EKG Artifacts and Troubleshooting

Artifacts in EKG Recordings

Broken Recording (Interrupted Baseline)

  • Occurs when the EKG machine cannot find a signal.
  • The stylus moves from side to side while the machine searches.
  • Common Cause: Frayed or broken lead wires (Fig. 7-7).
  • Prevention:
    • Check the EKG machine before each use to ensure lead wires are in good condition.
    • Do not use broken or frayed lead wires.

Somatic Tremor (Muscle Artifact)

  • Possible Causes:

    • Patient is cold.
    • Patient is experiencing a seizure.
    • Patient is experiencing tremor due to Parkinson's disease.
    • Patient is anxious.

  • Adaptations/Solutions:

    • Increase room temperature; offer a blanket.
    • Turn down lights and provide a quiet environment; delay EKG until the seizure is over.
    • Have patient place hands, palms up, under buttocks.
    • Reassure patient and encourage slow breaths.

Wandering Baseline

  • Possible Causes:

    • Patient's breathing is creating interference due to muscle movement.
    • Patient's body hair is preventing skin-electrode contact.
    • Natural skin oils or grooming products are interfering with skin-electrode contact.
    • Electrode gel is dried out.
    • Lead wires are tight or stretched.
    • Patient is very thin.

  • Adaptations/Solutions:

    • Encourage slow breaths; do not position limb lead electrodes on the torso.
    • Remove body hair using medical clippers or a razor.
    • Remove with soap and water and thoroughly dry skin.
    • Discard dry electrodes; store electrodes in airtight containers.
    • Place the machine close to the patient and avoid movement of wires during recording.
    • Place electrodes away from bony areas.

Electrical Interference (AC or 60-cycle)

  • Possible Causes:

    • There is electrical equipment in the area or interference being used by the patient.
    • There is an unknown source.

  • Adaptations/Solutions:

    • Move electrical equipment or turn it off if possible.
    • Turn off fluorescent lights and other nonmedical equipment in the room.
    • Do not use the machine with an extension cord.
    • Be sure the machine is properly grounded.
    • Move the machine to another location in the room or to a different outlet.

General Lead Wire Care:

  • Check for frayed or broken lead wires and replace if necessary.
  • Clean and store lead wires carefully to prevent wear.

Electrode Placement Errors

  • Electrode placement errors can create inaccurate EKG tracings.
  • Addressed in Chapter 9 (EKG rhythms and identification).