Running the EKG and Artifact ECG Interpretation #319

Running the EKG

There are many manufacturers and models of ECG equipment in the field. You must refer to the equipment you use at your facility for operating instructions. Some machines have an ECG or Run button others have a 12-Lead button.

Wandering Baseline

Once the machine has printed the EKG, or it is viewed on the screen prior to printing. Inspect the image for artifact.

A wavering baseline is often referred to as wandering baseline, and it is often caused by poor skin prep or breathing in some instances.

Muscle (Somatic) Tremor

Choppy interference throughout the tracing is often caused by patient movement, even shivering or chewing gum can cause artifact known as somatic tremor.

If your patient is anxious or cold, try giving them a nice warm blanket. I have seen this work countless times.

Electrical Interference

Tight rapid oscillations seen in the tracing which looks like a caterpillar (thick and fuzzy) is a type of interference called 60-cycle or AC interference. This is electrical interference that may be caused by power cords, lighting or electrical wires in the walls, ceiling and floor. In a case like this, try to figure out the source of the problem. You may have to turn off the lights or move a power cord or in some cases change the angle of the bed (45 degrees has worked for me).

Make sure the patient is not wearing a cell phone or other electronic device and that the patient cables are within the confines of the patient.

This patient had a cell phone in their left hand.