# ECG Recording

## Overview

This module describes how to record an electrocardiogram (ECG).

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“I am doing a test called an ECG. It is used to check the rhythm of your heart.”

### What can my patient expect?

“I will put a few stickers on your chest and attach wires from the machine. These wires monitor how your heart is beating. It is not painful, and the wires will not shock you.”

### What is my patient’s role?

“While I do the test, I need you to stay still and not talk, otherwise I’ll need to repeat the test.”

## Preparation

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### Documentation

### Equipment

## Site & Positioning

Recline the patient at a 45° angle on a stretcher or bed. To minimise muscle tremor artefact, ensure that the patient is relaxed, comfortable and warm. Improperly grounded equipment in the room may also cause artefact.

Check whether the patient has a pacemaker in situ as this will explain the pacing mark on the ECG.

The ECG leads usually have a colour-coded diagram attached to show where to place each lead.

### Precordial leads

### Limb leads

## Procedure

Follow medical asepsis without gloves.

## Troubleshooting

My patient has excessive breast tissue or breast implants.

When you reach the breast tissue, it is best to lift it up and stick the electrodes to the chest under the breast. Sticking over the breast can interfere with readings.

My patient is very sweaty.

Wipe the patient’s sweat down with a dry paper towel and stick on the electrodes immediately.

My patient has body hair and I can’t find a razor.

If absolutely necessary, you can use an ECG electrode sticker to “wax” body hair off a patient’s chest. As this is very painful, try to find a razor first.

The ECG has come out with jagged, irregular lines.

Patient movement may cause artefact. Try to encourage the patient to lie still.

There is one area of flat line on the ECG.

One of the leads may have gotten detached while you recorded, or that lead is broken.

The tracings are indistinct.

Check that there is sufficient ink or if the stylus has malfunctioned.

## Risks

## References