EKG Ch 2
Basic Patient Care Skills
1. Importance of Monitoring Vital Signs
Vital signs are critical indicators of a patient’s cardiovascular health, primarily the function of the heart.
Measured prior to consultations with doctors or healthcare providers, establishing a patient's baseline measurements.
Re-evaluated upon:
Numerous tests
New or worsening complaints
Alterations in consciousness (e.g., loss of consciousness).
Vital Signs Include:
Body temperature
Pulse rate
Respiration rate
Blood pressure
Blood oxygen level (via pulse oximetry)
Pain level (may also be included in initial assessments).
Objective vs. Subjective Information:
Signs: Objective data, verified measurements accessible to medical professionals.
Symptoms: Subjective data, based on patient’s personal experiences.
Quick Reference: Ranges for Adult Vital Signs
Temperature (Fahrenheit):
Mouth (oral): 97.6°-99.6°
Rectum (rectal): 98.6°-100.6°
Armpit (axillary): 96.6°-98.6°
Ear (tympanic): 97.2°-100.1°
Temporal Artery (forehead): 96.6°-99.7°
Pulse Rate: Normal range is 60-100 beats per minute.
Respiratory Rate: Normal range is 12-20 respirations per minute.
Blood Pressure Ranges:
Normal: Systolic 90-119 mm Hg, Diastolic 60-79 mm Hg
Low (Hypotensive): Systolic Below 90 mm Hg or Diastolic Below 60 mm Hg
Elevated: Systolic 120-129 mm Hg and Diastolic Less than 80 mm Hg
Stage 1 Hypertension: Systolic 130-139 mm Hg or Diastolic 80-89 mm Hg
Stage 2 Hypertension: Systolic At or over 140 mm Hg or Diastolic At or over 90 mm Hg
Hypertensive Crisis: Systolic Over 180 mm Hg and/or Diastolic Over 120 mm Hg
2. Role of the EKG Technician in Infection Prevention and Control
Microorganisms: Living entities too small to be seen without a microscope, prevalent in the environment.
Pathogens: Harmful microorganisms that invade the body, causing infections.
Infection Prevention (Control): Set of practices that avert the spread of harmful microorganisms.
Types of Infections:
Localized Infection: Confined to a specific area with corresponding local symptoms (e.g., redness, swelling).
Systemic Infection: Spreads through the bloodstream, eliciting general symptoms (e.g., fever, chills).
Healthcare-Associated Infection (HAI): Infections acquired in healthcare settings, can be localized or systemic.
Six Links in the Chain of Infection:
Causative Agent: Pathogenic microorganisms (e.g., bacteria, viruses).
Reservoir: Places where pathogens live (e.g., humans, animals, soil).
Portal of Exit: Body openings through which pathogens leave the host.
Mode of Transmission: How pathogens travel (e.g., direct contact, air).
Portal of Entry: Body openings through which pathogens enter a new host.
Susceptible Host: Individuals who could become ill (e.g., patients, healthcare workers).
Infection Prevention Practices:
Handwashing (Most critical method to prevent infection).
Standard Precautions: Guidelines treating all blood and body fluids as potentially infectious.
Guidelines for Handwashing:
Use soap and water, keeping clothing dry to avoid contamination.
Wet hands thoroughly; apply soap, lather using friction for at least 20 seconds.
Rinse hands and wrists thoroughly under running water without touching sink edges.
Dry hands with a clean paper towel while avoiding contact with unwashed surfaces.
Use a clean towel to turn off taps.
Infection-Control Agencies:
Occupational Safety and Health Administration (OSHA): Sets standards for worker safety and health.
Centers for Disease Control and Prevention (CDC): Provides guidelines and conducts health research.
Guidelines for Standard Precautions:
Always use gloves during patient contact to prevent biohazard exposure.
Wear masks and goggles when exposure to fluids is possible.
Additional Transmission-Based Precautions:
Airborne Precautions: For diseases transmitted through the air (e.g., tuberculosis).
Droplet Precautions: For diseases that spread via droplets (e.g., influenza).
Contact Precautions: For diseases spread by touch (e.g., MRSA).
