Performing an ECG

Question 1

Name 4 different ways to verify a physician order for an ECG.

Answer 1

1. patient name/date of birth
2. location/date/time of recording
3. age/sex/race/cardiac medications
4. height/weight

Question 2

What does AMA stand for?

Answer 2

against medical advice

Question 3

How would you prepare a patient for an EKG?

Answer 3

Remove clothing from the waist up and remove jewelry

Question 4

What can chills produce?

Answer 4

artifact

Question 5

If a patient refuses an ECG, what should your next actions be?

Answer 5

determine the reason for refusal, if needed report to supervisor

Question 6

Where is the angle of Louis?

Answer 6

One inch below the suprasternal notch where the mandible and the main part of the sternum attach

Question 7

Where is an acceptable alternative place to place the upper extremity electrodes ?

Answer 7

deltoids

Question 8

What are universal safety and infection control

Answer 8

• wash your hands
• wear gloves when exposure to blood or body fluids
• wear mask

Question 9

Name 4 reasons for artifact.

Answer 9

1. somatic tremor
2. wandering baseline
3. AC interference
4. interrupted baseline

Question 10

Define Somatic tremor and what causes it.

Answer 10

large spike caused by muscle movement caused by: shivering, muscle tension, talking, chewing and fear

Question 11

Define wandering baseline and what causes it.

Answer 11

Baseline shift caused by improper electrode application

Question 12

Define alternating current interference and what causes it.

Answer 12

small uniform spikes caused by electricity radiated from other machines

Question 13

Define sources of AC interference and what causes it.

Answer 13

Scratchy EKG caused by high tension wires diathermy machines

Question 14

Define interrupted base line and what causes it.

Answer 14

EKG returns to baseline unexpectedly caused by loose or unplugged leads switched/broken wires

Question 15

How would you maintain equipment quality?

Answer 15

1. keep machine clean to prevent infection
2. dispose of electrodes
3. cleen wires between each patient

Question 16

Name different techniques to treat a pediatric patient during an EKG?

Answer 16

1. keep directions simple
2. avoid technical words
3. identify child by name
4. infants may need pacifier

Question 17

Name 3 things you may have to change during a pediatric EKG?

Answer 17

1. small electrodes
2. paper speed may need to be adjusted for faster heart rates
3. V3R

Question 18

Where would you place an amputees limb leads.

Answer 18

place leads on upper chest and lower abdomen

Question 19

Where would you place leads for a pregnant patient?

Answer 19

place lower limb leads on thighs, not abdomen

Question 20

How would you handle geriatric patients concerning electrodes?

Answer 20

apply electrodes carefully avoid damaging skin

Question 21

What is dextrocardia?

Answer 21

heart on right side

Question 22

When would you use a 15- or 18-lead ECG

Answer 22

1. right and/or posterior view
2. aid in detection of heart attacks

Question 23

In the case of cardiac or respiratory arrest what are you required to do as a CVT?

Answer 23

quick/efficient ECG pre enter patients info

Be prepared to run second ECG

Question 24

In the case of a seizure emergency, what would you be expected to do as a CVT?

Answer 24

Stay with patient call for help

perform ECG before and after

Question 25

What does MVA stand for?

Answer 25

Motor Vehicle Accident

Question 26

Name 4 areas where you should not place electrodes during a routine ECG?

Answer 26

1. bones
2. irritated skin
3. areas where there is a lot of muscle movement
4. incisions