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Artifacts module 3
Terms in this set (60)
What is an artifact?
- They are irregular and erratic markings on the EKG strips that should not be there.
What is an artifact caused by?
- movement, apprehension, poor conduction, outside interference, and faulty equipment or technique.
Artifacts affect the quality of the EKG tracing t/f
t/f - Artifacts do not make it more difficult to manually measure EKG cycles
true/false - Artifacts may cause false-positive results on an EKG analyzed by a computer
true/false- The Medical Assistant is responsible for producing a clear EKG tracing
t/f- The Medical Assistant should be able to identify artifacts and correct them
Why should the artifact filter on an EKG unit be used as little as possible?
- It can affect the diagnostic accuracy of the EKG.
If the Medical Assistant is unable to correct an artifact, what should he/she do?
- The physician should be consulted or notify supervisor it is possible that the EKG might be broken.
If an EKG service technician is required to come out, how can the Medical Assistant assist in locating the problem?
By knowing what has already been done to locate and correct the problem, know the leads in which the artifacts occur and having a sample of the artifact caused by the machine.
What are the 4 main types of artifacts?
Muscle artifact (somatic tremor)
2. Wandering Baseline
3. 60- cycle interference (AC artifact)
4. Interrupted Baseline
What is the most common type of artifact?
- Muscle Artifact
What is another name for a muscle artifact?
- Somatic Tremor
How can a muscle artifact be identified?
- Fuzzy, irregular baseline and jagged peaks.
List the things that commonly cause muscle artifacts:
● Patient discomfort
● Cold or tense patient (shivering)
● Patient movement
● Patient talking, laughing, or sighing
● A physical condition (tremors)
● Patient needing to void
What can the Medical Assistant do to help an apprehensive patient?
Try to reduce the patient's apprehension, explain the procedure using a calming voice and reassure the patient that having an EKG is painless.
What can the Medical Assistant do to help alleviate patient discomfort?
Make the patient feel more comfortable, ensure table is wide enough to support arms and legs, place a pillow under the patient's head or knees and ensure room temperature is comfortable for pt.
What instructions should be given to the patient to reduce movement during an EKG?
- lie still, breath normally, do not talk, laugh, or sigh during the recording.
What are some diseases and disorders that can cause a patient to have tremors?
Parkinson's, multiple sclerosis, stroke, brain damage, side effect of certain drugs, alcohol abuse or withdrawal, liver failure and overactive thyroid.
What can be done to help reduce artifacts resulting from patient tremors?
- Have the patient place hands down under the buttocks or place a pillow under patient's knees.
17. How can a wandering baseline artifact be identified?
- A "roaming" or "wandering" pattern and a movement of the stylus from center of EKG paper.
What things might cause a wandering baseline artifact?
● Dried-out electrodes ● Body creams, oils, lotions or sweat
● Excessive movement of the chest wall during respiration
● Oil from EKG technicians' fingers
What can the Medical Assistant do to prevent loose electrodes?
Ensure electrodes are attached firmly to patient's skin
● Ensure alligator clips are attached to electrode tabs
● Do not allow lead wires to dangle
● Ensure patient cable is well supported on patient's abdomen or table/
What can happen if the EKG cable is not well supported on the patient's abdomen or exam table?
- It can cause electrodes to pull away from the skin
What are two ways that the Medical Assistant can correct loose electrodes?
- Reattach with hypo-allergenic tape and replace with new electrode
22. How can the Medical Assistant prevent using a dried-out electrode?
- Check the expiration date on electrode pouch and discard outdated electrodes
23. What should the Medical Assistant do to correct a dried-out electrode?
- Replace with a new electrode
24. Why should a patient be instructed not to use body lotion, cream, oil, or powder before an EKG?
- To prevent good adhesion of electrodes to patient's skin.
25. If the patient is sweating or wearing body lotion, cream, oil, or powder, what can the MA do?
- Clean the skin thoroughly
What should the MA do if he or she notices the excessive movement of the patient's chest during an EKG?
- Encourage patient to relax and breath more calmly or take several tracings if necessary, to provide the best EKG strip possible for the physician.
27. How can the MA prevent transferring oil from his or her fingers to the patient's skin?
- Perform hand hygiene and avoid touching the sticky part of the electrode.
28. What is a 60-cycle interference artifact also known as?
- AC Artifact
29. What is a 60-cycle interference artifact caused by?
- Electrical interference
30. How can a 60-cycle interference artifact be identified?
- A wide, "fuzzy" baseline and is thick and unreadable
31. How does an electrical current create a 60-cycle interference artifact?
- From power used by electrical appliances in the room and may be picked up and carried into the machine.
32. What can a 60-cycle interference artifact result from?
Improper grounding of the EKG machine
● Too many electrical items plugged in nearby
● Other electrical equipment in the room ● Electrical wiring in the floor, ceiling, or walls
● Crossed and dangling lead wires
● An electrical power surge
33. What does the right leg electrode do with any outside electrical current?
It picks up electrical current that has "leaked" onto patient and carries it into the EKG machine through the machines grounding system.
34. How can you ensure that the EKG machine is grounded?
- By making sure the plug is securely in three-pong wall outlet.
35. What should be done if any items plugged in nearby are suspected of leaking electric current?
- Unplug all nearby electrical equipment and remove them form the room if possible.
36. Can jewelry and watches interfere during an EKG?
37. What instructions should a patient be given regarding jewelry and watches?
- Ask patient to leave all jewelry at home and to remove watches, necklaces, etc.
38. Can cell phones interfere during an EKG?
39. What instructions should a patient be given regarding cell phones before having an EKG run?
- Ask the patient to remove from the body and turn cellphones off
40. If the MA suspects that wiring in the walls is causing an artifact, what should be done?
- Move the patient table away from walls if possible
41. How can crossed and dangling lead wires be prevented?
- By separating and organizing wire before attaching them. Keep wire uncrossed and arrange wires to lie flat. Follow patient's body contour.
42. What should the MA do if there is an electrical power surge during an EKG test?
- Re-run another EKG strip
43. How can an interrupted baseline artifact be identified?
- A break is seen between waves on the EKG tracing
44. What can an interrupted baseline artifact result from?
Frayed or broken cable/wire
● Detached metal tip on a lead wire
● Loose cables
● Loose or detached electrode
45. What should the MA do if he or she discovers a frayed or broken cable or wire on the EKG unit?
- Immediately stop using the machine and use another machine. Order a new cable/wire from the manufacturer.
What should the MA do if he or she discovers a detached metal tip on a lead wire?
Reattach lead wire tip to alligator clip.
47. How should the Medical Assistant correct a loose cable?
- Check cables and their connection to the machine and ensure cables are plugged in completely.
48. How should the Medical Assistant correct a loose or detached electrode?
- Check all electrodes, reattach or reapply if necessary.
49. What does "asystole" mean and how does it appear on an EKG tracing?
- It means without a heartbeat and it appears as a flatline on an EKG tracing.
50. What could cause a flat line that looks like asystole to appear on an EKG tracing?
- Loose or disconnected wires can produce a flat line that looks like an asystole.
51. What would a flat line more than one lead indicate?
- Two lead wires are switched
52. What would a flat line on all leads indicate?
- EKG unit or connection is faulty or the patient is in cardiac arrest.
60-cycle interference (AC artifact)
Interrupted baseline artifact
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