12 Lead ECG : Medical Assistants Class


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  • When performing an ECG, the positioning of the patient should be:

    flat on their back

    Rationale: A patient should be lying on their back when an ECG is obtained. It is essential that a patient remain flat and still while the ECG recording is being processed so that an accurate tracing is obtained. Any movement of the body can create a tracing that is not legible, or difficult to interpret.

  • In order to obtain the best ECG recording possible, the patient should be instructed to:

    lie as still as possible

    Rationale: A patient should be lying on their back when an ECG is obtained. It is essential that a patient remain flat and still while the ECG recording is being processed so that an accurate tracing is obtained. Any movement of the body can create a tracing that is not legible, or difficult to interpret. If you are having trouble obtaining a good reading on a patient that is holding still, having them take a deep breath and hold it while the ECG tracing is recorded can be helpful.

  • When preparing a patient for an ECG, the should be instructed that:

    the procedure will be over within 5 minutes

    Rationale: An ECG is a fairly quick procedure, and does not require much preparation on the part of the patient. Setting up for an ECG typically takes longer than the test itself. Placement of the electrodes on a patient should take about a minute, and the recording of the ECG should take under 30 seconds. This estimate is for a cooperative patient, without any complications. The test may take longer if the patient is having difficulty remaining still, which often happens when the patient is having chest pain or difficulty breathing. There is no pain associated with an ECG, so no pain medication or sedation is required.

  • A diagnostic tool that is used to assess the electrical and muscular functions of the heart is:

    EKG or ECG

    Rationale: An ECG is a non-invasive procedure, that can be performed in a variety of health care settings. It is most commonly ordered on patients that complain of chest pain or shortness of breath. Medical assistants can be trained to perform ECGs through on-site training, or by becoming certified through an accredited organization.

  • When obtaining an ECG, electrodes are placed on the chest, arms, and:

    legs

    Rationale: An ECG is obtained by placing 10 electrodes on the body. Six electrodes are placed on the chest, 2 on the arms, and 2 on the legs. The electrodes work together to send a signal across the body, which then produces a tracing of how the heart is functioning. This tracing looks like a line, with several peaks and valleys.

  • ECGs are most commonly ordered on patients that complain of:

    chest pain or shortness of breath

    Rationale: An ECG is used to assess the function of the heart. When a patient is complaining of chest pain or shortness of breath, a physician may order an ECG to determine if the patient is having a heart attack, and to look at how well the heart is functioning. An ECG may also be ordered for numerous other medical complaints, since an abnormal heart function can produce a variety of complaints. For example, lightheaded or dizziness can be a sign of a low heart rate, so an ECG may be ordered to see how the heart is functioning.

  • After an ECG is obtained, the results will be given to the patient:

    after they are interpreted by the physician

    Rationale: An ECG tracing should be interpreted by someone that is trained properly before the patient is informed of the results. It is possible for a medical assistant performing an ECG to recognize an abnormal ECG tracing, but the results should only be given to the patient by someone that is educated to provide all treatment options. If a patient asks for their results, simply tell them that you only obtain the ECGs, and the physician will go over the results.

  • An ECG is obtained by:

    placing electrodes on the skin

    Rationale: ECGs are obtained by placing electrodes on the skin, which are connected to an ECG machine. This machine is a computer that interprets the information sent from the electrodes and produces several views of the heart. There are a total of 10 electrodes placed on the skin in a set pattern, which produces 12 electrical views of the heart. These views of the heart are traced onto a piece of paper, which are printed out for the physician to review. The tracing that is recorded allows the physician to assess the electrical and muscular function of the heart.

  • When obtaining and ECG on a patient, and there is a large amount of body hair present on the chest, it may be necessary to:

    shave the chest hair

    Rationale: It is essential that the electrodes make good contact with the skin during an ECG, and many patients may have barriers to prevent this from happening. The most common is chest hair, which should be removed in order to obtain the best recording possible. The entire chest does not have to be shaved, but just the few spots where the electrodes need placed. This may also need to be done on the arms and legs. Always be sure to tell the patient what you are doing before you shave them, and educate them on the importance of obtaining a proper ECG tracing. There may also be a problem with having the electrodes stick to the chest because the patient is diaphoretic, or sweaty. Attempt to dry the skin as much as possible in order to get the electrodes to stick properly.

  • By interpreting the tracings created by an ECG, the physician can determine the patient's:

    heart rate and rhythm

    Rationale: The tracing that is produced during an ECG can give a physician with a significant amount of detail as to what is going on in the heart. First is the rate, which is how fast the heart is beating. Second is the rhythm, which refers to the pattern in which the heart is beating, and at which part of the heart that the electrical impulses are created. These two details can allow a physician to determine the severity of a patient's illness, and if further testing is required.

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