiac muscle requires an electrical stimulus to start a contraction.
Figure 1 shows how specialised cells within the sino-atrial SA node start the conduction process, by firing an impulse that spreads across the atria depolarising contracting the muscle as it travels. The impulse passes through the atrioventricular AV node, to the ventricles using the His-Purkinje fibre network. As the impulse travels through the His-Purkinje network, the ventricles are depolarised.
This depolarisation is the catalyst for the systolic and simultaneous action of oxygenated blood being pumped through the aorta, and deoxygenated blood out through the pulmonary artery. Finally, as the cardiac muscle relaxes, the ECG records the repolarisation relaxation , as the muscle prepares for the next contraction. This process should result in a sinus complex, shown in Figure 2. Explanation of each part of the sinus complex, corresponding with electrical activity within the heart.
There are many different makes and models of ECG machine, which adds to the confusion of using them. Some machines have three cables for electrodes, usually coloured red, yellow and green.
Others have four cables, generally red, yellow, green and black. Some machines even have five cables, which include a white cable and electrode. American machines have a different colour scheme completely, so it is best to refer to the user manual for clarification.
There is however a standardised protocol for electrode placement, which can be followed, no matter how many electrodes are present.
If there is a fifth lead, this can be attached anywhere on the thorax. To minimise artefact, have the cable running in the same direction as the other cables. Conductive gel or spirit should be applied to the patient to improve contact. ECG machine configuration and functionality varies from basic machines to complicated top range models. If unsure how to use the practice machine, refer to the user manual and practice using it as much as possible.
Figure 3 shows an example of an ECG machine, with a few of the basic options highlighted. Most ECG machines will have a display screen, and different views can be chosen. Lead II should be visible, as this is the standard lead used for interpretation.
If only one lead can be viewed at a time, scroll through to select lead II. Other leads are available, but are generally used for more advanced ECG interpretation. Sensitivity Ч as a starting point, select 10 mV and adjust if necessary. The larger the number, the bigger the complexes will appear. Automatic or manual settings Ч automatic is good for monitoring because it displays on screen only, and does not print. Some machines have an analysis feature as well, which the veterinary surgeon VS may or may not require.
Filter switch Ч if there is a filter button, it may be useful to turn it on, to dampen interference. However, caution should be exercised because it can dampen all electrical activity, and so P waves especially on cats will be more difficult to interpret.
See for examples of artefact. Ideally, the patient should be calm, and in a quiet room for the ECG recording. The patient should be lying in right lateral recumbancy on a non-conductive surface, such as a vetbed. Place the electrodes as listed above, and use either surgical spirit or gel to improve conduction. Surgical spirit is flammable, and therefore should only be used if the patient will not be defibrillated. If the patient is in respiratory distress, the ECG should be taken in sternal recumbancy.
Figure 4 shows gold standard positioning, and in this picture, note how the cables come away from the patient, so that respiration does not interfere with the trace. Furthermore, the limbs are being held slightly apart to minimise muscle tremor or movement artefact. An ECG is used to measure heart rate and rhythm, so any case that is critically ill, is undergoing anaesthesia, has a history of collapse, or has an auscultation abnormality would benefit from ECG monitoring.
The benefit of having an ECG attached is that problems can be identified quickly and treated appropriately. Suggested cases that should have an ECG attached are seen in. If ECG monitoring is not routinely used for anaesthetic monitoring, there are some specific surgical cases that it would be beneficial to monitor, due to the disease process, or the effect of increased vagal tone.
Examples of this type of surgery include correcting gastric dilatation volvulus, ocular or adrenal surgery, or cases with sepsis, gastrointestinal disease, splenic disease, or upper respiratory tract obstruction. Please note this list is not exhaustive. Life-threatening rhythms are usually very fast or very slow, therefore determining the heart rate is a crucial first step. Sinus complexes are individual to each patient, so after determining the rate, it is important to assess whether each complex has a P-QRS for each and every complex Figures 5 and 6.
Sinus tachycardia Ч a regular fast rhythm with a P wave for every QRS complex. Often seen in excitable or stressed patients, and is very common in cats Figure 7. Sinus bradycardia Ч this is a regular slow rhythm with a P wave for every QRS complex.
