The Perils and Pitfalls of ECG Recording Jane

The Perils and Pitfalls of ECG Recording Jane Mackenzie Chris Monaco

What is an ECG and Why do we record it? • An ECG records the electrical activity of the heart muscle ECG recordings are used to • Identify normal and abnormal heart rhythms • To diagnose life threatening conditions • To detect heart attacks • To determine the next course of action or treatment for the patient.

How Do we Record it? To record an ECG you need • An ECG machine and cables • A comfortable couch • A warm environment • Electrodes • Privacy • A TRAINED competent operator • Oh. . . and a patient !!!

Perils and Pitfalls • You could put electrodes in the wrong place YOU CAN MISS A HEART ATTACK • You use the wrong machine settings You can hide or create abnormal waveforms and therefore the patient could get the Wrong Diagnosis • The recording is of poor quality It cannot be interpreted

ECG waveforms should look like this. .

And NOT like this ! Muscle Electrical Wandering baseline

How to record an ECG • https: //www. youtube. com/watch? v=lrj. AYCi 1 du. I

Patient Care • • • Patient is informed Environment is safe Relaxed and comfortable Identified ( 3 points) and consented Lie patient on couch/ bed Semi supine position as per guidance

Follow the Guidelines • • Place electrodes on limbs In correct position Trained operator is available Feel and count the rib spaces Always be accurate Leeway – there isn’t any ! Learn how to record an artefact free ECG Select the correct machine settings

This ECG is perfect ! Are yours ? ?

ECG Training at Bradford PCTC • Block One – Practical ECG recording • Block Two – Interpret a Normal ECG • Block Three - Recognise Abnormal Rhythms • Block Four - Acute Coronary Syndrome ( identify heart attacks on the ECG)