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NMTEC 211-ECG Lab Instructions

1. The document provides instructions for a lab to practice placing ECG electrodes and identifying artifacts from rhythm strips. Students will work in gender-matched pairs. 2. It outlines safety procedures and machine preparation for 12-lead electrocardiograms. The greatest risk is from improperly placed electrodes or a malfunctioning device missing rhythm abnormalities. 3. Basic steps are explained, including powering up the machine, preparing electrodes and the patient's skin, placing electrodes in the correct locations, checking for artifacts, and printing the tracing.

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183 views4 pages

NMTEC 211-ECG Lab Instructions

1. The document provides instructions for a lab to practice placing ECG electrodes and identifying artifacts from rhythm strips. Students will work in gender-matched pairs. 2. It outlines safety procedures and machine preparation for 12-lead electrocardiograms. The greatest risk is from improperly placed electrodes or a malfunctioning device missing rhythm abnormalities. 3. Basic steps are explained, including powering up the machine, preparing electrodes and the patient's skin, placing electrodes in the correct locations, checking for artifacts, and printing the tracing.

Uploaded by

Risle
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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EKG Lab Summary and Instructions

1. Purpose of Lab:
 Practice placing ECG electrodes on fellow students (females working with females,
males with males)
 Practice printing rhythm strips and identifying artifacts
 Follow basic steps from Aehlert (below)

2. Safety/machine preparation for running 12-Lead Electrocardiograms


 Risk from leakage of current from the device to the patient is very small
o small amount of current may enter the patient, body interior is ‘wet’ and
conducts electricity
o tissue damage or ventricular fibrillation risk
 Greatest risk is from missed rhythm abnormalities as a result of improperly placed
electrodes, damaged wires, improperly prepped patient, or device malfunction.

3. Basic Steps involved (from Aehlert)


a. Power up the ECG machine
b. Check for function, making sure that the cable and lead wires are properly
connected
c. Explain the exam to the patient
d. Prepare electrodes by connecting one to the end of each lead wire
e. Prepare patient’s skin (see below)
f. Remove electrode backing and place each one in the appropriate location on the
patient’s chest
g. Check for artifacts
h. Ask patient to relax and print tracing

4. Patient preparation
 Explain procedure to patient
 Attach an electrode to each wire
 Prepare patient’s skin by rubbing with a gauze pad (alcohol or detergents are no
longer recommended)
 Shave or clip hair if necessary
 Remove electrode backing and place on the appropriate area
o Avoid areas with broken skin, rashes, bones, scars, or burns
 Patient should be relaxed and breathing normally

5. Electrode (patch) placement


 What are electrodes?
o Adhesive pads that are placed on a patient’s skin

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o Have a substance in the center that conducts electricity from the surface of
the body in that area
o Limb Electrodes:
 Placed on right arm (RA), left arm (LA), right leg (RL), and left leg (LL).
 Create the Frontal Plane leads
 Are bidirectional
 Measure electrical potential between two limb electrodes
 Leads I, II, and III (standard limb leads); Leads aVR, aVL, and
aVF (augmented limb leads)
o V1 through V6 Electrodes
 Create Precordial Leads
 Are unidirectional – electrical potential measured in one
direction only from a single electrode
 Where to place electrodes:
o RA lead (white) goes just below right clavicle
o LA lead (black) goes just below left clavicle
o RL lead (green) goes on the right side, below the rib cage
o LL lead (red) goes on the left side, below the rib cage
o V1 lead goes on the right side of the sternum at the 4th intercostal space
o V2 lead goes on the left side of the sternum at the 4th intercostal space
o V4 lead goes on the left side of chest at the mid-clavicular line in the 5th
intercostal space
o V3 lead goes between V2 and V4
o V5 goes on the left side of the chest in the 5th intercostal space at the anterior
axillary line
o V6 lead goes on the left side in the 6th intercostal space at the mid-axillary line

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6. Recording a 12-Lead
 What each lead ‘sees’
 Each lead measures the net result (or sum) of all electrical activity at that
particular position rather than all of the current flowing through the heart
 An EKG tracing is a graphical representation of the electrical activity from each
lead
 The vertical axis represents the voltage (amplitude) of the waveforms (expressed
in mm)
 Horizontal axis represents time
 Activity of the heart is shown with waveforms
o These may be positive (upward) or negative (downward)
o No activity is ‘baseline’
o The line between 2 waveforms is called a ‘segment’
o An ‘Interval’ is a waveform plus a segment
o A ‘complex’ is several waveforms together
o Each sinus rhythm is made up of waveforms

7. What will Electrocardiograms show?


 Orientation of the heart in the chest
 Heart rate
 Cardiac Rhythms
 Normal sinus rhythm
 Conduction disturbances/Arrhythmias
 Atrial fibrillation, PCVs, ventricular tachycardia, ventricular
fibrillation, heart block, Bigeminy/trigeminy, etc.
 Presence of ischemic damage
 Cardiac Function
 V3 and V4 – show anterior wall of the LV
 Leads I, aVL, V5, V6 – show the lateral wall of the LV
 Leads II, III, aVF – show the inferior surface of the LV
 V1 and V2 – show septal wall
o Lead II usually has tallest QRS of any non-chest leads, which makes it
good for monitoring gating, rate/rhythm

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8. Opportunities for Certification:
 NDT 350 EKG Dysrhythmias • 5 Credits at Bellevue College
Description:
This course covers standard EKG placement, cardiovascular anatomy, and
physiology, methods of EKG interpretation, and differentiation of normal and
abnormal rhythms. Students will learn to recognize sinus, atrial, junctional, and
ventricular dysrhythmias. Prerequisite: Permission of instructor.
 American Heart Association Courses (can be found online)

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