Transcript The EKG Machine - CPRinthecity.com

EKG
Plain and Simple
Third Edition
CHAPTER
4
Technical Aspects of
the EKG
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
The EKG Machine
• Electrically speaking, the heart is a
transmitter and the EKG machine is the
receiver
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-1 Man Attached to EKG Machine
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Control 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
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Electrical 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
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Electrical 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
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Electrical Safety
• ALWAYS CHECK FOR FRAYED WIRES
OR COMPONENTS BEFORE DOING AN
EKG
• NEVER USE A FAULTY MACHINE
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Artifact
• Unwanted jitter or interference on the EKG
tracing
• Four kinds
– Somatic tremors
– Baseline sway
– 60-cycle interference
– Broken recording
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-2 Somatic Tremors Artifact
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-3 Baseline Sway
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-4 60-Cycle Interference
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-5 Broken Recording
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Troubleshooting
• 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
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Artifact Troubleshooting
Practice 1
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Artifact Troubleshooting
Practice 2
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Artifact Troubleshooting
Practice 3
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Artifact Masquerading as
Asystole
• The rhythm looks like asystole (flat-line),
but is artifact. Several monitor wires and
patches were loose or disconnected. The
patient was fine
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-7 Artifact Masquerading as Asystole (Flat-Line)
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
True 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?
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-8 True Asystole
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Toothbrush 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
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-9 “Toothbrush Tachycardia” masquerading as a rhythm
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
True Lethal Rhythm
• The next slide is a true rhythm. Looks a lot
like the previous strip, doesn’t it?
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
Figure 4-10 Ventricular Tachycardia, a potentially lethal rhythm
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.
CPR Artifact
• Seen during CPR
• Can resemble ventricular rhythms
• May cause health care personnel to think
there is a rhythm when there is not
EKG Plain and Simple, Third Edition
Karen M. Ellis
Copyright ©2012 by Pearson Education, Inc.
All rights reserved.