Reading EKG’s is skill that is hard enough in a nice still cardiology office. But it can be even harder in the back of a moving ambulance. This Microwave Medic installment gives some EMS based advice on preventing artifact in your EKG’s.
Podcast: Download
Electrode Placement
http://www.mikecowley.co.uk/leads.htm
Artifact causes
http://www.general-devices.com/rx-ecg-artifact
Do you prep the skin before applying the ECG electrodes to the patient?
Were your electrodes pre-attached potentially drying out the electrodes?
Is there proper lead placement?
Check for placement on boney prominences or for correct lead placement.
Do you place the limb leads on the chest or limbs?
Ultimate EKG Guide
http://ems-safety.com/ult-ekg.htm
A Different Approach To Cardiac Monitoring
Have some artifact prevention tips? Post them below in the comments.
Hi Jim,
Thanks for commenting recently on my article in JEMS
Cool blog site. Hey the biggest thing for preventing artifact is skin prep. Three things
1. If their skin is sweaty, dry it off. use a towel and if necessary an alcohol wipe will buy you some time.
2. If their skin is hairy, MOW THE Yard. Use 3m surgical clippers to clip the chest. Do not use razors!
3. Knock off their dead skin. The outer layer of skin, the epidermis, is dead therefore it does not conduct electricity as well. Therefore the signal is not great. That is why you get the “Noisy data” or “waiting for good data text”
This can be accomplished by using the commercially available 3M Skin Prep tape, Which looks like Scotch tape with sandpaper on it, or use a strip from the Scotch Brite pad. A light abrading will knock off dead skin and allow better adhesion and better conduction. My paramedic class did a research project and found that on real patients, by prepping the skin in this manner, the increase in first attempt success on 12 lead acquisition was increased by 75% Not bad.
Bob Page, Multi-Lead Medics