Purpose of the Electrocardiogram (ECG) in Paramedic Practice

Purpose of the Electrocardiogram (cardiogram) in Paramedic designLachlan Donnet-JonesIntroElectrocardiogram, commonly abbreviated to cardiogram or EKG, is defined as a graphic tracing of the variations in galvanic potential ca employ by the excitationof the nervus muscle and detected at the body surface (Dorlands). An cardiogram observe maneuver is the device that has the ability to meditate and graphic every last(predicate)y present an electrocardiogram reading (Mosbys Dictionary of Med) via a digital monitor or printed on a strip of special graph paper knowing to show the rhythm of the heart over time (Mistovich). There ar m whatever unalike manufacturers of cardiogram monitors such as Philips and Physio-Control (ASNSW Protocols). An electrocardiogram monitor allows 2 methods of recording electrical legal action, a 4- legislate reading and a 12-lead reading. The electrocardiogram readings consist of three segments a P wave, QRS complex and a T wave. The PQRST waves be the components that create the waves or spikes presented on an cardiogram reading. cardiography has an coarse history dating back many centuries as pioneers of medical light were eager to understand the electrical meshality of the heart.History of ECG, what was before ECG?In the year 1600 William Gilbert discovered static electricity, a discovery that would eventuate in the development of one of the most important medical innovations of all time, the cardiogram. In the advance(prenominal) nineteenth century the first instruments were invented that were sensitive abounding to detect small electrical currents in the heart. The first functioning electrocardiogram was created by Willem Einthoven, a Dutch doctor and physiologist, in 1903. Einthoven won the Nobel evaluate in medicine in 1924 for his electrocardiogram invention.Prior to the invention of the electrocardiogram an instrument called the gearing galvanometer was exercised to detect electrical activity, it was an earlier invention of Einthovens. The string galvanometer could be used to measure cardiac electrical activity in a procedure where patients would submerge three of their arms into a salty solution creating Einthovens Triangle, a principle still used in contemporary electrocardiogram recording. Before both the electrocardiogram and string galvanometer were invented a device called the capillary electrometer was invented by Gabriel Lippmann in 1872. The capillary electrometer consisted of sulfuric acid and mercury in a capillary tube with wires at each end (WEST INDIAN MED JOURNAL). Similar to the string galvanometer Lippmanns device requires the patient to place limbs into tubs of saline solution and was the first device to read cardiac activity using this method (WEST INDIAN MED JOURNAL). Little did these early inventers know that their inventions would go on to be used thousands of times per twenty-four hours at all corners of the globe with its purpose and functionality contin ually polished and smooth over the years as is evident in modern sidereal day ECG monitors.http//www.jchimp.net/index.php/jchimp/article/view/14383/htmlhttp//caribbean.scielo.org/scielo.php?script=sci_arttextpid=S0043-31442005000300012lng=enhttp//www.ieeeghn.org/wiki/index.php/Willem_Einthovenhttp//en.wikipedia.org/wiki/Lippmann_electrometerNaming the waves of ECG their genesis.pdfThe origins of the electrocardiogram as a clinical instrument.pdfhttp//search.credoreference.com.ezproxy.utas.edu.au/content/entry/dicscientist/einthoven_willem_1860_1927/0?searchId=1a112bd3-b32d-11e3-9ce6-12c1d36507eeresult=0http//search.credoreference.com.ezproxy.utas.edu.au/content/entry/ehsmed/einthoven_s_triangle/0http//search.credoreference.com.ezproxy.utas.edu.au/content/entry/columency/galvanometer/0http//www.ecglibrary.com/ecghist.htmlPurpose functionalityThe ECG machines purpose and functionality is to provide information and understanding of the hearts electrical functionality. (MISTOVICH) T his includes information on the current rate at which the heart is beating, whether the heartbeat rhythm is regular or irregular, how strong the electrical signals are and the timing between the electrical signals.There are two methods to procure an ECG reading, a 4-lead and a 12-lead. The main difference is the bit of leads used to accomplish a reading which in effect allows for a better or worse reading. They are both effective in attaining information on the hearts electrical activity, however they are different and have their advantages and disadvantages. The 4-lead method, sometimes called 3-lead, typically uses three limb-leads RA (right arm), LA ( leave arm) and RL (right leg). severally lead is attached to the torso despite the lead labels indicating otherwise. The RA lead (white) is placed to the right side of the anterior chest just under the clavicle at the midclavicular line and is the negative lead, meaning it augments the signal of the LA lead. The LA lead (black, b rown or green) is placed OPPOSITE the RA lead and is the grounding lead. RL lead is the final lead and is placed to the left lower chest at about the seventh intercostal set on the anterior axillary line and is the positive lead. 4-lead monitoring is reclaimable as it is quick to apply and 4-lead monitoring has its benefits however it cannot deliver the like level of comprehensive and detailed information that a 12-lead reading is suitable of. The application of a 12-lead ECG monitor requires applying 10 leads, 4 limb leads and 6 precordial leads.4 lead12 leadPQRSTgraphical record paperDefibrillationPhillips, lifepakOther functionsGuidelines for electrocardiography.pdfhttp//www.southsudanmedicaljournal.com/archive/ may-2010/how-to-read-an-electrocardiogram-ecg.