Ateneo de Zamboanga University

College of Nursing

NURSING SKILLS OUTPUT (NSO)

Report No. 12

ECG APPLICATION

I. DESCRIPTION
The electrocardiogram (ECG or EKG) is a diagnostic tool that is
routinely used to assess the electrical and muscular functions of the heart.
While it is a relatively simple test to perform, the interpretation of the ECG
tracing requires significant amounts of training. Numerous textbooks are
devoted to the subject. The heart is a two stage electrical pump and the
heart's electrical activity can be measured by electrodes placed on the skin.
The electrocardiogram can measure the rate and rhythm of the heartbeat,
as well as provide indirect evidence of blood flow to the heart muscle.
A standardized system has been developed for the electrode placement for
a routine ECG. Ten electrodes are needed to produce 12 electrical views of
the heart. An electrode lead, or patch, is placed on each arm and leg and
six are placed across the chest wall. The signals received from each
electrode are recorded. The printed view of these recordings is the
electrocardiogram. Heart problems often affect the electrical activity of your
heart. Your doctor may recommend an EKG if you are experiencing
symptoms or signs that may suggest a heart problem, including:

Pain in your chest

Trouble breathing

Feeling tired or weak

Pounding, racing or fluttering of your heart, or a feeling that your

heart is beating unevenly

Detection of unusual sounds when your doctor listens to your heart

II. MATERIALS / EQUIPMENTS NEEDED:

WelchAllyn Schiller AT-1 3-Channel Electrocardiograph

III. PROCEDURES:

MACHINE PREPARATION:

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Connect the power cord to wall outlet. It can be used by back up built in battery unit
if necessary. (Fully charged batteries will last 2 hours on battery use)

PATIENT PREPARATION:

Assure patient there is no danger or pain involved. Have the patient remove
clothing above the waist and place in a cloth gown opening to the back if desired.
Make the patient comfortable lying down on the exam table. Expose the arms and
legs. If necessary shave the electrode areas before cleaning the exposed skin with
alcohol for proper electrode adhesion.

Limb Sensor Application

Place the sensors on a smooth fleshy area of the upper arms and lower legs. Attach
the limb leads.
Chest Sensor Application
Place the 6 Chest sensors on the patients chest as follows:
V1 Fourth intercostal space at right border of the sternum
V2 Fourth intercostal space at left border of the sternum
V3 Midway between position V2 and position V4
V4 At the mid-clavicular line in the fifth intercostal space
V5 At the anterior axillary line on the same horizontal level as V4
V6 At the mid-axillary line on the same horizontal level as V4 and V5
Attach the chest leads.

IV. DIAGRAM/ILLUSTRATION

V. NURSING RESPONSIBILITIES

A. Patient Preparation for Electrocardiography (ECG)

B. Explain to the patient the need to lie still, relax, and breathe normally during the
procedure.
C. Note current cardiac drug therapy on the test request form as well as any other
pertinent clinical information, such as chest pain or pacemaker.
D. Explain that the test is painless and takes 5 to 10 minutes.

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E. Implementation
F. Place the patient in a supine or semi-Fowlers position.
G. Expose the chest, ankles, and wrists.
H. Place electrodes on the inner aspect of the wrists, on the medical aspect of the
lower legs, and on the chest.
I. After all electrodes are in place, connect the lead wires.
J. Press the START button and input any required information.
K. Make sure that all leads are represented in the tracing. If not, determine which
electrode has come loose, reattach it, and restart the tracing.
L. All recording and other nearby electrical equipment should be properly
grounded.
M. Make sure that the electrodes are firmly attached.
N. Nursing Interventions
O. Disconnect the equipment, remove the electrodes, and remove the gel with a
moist cloth towel.
P. If the patient is having recurrent chest pain or if serial ECGs are ordered, leave
the electrode patches in place.

REFERENCES:

http://nursingcrib.com/medical-laboratory-diagnostic-test/electrocardiography-ecg/

http://www.healthline.com/health/electrocardiogram#OtherOptions3

Sept. 09, 2015 Maria Fe Aguilar, RN, MN

Date Clinical Instructors Initials

JAN PATRICK R. CABRERA

BSN III - B

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