EKG Ch 6
Basic EKG Procedures
1. Patient Identification, Preparation, and Response to Emergency Situations
Importance of Patient Identification
Before conducting an EKG test, the technician must identify and prepare the patient.
Identification of oneself by name and title is required.
Use of interpreters is essential for patients who do not understand English, complying with facility policy.
Understanding Care as a Patient Right
Definition: Medical interpretation ensures patient understanding of their care, enabling them to answer questions and ask their own.
Many facilities use telephone- or computer-based interpretation services, which technicians must be familiar with.
Family or friends may assist in initial communication but cannot explain medical information.
Proper Patient Identification Procedure
Use two identifiers:
Full name
Date of birth
Technician should ask the patient to state their full name and date of birth, which are then checked against the provider's order.
Warning: Do not ask patients to confirm stated information, as they may mishear or misunderstand.
Avoid using addresses or room numbers, as these may change.
Wristband Verification
Confirm the identifier information matches what is on the wristband.
If discrepancies exist, report immediately; do not perform the test until identity is confirmed.
Patient Information Entry
If not using barcodes, manually enter:
Full name
Date of birth
Gender
Race
Medical record number
Provider's name
Additional details may be entered, such as medications, current symptoms, and special considerations.
Infection Control Practices
Utilize Standard Precautions in all interactions.
Increased precautions may be necessary for certain cases; refer to Chapter 2 for specific guidelines.
Inspect skin prior to electrode placement for moisture, dirt, or abnormal conditions (e.g., active sores).
Emergency Preparedness
EKG technicians must recognize and respond to emergency situations during testing.
Continuous monitoring of patient's condition is crucial.
2. Performing the 12-Lead EKG Test
12-Lead EKG Overview
Used as a screening or diagnostic tool for heart issues.
Technicians should assure patients that the test is painless and important for heart health.
Considerations for Pediatric Patients
Reassure children that the EKG is quick and painless.
Use simple terminology; refer to electrodes as stickers, thorax as chest or tummy, etc.
Allow children to ask questions before the test.
Considerations for Patients with Developmental Disabilities
Treat adult patients with disabilities as adults.
Parents/caregivers may stay with the patient during the test.
Use communication boards as needed and obtain consent before any physical contact.
Allow anxious patients time to feel comfortable before proceeding.
3. Steps for Obtaining a 12-Lead EKG
Equipment Needed
EKG machine, lead wires, electrodes, gloves (if required), patient gown, towel, clippers.
Procedure Steps
Identify yourself by name and the patient according to policy.
Wash hands.
Explain the procedure clearly to the patient, maintaining face-to-face contact.
Ask the patient to undress from the waist up and don a gown.
Ensure patient privacy while changing.
Assist patient into a supine position.
Set up the EKG machine.
Enter or scan patient information into the machine.
Prepare the patient's skin for electrode placement.
Attach electrodes in correct positions while ensuring patient modesty.
Instruct the patient to relax and be still as the test proceeds.
Monitor the trace for clarity; print EKG if satisfactory.
Assess EKG for lethal dysrhythmias or abnormalities, and report findings.
Disconnect wires gently, providing care as needed while removing electrodes.
Upload or file the EKG into medical records and document as per policy.
Clean the equipment and wash hands afterwards.
4. Patient Preparation and Monitoring for Telemetry
Telemetry Overview
Telemetry packs monitor cardiac activity over time.
Technicians monitor signals externally and must notify medical staff of changes.
Procedure for Applying a Telemetry Pack
Equipment: Telemetry pack, lead wires, electrodes, gloves, towels, clippers, instruction sheet.
Identify yourself and the patient.
Wash hands.
Explain the procedure clearly to the patient.
Ask the patient to undress appropriately and put on the gown.
Prepare the patient's skin as necessary.
Attach electrodes, ensuring proper skin care and position.
Connect to telemetry pack, test it to ensure it’s functional.
Instruct the patient to report any issues with electrodes or wires.
Document the procedure as required, ensuring accurate records.
5. Performing a Stress Test
Stress Test Purpose
Measures heart response under stress, used to detect potential heart problems.
May be administered using exercise or pharmacologic agents.
Instructions for Patients
Avoid caffeine for 24 hours prior to the test.
Follow directives regarding regular medications.
Fast for 3 hours before the procedure except for water.
Dress comfortably, in loose clothing and suitable footwear.
Target Heart Rate Calculation
Maximum heart rate calculation:
220 - ext{age}Target heart rate for testing:
ext{max HR} imes 0.85
Stress Test Equipment
Treadmill or stationary bike, EKG machine, lead wires, sphygmomanometer, gloves, towel, clippers.
Procedure for Conducting a Stress Test
Identify yourself and the patient, and wash your hands.
Explain the procedure clearly with reassurances.
Obtain baseline EKG and vital signs, then commence stress test.
Continuously monitor vital signs and adjust as necessary.
Document the test results and monitor recovery after the test concludes.