24 Hour Ambulatory ECG Flashcards
How would you prevent infection/ damage to the monitor?
Put in a plastic wallet.
What is Class I for evidence?
Agreement that the treatment is useful and effective.
What is Class II for evidence?
Conflicting evidence and /or a divergence of opinion about the usefulness/ efficacy of a treatment.
What is Class IIa for evidence?
Weight of evidence is used in favour of treatment.
What is Class IIb for evidence?
Usefulness/ efficacy is less well established by evidence.
What is Class III for evidence?
Evidence and/ or general agreement that the treatment is not useful/ effective and in some cases may be harmful.
What is syncope?
A transient loss of consciousness, usually leading to a fall (onset is very rapid and recovery is spontaneous)
What are palpitations?
Increased awareness of heartbeat (benign or malignant)- described as being too forceful (unpleasant, pounding).
What do malignant palpitations mean?
Ventricular ectopics.
What is a differential diagnosis?
Trying to find out the cause of the symptom (eg syncope).
How do you prepare the patient for a lifeguard application?
-explain (obtain informed consent)
-reassure
-guidance (say it isn’t water resistant etc)
-dos and donts (no bath or shower, dont stand near microwaves)
How do you prep the skin?
-remove outer layer (dead cells)
-remove grease otherwise stickers will just fall off
-shave if necessary
-do not overprep (risk breaking the skin which will increase impedance).
For a good reading, do we want the impedance to be high or low?
Low as possible.
What is the electrode position for the red wire on lifecard?
Left anterior axillary line on 6th rib.
What is the electrode position for the yellow wire on lifecard?
Right sternal border at level of 2nd rib.
What is the electrode position for the green wire on lifecard?
Right anterior axillary line on 6th rib.
How to adjust the electrode positioning with larger patients?
Move the electrodes closer to the midline of the body to obtain larger complexes.
What is the purpose of a stress loop?
A stress loop is where you create a loop in the wire and tape across this so the pressure is removed from the electrode and stops the stickers coming off.
When checking the monitor, what position should the patient be in?
Have them do postural changes (sitting, standing and arm movements).
What is the point of a diary sheet?
Shows what activity the patient was doing when they had a symptom and how often they had symptoms. Also allows them to record mealtimes and when they go to sleep, making it easier when analysing.
What can be some issues with the recording?
-movement artefact (unstable electrodes)
-morphological changes
-wandering baseline
-AC interference
-broken patient cable