3. Guidelines for Measuring Body Temperature and Observing Skin Condition
Normal body temperature: Approximately 98.6°F (37°C).
Affected by factors like age, illness, environment.
Measuring Oral Temperature:
Equipment: Electronic thermometer, gloves, disposable probe cover.
Procedure:
Introduce yourself and confirm patient identity.
Ensure no food, drink, or activity has occurred that might alter readings.
Wash hands, explain procedure.
Insert thermometer under the patient's tongue, instructing them to keep lips closed.
After a tone or light signals readiness, read and record the temperature.
Observing Skin Condition:
Skin should be warm, dry, and free of discoloration.
Common skin abnormalities and interpretations:
Hot and Dry: Possible fever or heat emergency.
Cyanosis: Indicates low oxygen levels.
Pallor: May show decreased circulation.
Flushing: Indicates potential fever or heat.
4. Pulse Definition and Guidelines for Counting
Pulse: The heart's beat felt at various points in the body. It is generated by heart contractions.
Pulse Measurement Guidelines:
Normal adult pulse: 60-100 BPM.
Count for a full minute via palpation or auscultation (stethoscope).
Common pulse points: Radial (wrist), carotid (neck), brachial (arm).
Difference in pulse rates indicates possible health issues.
Counting and Recording Pulse:
Procedure involves identifying patient, washing hands, explaining measurements,
Record as per protocol, and report abnormalities.
5. Respirations Definition and Measurement
Respiration: The process includes inhalation and exhalation.
Count: One inhalation plus one exhalation.
Abnormal respiratory conditions: Apnea, Dyspnea, Tachypnea, Cheyne-Stokes.
Guidelines for Measuring Respirations:
Identify and confirm patient identity.
Count for a full minute while monitoring pulse.
Record findings and ensure accuracy.
6. Blood Pressure Definition and Measurement Guidelines
Blood Pressure: Measurement of the pressure in arteries during heartbeats identified as systolic and diastolic readings.
Normal ranges and units: Reported in mm Hg (e.g., 120/80).
Measurement Procedure:
Use manual or electronic sphygmomanometer.
Ensure patient stability and assess correct cuff size.
Record results accurately as well as which arm was used.
7. Pediatric Vital Signs
Ranges Change with Age: Pediatric patients have distinct normal ranges for heart rate, respiratory rate, and blood pressure.
Quick Reference: Pediatric Vital Signs
Age | Heart Rate | Systolic BP | Diastolic BP | Respiratory Rate
0-3 mo.: 110-160 | 65-85 | 45-55 | 30-60
3-12 mo.: 90-150 | 70-100 | 50-65 | 25-45
1-2 years: 90-150 | 90-105 | 55-70 | 20-30
Preschool: 80-120 | 90-110 | 55-75 | 20-30
School-age: 70-100 | 90-119 | 60-75 | 14-22
Adolescent: 60-100 | 90-119 | 70-80 | 12-20
8. Pulse Oximetry Readings
Pulse Oximeter: Device to measure oxygen saturation levels.
Normal reading: 95%-100%. Keep in mind factors affecting readings (e.g., cold extremities, nail polish).
Measuring and Recording:
Identify yourself and the patient.
Use appropriate sensor(s), ensuring it's placed correctly.
Document and report abnormal readings.
9. Importance of Monitoring Pain and Level of Consciousness
Pain Management: Although not a vital sign, monitoring pain is crucial due to its effect on physiological metrics.
Assess pain using questions regarding its:
Location
Onset
Severity
Description
Indicators of Pain:
Physiological responses: Increased pulse, uncontrollable behavior reactions like crying and frowning.
Assess consciousness through patient responses, and report changes immediately.
10. Patient Body Positions Used During EKG Testing
Common Positions:
Supine Position: Patient lies flat on their back.
Fowler's Position: Head elevated 45-60 degrees, often used in acute care.
Semi-Fowler’s Position: Head elevated less than 45 degrees.
Wrap-Up: Chapter Review
EKG technicians play a pivotal role in patient care, emphasizing the importance of managing and measuring vital signs while ensuring compliance with infection control protocols.