Managing an ECG Monitor involves setting up a continuous recording of the electrical activity of the heart, ensuring the recorder is functioning correctly, and interpreting the tracing. An electrocardiography monitor, or cardiac monitor, can be used to observe cardiac rhythm. It displays a single lead trace on a screen, in real time. ECG monitoring should be used in patients who may be at risk of developing arrhythmias, otherwise known as an abnormal rate or rhythm. This is to enable early detection and treatment of these arrhythmias, which may lead to cardiac arrest. The trace from an ECG monitor should only be used for rhythm recognition, not the analysis of other ECG abnormalities such as ST segment changes. When an arrhythmia occurs, a 12-lead ECG should ideally be recorded alongside the single lead monitoring trace. The procedure of Recording a 12 lead ECG is covered elsewhere in the Tomorrow’s Clinicians series.<\/p>\n
Once you have watched this video, why not attempt the multiple choice quiz to test your knowledge?<\/p>\n","protected":false},"excerpt":{"rendered":"
Managing an ECG Monitor involves setting up a continuous recording of the electrical activity of the heart, ensuring the recorder is functioning correctly, and interpreting the tracing. An electrocardiography monitor, or cardiac monitor, can be used to observe cardiac rhythm. It displays a single lead trace on a screen, in real time. ECG monitoring should […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,1],"tags":[],"class_list":["post-42","post","type-post","status-publish","format-standard","hentry","category-tomorrows-clinicians","category-uncategorized","entry"],"youtubeVideo":"471377456\/e6850c2e25","question1":"What are the indications for ECG monitoring?","answers1":" Arrhythmias\r\n| Cardioversion\r\n| During administration of anaesthesia\r\n| All of the above","correctAnswer1":"3","correctAnswerText1":"ECG monitoring can be used to monitor unstable arrhythmias, during treatment for arrhythmias e.g. cardioversion, or during anaesthesia as drugs given can cause arrhythmias.","question2":"How should the skin be prepared for placement of the ECG electrodes? ","answers2":"Use a razor to remove hair, exfoliate with an abrasive pad, clean with an alcohol wipe\r\n|Use a razor to remove hair, clean with an alcohol wipe\r\n| Exfoliate with an abrasive pad, remove hair with razor, clean with an alcohol wipe\r\n| Clean skin with alcohol wipe, remove hair with razor if required","correctAnswer2":"0","correctAnswerText2":"Use a razor to remove hair (if required), then exfoliate the skin with an abrasive pad, then clean with an alcohol wipe and allow to dry, before placement of electrodes.","question3":"Why is it important to place electrodes over bony prominences?","answers3":"To make the electrodes stick better\r\n| Gives a better ECG trace as electrical activity is conducted by bone\r\n| To reduce artifact produced by muscle tremor and activity\r\n| Easier for clinician to find landmarks for correct electrode placement","correctAnswerText3":"To reduce artifacts in the ECG trace, as it is skeletal muscle activity which produces artifact.","correctAnswer3":"2","question4":"Where should the electrodes for ECG monitoring be attached?","answers4":" Over the anterior shoulders bilaterally and lower left chest wall\r\n| Over the acromion bilaterally and left medial malleolus\r\n| Over the anterior shoulders bilaterally and the lower right chest wall\r\n| Over the acromion bilaterally and the left iliac crest","correctAnswer4":"0","correctAnswerText4":"","question5":"Typically, how many leads are used in ECG monitoring?","answers5":"1| 2| 3| 4","correctAnswer5":"2","correctAnswerText5":"Typically, 3 modified limb leads are used in ECG monitoring.","question6":"Typically how many leads are displayed on screen?","answers6":"1| 2| 3| 4","correctAnswer6":"0","correctAnswerText6":"One lead is normally displayed on screen, with the option to view other leads if required.","question7":"What is the correct limb lead placement for ECG monitoring?","answers7":" Red \u2013 right shoulder, green \u2013 left shoulder, yellow \u2013 left lower chest wall\r\n| Red \u2013 right shoulder, yellow \u2013 left shoulder, green - left lower chest wall\r\n| Red \u2013 left shoulder, yellow \u2013 right shoulder, green \u2013 right lower chest wall\r\n| Red \u2013 right shoulder, yellow \u2013 left shoulder, green \u2013 right lower chest wall","correctAnswer7":"1","correctAnswerText7":"Red \u2013 right shoulder, yellow \u2013 left shoulder, green - left lower chest wall, is correct, as an aide memoire \u2013 Red goes Right, Yellow goes Left, Green goes over Spleen (left lower chest wall).","question8":"Which lead\/s are normally selected for ECG monitoring?","answers8":" Lead I\r\n| Lead II\r\n| Lead III\r\n| All of the above","correctAnswer8":"1","correctAnswerText8":"Lead II displays large magnitude deflections for atrial and ventricular activity making rhythm recognition easier.","question9":"For female patients, what does the clinician need to consider during ECG monitoring?","answers9":" Chaperone\r\n| Patient dignity\r\n| Placement of electrodes\r\n| All of the above","correctAnswer9":"3","correctAnswerText9":"Since the chest is exposed a chaperone is usually required, preserve the patients dignity be ensuring privacy and covering up the patient as soon as possible, remember to place electrodes under breast tissue.","question10":"What interpretations can be made from ECG monitoring?","answers10":" Prolonged QT segment\r\n| Rhythm recognition \r\n| ST segment deviation\r\n| All of the above","correctAnswer10":"1","correctAnswerText10":"3 lead ECG monitoring should only be used for rhythm recognition, a 12 lead ECG recording should be used for diagnosis e.g. of a myocardial infarction.","question11":"","answers11":"","correctAnswer11":"","correctAnswerText11":"","question12":"","answers12":"","correctAnswer12":"","correctAnswerText12":"","question13":"","answers13":"","correctAnswer13":"","correctAnswerText13":"","question14":"","answers14":"","correctAnswer14":"","correctAnswerText14":"","question15":"","answers15":"","correctAnswer15":"","correctAnswerText15":"","icon":"managing-an-ecg-monitor","parentId":"","recapId":"394","_links":{"self":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/42"}],"collection":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=42"}],"version-history":[{"count":5,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/42\/revisions"}],"predecessor-version":[{"id":288,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/42\/revisions\/288"}],"wp:attachment":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=42"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=42"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=42"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}