Recording-2025-04-01T23:30:03.437Z

Overview of EKGs and PFTs

• EKG (Electrocardiography): Procedure that records heart's electrical signals.

  • Evaluates symptoms of heart disease and detects abnormal heart rhythms.

  • Useful after myocardial infarction (MI) to monitor progress.

  • Important for patients on heart medications to assess medication effectiveness.

• PFT (Pulmonary Function Test): Assesses lung function, measuring lung capacity and volume.

  • Typically ordered for patients experiencing shortness of breath (SOB).

  • Monitors effectiveness of respiratory or pulmonary medications.

Cardiac Conduction System

• Heart's electrical system controls heart rate and rhythm through electrical signals.

• Polarity: Refers to two separate poles (positive and negative).

  • At rest, cardiac cells are polarized (negatively charged outside, positively inside).

  • Depolarization: Loss of polarity; triggers muscle contraction (like an electrical shock).

  • Repolarization: Restoration of polarity; leads to relaxation of heart muscles.

  • The cardiac cycle includes contraction and relaxation phases.

EKG Machine and Tracing

• EKG Machine: Records the electrical activity of the heart, displayed as an EKG tracing.

  • EKG waves are labeled as P, Q, R, S, T based on their patterns.

  • 12-lead EKG: Records from 12 different viewpoints using only 10 electrodes placed on the body.

  • Electrodes: Disposable sticky pads that detect electrical impulses.

EKG Paper and Reading

• EKG paper moves at a speed of 25 mm/s.

  • Small squares: 1x1 mm (0.04 seconds), Large squares: 5x5 mm (0.2 seconds).

  • To estimate heart rate using the six second rule: Count R-waves in 30 large squares (6 seconds), multiply by 10.

Performing an EKG

• Set up in a private, quiet environment, free from electrical interference.

• Ensure the EKG machine has sufficient paper and fresh electrodes.

• Explain the procedure to the patient and ensure stillness during recording.

• Proper electrode placement:

  • 1 on each arm, 1 on each leg (limb leads).

  • 6 on chest (precordial leads).

Interpreting EKG Tracings

• Skillful recognition of normal vs. abnormal patterns is critical for MAs.

• Artifacts: Factors affecting EKG readings, such as:

  • Wandering baseline: Caused by patient movement or poor electrode adhesion.

  • Flatline: Indicates disconnected wire or potential cardiac arrest.

  • Alternating current interference: Caused by nearby electrical devices.

  • Somatic interference: Due to patient movement or tremors.

Common Cardiac Dysrhythmias

• Ventricular Fibrillation (V Fib): Life-threatening; ventricles quiver without effective blood pumping.

• Premature Ventricular Contractions (PVCs): Extra heartbeats from the ventricles, caused by various factors including MI or electrolyte imbalance.

• Atrial Fibrillation (A Fib): Fast heartbeats from the atrium, often linked to hypertension or heart attacks.

Other Cardiac Tests

• Stress Test: Records heart activity during exercise to assess oxygen demand.

• Echocardiography: Utilizes sound waves to view the heart in motion, multiple methods exist (transthoracic, transesophageal).

• Holter Monitor: Continuous recording of electrical activity for 24 hours to diagnose intermittent issues.

Pulmonary Function Tests (PFTs)

• PFTs measure lung capacity; spirometry is a common test using a spirometer.

  • Evaluates effectiveness of medications, especially inhalers for patients with conditions like asthma.

  • Preparing patients requires checking for recent illnesses and medications that could affect test results.

• Peak Expiratory Flow Rate: Measures quick air release; used by asthma patients for self-monitoring.

  • Color zones indicate condition: Green (good control), Yellow (caution), Red (medical emergency).

Conclusion

• Staff need a thorough understanding of procedures and equipment to effectively carry out EKGs and PFTs.

• Clear instructions and patient preparation are critical for obtaining accurate results.