Electrocardiography

Authors: Rednenko V.V., Rednenko L.I.

Editor: Rednenko V.V.

Equipment for the practical skill:

• patient (patient phantom, standardized patient)
• electrocardiograph
• electrode conductive gel (solution)
• gauze pad (when using conductive solution)
• container for collecting used pads
• couch
• movable table for placing the ecg apparatus

Clinical situation:

• You are a nurse at a hospital. Perform an ECG on the patient. The ECG machine is prepared for operation in advance (the patient cable is connected to the main unit, the scale is adjusted, the paper is loaded)

Order of the skill performance:

Preparatory stage:

• Perform patient identification:
  • say hello to the patient, introduce yourself
  • specify the last name, first name and patronymic of the patient
  • check the patient's name with the prescription sheet (referral)
• Get informed consent for the procedure
  • inform the patient about the upcoming manipulation
  • obtain verbal consent for it
• Position the patient for the procedure
  • have the patient free the chest, wrists, and lower legs from clothing
  • lay the patient horizontally
• Prepare for use and arrange equipment rationally
• Prepare the device for procedure:

• turn on the device
• select the speed of ECG registration
• select the desired mode
  • monitoring one of the lead groups
  • automatic mode - sequential registration of all 12 leads
• check (untangle) the patient cable wires without intertwining them

Maine stage:

• take a container with a electrode conductive gel (a pad moistened with a electrode conductive solution)
• apply the electrode conductive gel (solution) on the contact surface of the selected electrode and if necessary apply it on the patient's body
• apply and secure the electrodes to the patient's limbs:
  • red (R) - right hand;
  • yellow (L) - left hand
  • green (F) - left leg
  • black (N) - right leg

• place electrodes on the chest
  • V1 - 4th intercostal space along the right edge of the sternum;
  • V2 - 4th intercostal space along the left edge of the sternum;
  • V4 - 5th intercostal space on the left midclavicular line;
  • V3 - between V2 and V4;
  • V5 - at the level of V4 along the left anterior axillary line;
  • V6 - at the level of V4 along the left mid-axillary line.

• Turn on the ECG recording:
  • turn the ECG registration (press Start);
  • turn off ECG recording.
• Tear off the ECG tape (when using ECG recording on paper)

Final stage:

• Remove the electrodes
• Restore the workplace to its original state