-part-one-basic-principles-of-the-ecg.-the-normal-ecg.htmlECG contribution to patient mindECG Monitoring is typically used following a aboriginal sound judgement especially in cases where at that place is a suspected douse with the heart or cardiovascular system. An ECG provides paramedicalals with information about the electrical functionality of the cardiovascular system. This is done by analysing the electrical activity displayed on the ECG reading and observing any changes in the waveform in congener to the rate and rhythm. As well as the rate and rhythm the paramedic would note any changes in the P wave, PR intervals, QRS complex, S-T segments and the P to R ratios (REFERENCE). Through this method of analysis the sign and symptoms of a patient pretended to be having cardiac issues can be confirmed for the initial diagnosing (REFERENCE). For example during the primary judging the patient is suspected of having a myocardial infarction and is showing symptoms of chest pain, hypotension, diaphoresis and a weak and rapid pulse the paramedics primary goal would be to obtain an ECG reading which can then confirm the initial assessment by virtue of the PQRST waveform. Ambulance wait on New S outh Wales protocols provides a proclivity of common conditions that may require ECG monitoring, the list includes Acute coronary thrombosis Syndrome (ACS), Dyspnoea (SOB), trauma, lowered level of consciousness (LOC), post syncope episode, cardiac dysrhythmias and many other conditions which interfere with the hearts normal capacity to function (ASNSW Protocols).Provides paramedic information in a situation (subsequent to primary assessment/surgery) that may involves cardiac issues, events or abnormalities via reading the ECG reading and linking any abnormalities in the PQRST waveform to the patients symptoms condition. (LOOK IN MISTOVICH, PP. 1463ish)Situations or indications that may require ECG monitoring include post syncopal episode, a rock-bottom level of consciousness, chest pain, acute coronary syndrome, shortness of breath, dysrhythmias or if any cardiac occurrence is suspected (ASNSW Skills 2011, 103.5.2).FOR EXAMPLES Myocardial Infarction etc. occasion a med journal /article/study?Strengths, weaknesses challenges faced by paramedics (critique)An ECG monitor such as the Phillips carried by Ambulance Tasmania or the Lifepak15 carried by Ambulance Service New South Wales are incredibly versatile diagnostic tools. They are portable and can be taken into the field to patients even in challenging situations such as the small interior of a change integrity car or a in a remote crotch hair area (ASNSW Protocols AT Protocols). The ECG monitor allows for immediate and continuous monitoring of the electrical functionality of the heart permitting a critical assessment of the patients condition to be made. The paramedic can then inform the receiving infirmary of the patients condition and allow for the necessary measures for treatment to be organised prior to the patients arrival. (REFERENCE)One of the significant faults of an ECG is it can only illustrate the electrical activity of the heart, it does not give notice (of) us how well the heart is functi oning mechanically (Jones, 2008).Though there are clear benefits of using an ECG monitor in the paramedic field there are also certain weaknesses in its use such as the unreliability of consistent and accurate ECG readings. It is inseparable for paramedics to accurately interpret ECG readings to avoid mistaken initial diagnosing which can prove costly for patient well-being in time-critical situations. lend factors to inaccurate ECG interpretation include cognitive bias and heuristics (mental shortcuts) (ECG READINGS BY DOCTORS). Properly cleaning skin with swabs, removing any hair in the guidance and certifying that the area is dry before application of electrodes will help to accession ECG accuracy and reduce inaccuracies (MISTOVICH ASNSW Protocols). Other environmental factors such as vehicle movement can contribute to inaccurate ECG readings by virtue of unstable leads creating artefacts. Similarly if the patient is in a agonistic or wrestles state it can interfere with clea r ECG readings, so keeping the patient calm, reducing anxiety and eliminating stressful factors can be beneficial to both acquiring vital information and the patients well-being. (REFERENCE)References2011 Electrocardiogram inDorlands illustrated medical dictionary, Elsevier health Sciences, Philadelphia, USA.2012 Electrocardiogram (ECG, EKG) inMosbys dictionary of medicine, nursing, health professions, Elsevier Health Sciences, Philadelphia, USA. Accessed 30 March 2014, from Credo ReferenceGoy, Jean-Jacques Staufer, Jean-Christophe Schlaepfer, Jrg Christeler, Pierre 2013, Electrocardiography (ECG), e-book, accessed 19 March 2014, http//UTAS.eblib.com.au/patron/FullRecord.aspx?p=1310813.Jones, SA 2008,ECG Success Electronic Resource Exercises In ECG Interpretation / Shirley A. Jones, n.p. Philadelphia F.A. Davis Company, c2008., Items in the Library Catalogue, EBSCOhost, viewed 19 March 2014.Resourceshttp//www.nhlbi.nih.gov/health/health-topics/topics/cardiogram/http//www.nlm.nih .gov/medlineplus/ency/article/003868.htmhttp//www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Electrocardiogramhttp//explosive detection system.b.ebscohost.com.ezproxy.utas.edu.au/eds/detail?sid=59a6c19e-901d-440a-b791-a71625c1f886%40sessionmgr114vid=1hid=104bdata=JnNpdGU9ZWRzLWxpdmU%3ddb=cat02831aAN=UTas.b1560119http//eds.b.ebscohost.com.ezproxy.utas.edu.au/eds/results?sid=127dd355-fcfc-42af-a93e-9ccff2e157c5%40sessionmgr115vid=1hid=104bquery=ecg+(PT+book+OR+PT+ebook)bdata=JmNsaTA9RlQxJmNsdjA9WSZ0eXBlPTAmc2l0ZT1lZHMtbGl2ZQ%3d%3d rascal 1 of 8