It is often seen in resting dogs, but also in athletic or working dogs Figure 8. Sinus arrhythmia Ч a common arrhythmia seen in small animal practice. It always has a P wave, followed by a normal QRS complex, but the heart rate can vary. It is associated with vagal tone and often corresponds with respiration, particularly in dogs. This is a normal finding in dogs, but uncommon in cats Figure 9.
Second degree atrioventricular AV block Ч depending on the intrinsic heart rate, second degree AV block may or may not be clinically significant Dennis, Often seen with bradycardia and fit, healthy dogs Figure Ventricular premature complexes VPC Ч VPCs are a common finding in dogs and cats Martin, and can be caused by a variety of cardiac and non-cardiac causes.
They can vary in morphology and size, as seen below in Figures 11 Ч Common questions to consider are how frequently they occur, the underlying heart rate, and disease process. The arrhythmias that should cause alarm are generally either fast or slow ones. It should be repeated however, that if there is any concern whatsoever, a VS should be consulted immediately. Severe arrhythmias may result in haemodynamic compromise, and less severe arrhythmias can be an indicator for more severe arrhythmias or sudden death Dennis, Ventricular tachycardias Ч these arrhythmias are unstable because they are either too fast for proper and organised ventricular contraction, or are firing from many different foci within the ventricles.
Complexes can have a uniform or multiform appearance, but are usually wide and bizarre Figure Atrial arrhythmias Ч these are usually associated with structural heart disease and are haemodynamically unstable when very fast Figure 15 Ware, Atrioventricular block Ч high grade AV block 2nd or 3rd degree can be potentially life threatening because they can be haemodynamically and electrically unstable Figure There are three arrhythmias that are life threatening and require urgent attention.
All of the arrhythmias shown below Figures 17 Ч 19 would need immediate cardiopulmonary resuscitation CPR and electrical defibrillation. See for CPR algorithm. It may be beneficial to have a mental checklist ready when concerned about an arrhythmia, or a particular patient. Table 2 is a suggested checklist, with issues that might need to be addressed or discussed with the VS. Using an ECG can be beneficial to all patients undergoing anaesthesia, and routine procedures will allow time for staff to become comfortable with the machine and preferred settings.
Emergencies, patients in a critical condition, and high risk patients should all be monitored with an ECG to allow arrhythmias to be treated in an appropriate and timely manner. The role of the ECG should be to complement the monitoring techniques that veterinary nurses already employ, such as recording pulse rate and pulse quality, and respiratory rate and effort. Electrocardiogram ECG machines play an important role in monitoring patients and can be a useful tool for diagnosis.
Recommendations for the use of an ECG are emergencies, anaesthesia, post surgical cases, toxicity, electrolyte disturbances, if an arrhythmia is suspected or to assess the effectiveness of cardiac drugs. Increasing familiarity with the ECG machine will help build confidence in its use and interpretation.
If a life threatening arrhythmia has occurred, commence cardiopulmonary resuscitation CPR immediately and call for help. Sign up to The Veterinary Nurse's regular newsletters and keep up-to-date with the very latest clinical research and CPD we publish each month. Review How to use an ECG machine. Figure 1. Illustrates the conduction system and the path that each impulse takes. Figure 2. A sinus complex. Table 1. Section of the complex Event P wave SA node starts depolarisation process.
Impulse spreads from right to left across the atria, contracting the atria in a coordinated manner. When the whole of the atria have been depolarised, the electrical difference returns to baseline P Ч R interval The AV node slowly conducts the impulse from the atria to the ventricles to allow coordinated ventricular contraction. No muscle is depolarised, therefore the baseline remains flat Q wave Depolarisation of the ventricular septum. R wave The large muscle mass of the ventricles is depolarised via the His-Purkinje fibre network S wave Remaining basal regions of the ventricles are depolarised.
T wave Repolarisation of the ventricles. T wave morphology can vary largely from patient to patient, and are generally not of diagnostic value in small animal medicine How to use the machine Cables and electrodes There are many different makes and models of ECG machine, which adds to the confusion of using them.