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10.
RECORD AN ECG
Patient Preparation
Before attaching the electrodes, ensure the patient fully understands the procedure and what to expect.
Privacy is very important in ensuring the patient is relaxed.
Reassure the patient that the procedure is painless and that the electrodes on their skin are all that they
will feel.
Make sure the patient is lying down and is comfortable. If the table is narrow, tuck the patient’s hands
under his/her buttocks to ensure their muscles are relaxed.
Once all the electrodes are attached, ask the patient to lie still and not talk. Conditions such as jerking,
shivering, or muscle tremors can interfere with ECG results. Explaining the process to the patient may help
relax them further and assist in acquiring a good ECG.
Preparing Patient Skin
Thorough skin preparation is very important. There is natural resistance on the skin surface from various sources
such as hair, oil, and dry, dead skin. Skin preparation is intended to minimize these effects and maximize the quality
of the ECG signal.
To prepare the skin:
Shave or clip hair from electrode sites if necessary.
Wash area with warm, soapy water
.
Dry skin vigorously with a pad such as 2 x 2 or 4 x 4 gauze to remove dead skin cells and oil, and to
increase capillary blood flow.
NOTE
: With elderly or frail patients take care to not abrade the skin causing discomfort or bruising.
Clinical discretion should always be used in patient preparation.
Patient Hookup
Correct electrode placement is important for acquiring a successful ECG.
A good minimum-impedance pathway will provide superior noise-free waveforms. High quality silver-silver
chloride (Ag/AgCl) electrodes similar to those provided by Mortara are recommended.
TIP
: Electrodes should be stored in an air-tight container. Electrodes will dry out if not stored properly
causing loss of adhesion and conductivity.
To Attach the Electrodes
1.
Expose the arms and legs of the patient to attach the limb leads.
2.
Place the electrodes on flat, fleshy parts of the arms and legs.
3.
If a limb site is not available, place the electrodes on a perfused area of the stump.
4.
Attach the electrodes to the skin. A good test for firm electrode contact is to slightly tug on the electrode to
check adhesion. If the electrode loosens, it needs to be changed. If the electrode is secure, a good
connection has been obtained.
TIP
: Check the display for any notification messages indicating lead problems.
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