GE HEALTHCARE B20, Руководство пользователя

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B40/B20 Patient Monitor
10-10
Advanced arrhythmia troubleshooting
Why is the monitor calling
V Tach when the patient
is not in V Tach?
The monitoring system may be detecting a wider QRS complex or artifact in
some of the analyzed ECG waveforms. In addition, the V leads may be
exhibiting polarity changes, which may occasionally cause an inaccurate call.
1. Check the ECG signal acquired from the patient.
- Reprep the patient’s skin, replace electrodes, and adjust the electrode
placement.
- It may be beneficial to move V lead electrodes (chest lead) to alternate
precordial electrode placements to improve detection.
2. Relearn arrhythmia. It is important to relearn the patient’s ECG pattern any
time the electrode configuration is adjusted.
How can pacemaker
detection be improved? Possible problems include:
•
Heart rate double counting.
•
Inaccurate alarms for low heart rate or asystole.
•
Pacemaker spikes not recognized by the software.
•
False PVC detections and arrhythmia alarms.
Possible solutions include:
•
Relearn arrhythmia.
•
Try an alternate electrode placement.
Why is the monitor
double-counting the heart
rate, alarming for a low
heart rate, or not
detecting pacemaker
spikes? The monitor is not detecting pacemaker activity. Causes may include:
•
The pacemaker signal is too weak for the monitor to detect.
•
The ECG signal is too weak for the monitor to detect.
•
The monitor is detecting atrial pacemaker artifact or non-QRS features as
beats.
If the monitor is alarming for low heart rate or asystole, assess the QRS
amplitude.
1. View all ECG leads to assess the amplitude of the QRS complexes. To
ensure correct HR readings, a 0.5 mV QRS amplitude is recommended for a
normal ECG signal. If the QRS amplitude drops below 0.5 mV or an
abnormal QRS width occurs (more than 120 ms), QRS detection may be
reduced, leading to false
Asystole alarms.
2. If necessary, reprep the skin and reposition the electrodes.
3. Relearn ECG.
Symptom Possible cause and solution
Extra arrhythmia alarms The morphology of the ECG signal has changed.
•
Start relearning manually through the ECG menu.
Extra Ventricular
Fibrillations are detected Patient’s medical condition.
•
Check the patient status.
Low amplitude signal in some ECG leads.
•
Leads I and II: Select the one with the largest amplitude to ECG1.
•
After selecting the leads, start relearning manually.