ECG TRAINING MODULE 3

1. ECG TRAINING MODULE 3 BY BRAD CHAPMAN RCT

2. OBJECTIVES • THE MACHINE TYPES • THE PAPER

3. SINGLE CHANNEL • This is an old single channel ECG machine. • This would connect to the patient with suction cups and creams

4. NEW SINGLE CHANNEL MACHINES • Very user friendly but doesn’t give enough diagnostic results for a hospital setting.

5. PHYLIPS PAGEWRITER • Very reliable machine • Only shows 3 leads on the screen at one time • Saves ECG tracings to disk to be downloaded

6. GE MAC 5500 • Shows 12 leads on the screen at the same time • Saves ECG’s to a network not disk

7. OTHER MACHINES • The machines used in Zone 3 are the MAC 5500 & Philips Pagewriter. • This training is not to promote one over the other. More emphases will be placed on the MAC 5500 as the older Philips machines will be replaced with this model.

8. What to look for on an ECG 1: Check for correct patient information, ordering physician, location, time and date. 2: Paper speed (25 mm/ms) 3: Standardization should be at (10 mm/mv) to check if this is accurate, check your squares at the end of leads V4, V5 and V6 . 4: All leads are visible and without artifact. 5: You should have a positive R wave in lead I.

9. What to look for on an ECG 6: You should have a good R wave progression in the chest leads V1 to V6. The R wave is small in V1 and becomes progressively larger as it continues to V6. 7: 1 P wave per QRS complex, 1:1 ratio. 8: Before removing your electrodes check to make sure all limb leads and chest leads are situated in the right position.

10. Troubleshooting problem ECG’s If you have artifacts in: Leads I or II, check the patient’s RA. Leads I or III, check the patient’s LA. Lads II or III, check the patient’s LL.

11. Troubleshooting problem ECG’s If you have no tracing at all and all your electrodes are well connected, check the control box, push on the wires on the box to make sure they are connected properly.

12. Troubleshooting problem ECG’s If you are having baseline wondering in one of the leads, check to make sure the leads and wires are well connected to the patient’s skin. If that doesn’t work, wipe off the tip of that particular wire. If the machine is not clean, this can cause artifact. Make sure the patient is not moving and is relaxed. Make sure your patient is comfortable with no limbs hanging on either side of the bed. If the skin is oily or the patient is diaphoretic, make sure you wipe the skin with alcohol & dry, before applying the electrode. If the patient is hairy do the necessary steps so that the ECG electrode remains in place.  

13. How do I use the new Machine? • Turn on power @ top Right Hand Corner • Push “F1” key for Patient Data • Enter all appropriate fields – ID Number is mandatory • Hit enter to go to next field • To enter Month, hit enter then push the down arrow to desired month, then push enter again • Confirm buttons read as follows if the machine was already on (it will default to these settings if you have just turned it on): • 25 mm/s • 10 mm/mv • 150 Hz

14. How do I use the new Machine? • Once a clear ECG is on the screen, (you should see a green light at the top right hand corner of the screen) press the ECG button • This button is green and on the right side • Push this only once • Press continue if satisfied • Choose either “Same Patient” or “Next Patient” • When you go to remove your stickers, make sure they are in the right spots and in the right order.

15. Changing the Paper/Editing To change the paper, press the button at the far back left hand corner. The lid will flip up and place the paper, tracing side up. To edit a poor quality tracing that has been stored, click on: “More” button “Main Menu” “File Manager” “Select” Move cursor up or down to choose ECG Press enter or center of arrows Press “Edit” To delete, do the same as above but choose “delete” not edit.

16. Movie Time!

17. GE HEALTHCARE INFORMATION TECHNOLOGIES MAC 5500 RESTING ECG ANALYSIS SYSTEM DVD 2028776-003

18. REVIEW QUIZ! • Thank you for your time.