Troubleshooting the ECG

Improper ECG monitoring is dangerous to patient care. Artifact in ECG monitoring can be annoying, costly and produce delays in proper care. Understanding the technical sources of artifact and care in the application of monitoring electrodes can significantly reduce or even eliminate the problem. Critical to the success of ECG monitoring are the technical aspects of proper equipment selection, preventive maintenance, and timely and rapid application to the patient, all to deliver the highest quality patient care. Just as critical is the prehospital clinician's understanding of equipment capabilities and limitations. Take time to read and understand the operator's manual for the ECG monitor/defibrillator in use in your ambulance. The ECG offers invaluable diagnostic information to EMS clinicians. With recent technological advances, today's ECG monitors provide even greater ease and versatility, which results in enhanced patient monitoring. Many factors can affect the quality of the ECG trace and therefore must be controlled in order to gain the most accurate and meaningful reading. Electrode placement and selection, as well as site preparation, are key considerations when applying and monitoring a patient's ECG.