ECG Training Edan SE-601

1. Cardioscan Pty. Ltd. ECG TrainingEdan SE-601

2. Cardioscan Pty. Ltd. Company Information Cardioscan is the largest provider of cardiac reporting offering services to Pathology companies, General Practitioners and Private Hospitalsin Australia and has been running since 1984. Backed by a team of dedicated Cardiologists and Technicians. The mission: To deliver superior cardiac reporting services by providing excellent reporting turnaround times, 2 hours for urgent turnaround and 4 hours for normal ECG’s, 24 hour turnaround service for Holter and NBP’s. Our aim is for our customers to be able to transfer data electronically and receive these reports back in a timely manner with the ability to produce statistical reports reducing duplication and excessive paperwork.

3. Overview of Equipment • Edan 601 Monitor • 12 Lead Set • Trace Paper • Telstra WiFi Device • Netgear Device Picture

4. TRANSMITTING DEVICES • Netgear leads • Netgear (modem) • Telstra Wi Fi device

5. Cardioscan Pty. Ltd. ELECTRODES AND ALIGATOR CLIPS 12 Lead set – coloured coded Aligator clips with the correct fitting of electrodes

6. Initial Set Up Netgear cables 12 lead cable connection • Ensure the Edan ECG machine is placed on a stable surface or trolley • Attach the Blue Alligator clips to the 12 lead set and plug cord into the unit • Insert the 2 NetGear cables into the NetGear device then connect same cables to the right side of the Edan ECG unit

7. Cardioscan Pty. Ltd. ECG TRACINGSTEP ONE • Check Telstra WiFi device is on, turn on if required by pressing and holding power button. • Unit should remain on at all times, do not turn off. • Check a number 1 is beside signal tower at top centre of screen. • Check signal strength indicated by number of bars in top left corner.

8. Cardioscan Pty. Ltd. STEP TWO Press and hold power button until “booting” appears on screen . • Once the ECG machine is turned on check that the following 3 steps occur. • Power Light will be on • LAN light will be on • WLAN light will be amber and change to green once Telstra device is connected.

9. STEP THREEPLACEMENT OF LEADS Lead Placement Limb Leads Apply limb ECG electrodes to the soft tissue of limbs or outer torso LA: black – Left Arm LL: red – Left Leg RA: white – Right Arm RL: green – Right Leg Chest Leads V1: red– 4th Intercostal space, right sternal border. V2:yellow – 4th Intercostal space, left sternal border. V3:blue– Midway between V2 and V4. V4:green – 5th Intercostal space, midclavicular line. V5:orange– Anterior axillary line, horizontal to V4 V6: purple – Mid axillary line, horizontal to V4 and V5.

10. Cardioscan Pty. Ltd. STEP FOURPATIENT DATA - PRESS F1 PATIENT ID TO COMMENCE WITH “PREFIX” TAB TO OK THEN PRESS “ENTER” N.B: Lab Number must commence with Pathology site prefix Patient Details To enter patient details, Tab across to each field. If you tab past a field, press shift and tab together to return to field required When entering DOB use only one digit For example: 1st March 1978 = 1.3.1978 DO NOT USE ZERO other than in the year field If the ECG Trace is classed as URGENT, add # after the lab number. For example LV13765421# Press shift and 3 down together to produce hash symbol Once all fields have been completed, tab to OK then press enter button. This will return screen to ECG Tracing

11. Cardioscan Pty. Ltd. STEP FIVERECORDING ECG • Check patient details are correct • Ensure all leads are connected to patient • Check to ensure Netgear and Telstra devices are connected • To commence recording of ECG press stop / start button

12. Cardioscan Pty. Ltd. STEP SIX - CHECK • At top centre of screen under auto the following will appear; • Analysing (ECG trace sent to Patient File) • Printing (if programmed) • ECG Printout will occur automatically • Transmitting • The word Trans is visible until transmission is complete. • If transmitting NOT successful, ECG is stored, accessed and manually transmitted via F5, Patient Files (see Access Patient Files)

13. Cardioscan Pty. Ltd. • On completion of this final step the ECG will be automatically sent to Cardioscan in Melbourne for analysing and reporting • An ECG recording will be automatically saved in patient file.

14. To Access Patient Files Use the blue menu strip at the bottom of the screen as a guide. • Press F5 button (>>) and then press F2 button (File) • Use F1/F2 buttons to scroll up and down to required patient. • Once patient has been selected press F4 Button (Select) • Blue Menu Strip at the bottom of the screen will change to allow the following functions: • F1 = Edit– This allows you to change the patient information demographics • F2 = Trans– This allows you to send the ECG for reporting if T does not appear in the Column called STATE • F3 = Export– This allows data to sent to external device • F4 = Delete– This allows selected data to be deleted from recorder • F5 = Preview– This allows you to view ECG recording and if required print new copy of tracing by pressing F5 again

15. TROUBLE SHOOTING Incorrect Correct • Chest leads • poor contact or alligator clip is attached incorrectly to dot • Lead indicators are highlighted in yellow if incorrect

16. Troubleshooting http://incenter.medical.philips.com

17. HINTS FOR DOING THE ECG Prior • Ensure all equipment on ECG trolley: ECG electrodes, Chlor-Hex swabs, clippers and blades; check paper level in machine • Explain ECG procedure to patient • Wash hands • Patient Prep - Electrodes need good skin contact for good ECG tracing 1 Position patient 2 Expose chest area 3 For males shave chest as required • Enter patient data into machine – all fields MUST be filled (ref p2) Important • Be aware of any cardiac symptoms at the time of recording, such as chest pain, palpitations or shortness of breath • Symptoms must be hand written on the printout and reported to nurse in charge • Check Telstra Device connection – can be manually transmitted later • Ensure good quality ECG trace before printing/sending. • Remove electrodes: re-stick electrodes on plastic film from packet, place patient label on back of film and store in patient folder • Cover the patient and return them to a position of comfort • Wash Hands • Return ECG trolley to storage. Plug In yellow power cord. • Wipe leads with detergent wipes, replace equipment as required and leave trolley clean

18. Additional Information The small space between the clavicle and the 1st rib is NOT the 1st ICS The center of the active surface of the electrode should be aligned with the relevant anatomical landmark When recording and ECG from female patients, it is convention that V4 – V6 are placed under the breast. If correct anatomical positions are not possible, then position electrode in best practical position. Check for an inverted or negative QRS in lead aVR, as this indicates arm lead reversal Remember: “white is right” There are many rhymes to remember the limb leads – ask your senior nurses Using out of date / old electrodes may degrade the ECG signal quality.