ECG TRAINING MODULE 3ECG TRAINING MODULE 3

BYBY

BRAD CHAPMAN RCTBRAD CHAPMAN RCT

OBJECTIVESOBJECTIVES

1.1. THE MACHINE TYPESTHE MACHINE TYPES

2.2. THE PAPERTHE PAPER

SINGLE CHANNELSINGLE CHANNEL

This is an old single This is an old single

channel ECG machine.channel ECG machine.

This would connect to This would connect to

the patient with the patient with

suction cups and creamssuction cups and creams

NEW SINGLE CHANNEL NEW SINGLE CHANNEL MACHINESMACHINES

Very user friendly but doesn’t give enough Very user friendly but doesn’t give enough diagnostic results for a hospital setting.diagnostic results for a hospital setting.

PHYLIPS PAGEWRITERPHYLIPS PAGEWRITER

Very reliable machineVery reliable machineOnly shows 3 leads on Only shows 3 leads on

the screen at one timethe screen at one timeSaves ECG tracings Saves ECG tracings

to disk to be downloadedto disk to be downloaded

GE MAC 5500GE MAC 5500

Shows 12 leads on the Shows 12 leads on the

screen at the same timescreen at the same timeSaves ECG’s to a Saves ECG’s to a

network not disknetwork not disk

OTHER MACHINESOTHER MACHINES

The machines used in Zone 3 are the The machines used in Zone 3 are the MAC 5500 & Philips Pagewriter. MAC 5500 & Philips Pagewriter.

This training is not to promote one over This training is not to promote one over the other. More emphases will be placed the other. More emphases will be placed on the MAC 5500 as the older Philips on the MAC 5500 as the older Philips machines will be replaced with this model.machines will be replaced with this model.

What to look for on an ECGWhat to look for on an ECG

1: 1: Check for correct patient information, Check for correct patient information, ordering physician, location, time and date.ordering physician, location, time and date.

22: Paper speed (25 mm/ms): Paper speed (25 mm/ms) 3: 3: Standardization should be at (10 mm/mv) to Standardization should be at (10 mm/mv) to

check if this is accurate, check your squares at check if this is accurate, check your squares at the end of leads V4, V5 and V6 .the end of leads V4, V5 and V6 .

44: All leads are visible and without artifact.: All leads are visible and without artifact. 5: 5: You should have a positive R wave in lead I.You should have a positive R wave in lead I.

What to look for on an ECGWhat to look for on an ECG

6: 6: You should have a good R wave You should have a good R wave progression in the chest leads V1 to V6. progression in the chest leads V1 to V6. The R wave is small in V1 and becomes The R wave is small in V1 and becomes progressively larger as it continues to V6.progressively larger as it continues to V6.

7: 7: 1 P wave per QRS complex, 1:1 ratio. 1 P wave per QRS complex, 1:1 ratio. 8:8: Before removing your electrodes check Before removing your electrodes check

to make sure all limb leads and chest to make sure all limb leads and chest leads are situated in the right position.leads are situated in the right position.

Troubleshooting problem ECG’sTroubleshooting problem ECG’s

If you have artifacts in:If you have artifacts in:

Leads I or II, check the patient’s RA.Leads I or II, check the patient’s RA.

Leads I or III, check the patient’s LA.Leads I or III, check the patient’s LA.

Lads II or III, check the patient’s LL.Lads II or III, check the patient’s LL.

Troubleshooting problem ECG’sTroubleshooting problem ECG’s

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

Troubleshooting problem ECG’sTroubleshooting problem ECG’s

If you are having baseline wondering in one of the leads, check If you are having baseline wondering in one of the leads, check to make sure the leads and wires are well connected to the 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 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 particular wire. If the machine is not clean, this can cause artifact. artifact.

Make sure the patient is not moving and is relaxed.Make sure the patient is not moving and is relaxed. Make sure your patient is comfortable with no limbs hanging on Make sure your patient is comfortable with no limbs hanging on

either side of the bed.either side of the bed. If the skin is oily or the patient is diaphoretic, make sure you If the skin is oily or the patient is diaphoretic, make sure you

wipe the skin with alcohol & dry, before applying the electrode.wipe the skin with alcohol & dry, before applying the electrode. If the patient is hairy do the necessary steps so that the ECG If the patient is hairy do the necessary steps so that the ECG

electrode remains in place.  electrode remains in place.  

How do I use the new Machine?How do I use the new Machine?

Turn on power @ top Right Hand CornerTurn on power @ top Right Hand Corner Push “F1” key for Patient DataPush “F1” key for Patient Data Enter all appropriate fields – ID Number is mandatoryEnter all appropriate fields – ID Number is mandatory Hit enter to go to next fieldHit enter to go to next field To enter Month, hit enter then push the down arrow to desired To enter Month, hit enter then push the down arrow to desired

month, then push enter againmonth, then push enter again Confirm buttons read as follows if the machine was already onConfirm buttons read as follows if the machine was already on

(it will default to these settings if you have just turned it on):(it will default to these settings if you have just turned it on): 25 mm/s25 mm/s 10 mm/mv10 mm/mv 150 Hz150 Hz

How do I use the new Machine?How do I use the new Machine?

Once a clear ECG is on the screen, Once a clear ECG is on the screen,

(you should see a green light at the top right hand corner of the screen) (you should see a green light at the top right hand corner of the screen) press the ECG button press the ECG button This button is green and on the right sideThis button is green and on the right side Push this only oncePush this only once Press continue if satisfiedPress continue if satisfied

Choose either “Same Patient” or “Next Patient”Choose either “Same Patient” or “Next Patient”

When you go to remove your stickers, make sure they are in the When you go to remove your stickers, make sure they are in the right spots and in the right order.right spots and in the right order.

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

Movie Time!Movie Time!

GE HEALTHCARE INFORMATION GE HEALTHCARE INFORMATION TECHNOLOGIESTECHNOLOGIES

MAC 5500 RESTING ECGMAC 5500 RESTING ECG

ANALYSIS SYSTEM DVDANALYSIS SYSTEM DVD

2028776-0032028776-003

REVIEW QUIZ!REVIEW QUIZ!

Thank you for your time.Thank you for your time.