1. The use of ECG monitor
For critically ill patients, continuous monitoring of heart rate, rhythm, respiration, blood pressure, pulse and meridian is required. Patients with skin oxygen saturation, etc.
Second, ECG monitor electrode placement positions
There are five electrode placement positions as follows:
Right upper (RA): the first intercostal space in the midclavicular line on the right sternum border.
Right lower (RL): at the level of the xiphoid process on the right midclavicular line.
Middle (C): Fourth intercostal space on the left side of the sternum.
Upper left (LA): the first intercostal space at the midclavicular line on the left sternal border.
Lower left (LL): at the level of the xiphoid process on the left midclavicular line.
III. Operation process of ECG monitor
Preparations: mainly ECG monitor, ECG blood pressure plug-in connection lead, electrode pads, normal saline Cotton balls, matching blood pressure cuff.
The operation procedure is as follows:
1. Connect the power of the ECG monitor.
2. Place the patient in a supine or semi-recumbent position.
3. Turn on the main switch.
4. Wipe the skin where the electrodes are attached to the patient’s chest with a saline cotton ball.
5. Paste the electrodes, connect the ECG lead wires, and the ECG oscilloscope will appear on the screen.
6. Tie the cuff to the two fingers above the elbow socket. Press measure – set alarm limit – measure time.
4. Matters needing attention during monitoring of different functions
1. Matters needing attention during ECG monitoring
1) Take out the ECG lead wire, align the convex surface of the plug of the lead wire with the groove of the “ECG” jack on the front panel of the main unit, and insert it.
2) Connect the other end of the ECG lead wire with 5 electrode heads to the human body to be tested. The steps for correct connection are:
a. Use 75% ethanol for The surface of the measurement site is clean, the purpose is to remove the stratum corneum and sweat stains on the human skin and prevent poor contact of the electrode pads.
b. Fasten the electrode head of the ECG lead wire with the electrodes on the 5 electrode pads.
c. After the ethanol has evaporated cleanly, stick the 5 electrode sheets to the specific position after cleaning to make the contact reliable and not fall off.
d. Clamp the placket clip on the lead wire to the hospital bed and fix it. And tell the patient and medical staff not to pull the electrode wire and lead wire.
3) Please be sure to connect the ground wire, which will play a very important role in the normal display of the waveform.
2. Precautions for blood pressure monitoring
The connection between the blood pressure cuff and the patient is different for adults, children and neonates, and must be Use cuffs of different sizes, here is only an example for adults.
1) After the cuff is deployed, it should be wrapped around the patient’s elbow joint at 1-2cm, and the tightness should be suitable for inserting 1-2 fingers. Too loose may lead to high pressure measurement; too tight may lead to low pressure measurement, while making the patient uncomfortable, affecting the patient’s arm blood pressure recovery. The catheter of the cuff should be placed at the brachial artery, and the catheter should be in the extension of the middle finger.
2) The arm should be kept flush with the human heart, and the patient should be instructed not to speak or move when the blood pressure cuff is inflated.
3) During the pressure measurement, the position of the cuff on the arm should be kept flush with the heart, and the patient should not speak or move.
4) The pressure measuring arm should not be used to measure the body temperature at the same time, which will affect the accuracy of the body temperature value.
5) There should be no intravenous drip or malignant trauma, otherwise it will cause blood backflow or wound bleeding.
6) Generally speaking, the first pressure measurement is only for reference
3. Precautions for blood oxygen monitoring
1) The plug of the blood oxygen probe and the “blood oxygen” jack on the host panel must be inserted in place. Otherwise, the blood oxygen information may not be collected, and the blood oxygen value and pulse value cannot be displayed.
2) It is required that the patient’s nails should not be too long, and should not have any stains, dirt or onychomycosis. If the patient’s finger feels uncomfortable after blood oxygen monitoring for a long time, another finger should be replaced for monitoring.
3) The patient and medical staff should not collide and pull the probe and wire to prevent damage and affect the use.
4) The position of the blood oxygen probe should be separated from the blood pressure measuring arm, because blood flow is blocked during blood pressure measurement, but blood oxygen cannot be measured at this time, and the screen displays “blood oxygen probe off” typeface.
4. Precautions for external power supply
1) The quality of the power distribution box should be good and reliable, and the plug connection should be firm. In order to avoid poor contact of the plug, the host cannot work normally, and even the power supply of the host will be damaged.
2) The principle of uninterrupted and stable power supply.
V. Main observation indicators of ECG
1. Regularly observe and record heart rate and rhythm.
2. Observe whether there is a P wave, and what is the shape, height and width of the P wave.
3. Measure PR interval and QT interval.
4. Observe whether the QRS waveform is normal and whether there is “missing beat”.
5. Observe whether the T wave is normal.
6. Pay attention to whether there is any abnormal waveform.
