ECG/EKG Skills Outline

1. AGE SPECIFIC PRACTICE CRITERIA:

     - CHF- Newborn/Neonate (birth to 30 days)

     - Infant (30 days to 1 year)
     - Toddler (1 -3 years)
     - Preschooler (3-5 years)
     - School Age Children ( 5-12 years)
     - Adolescent (12-18 years)
     - Young Adults (18-39 years)
     - Middle Adults (39-64 years)
     - Geriatric (64 +)

2. EXPERIENCE WITH AGE GROUPS:

     - Able to adapt care to incorporate normal growth

       and development

     - Able to adapt method and terminology of patient

       Instructions to their age, comprehension and

       Maturity level
     - Ensures safe environment reflecting specific

        needs of various age groups

3. EXPERIENCE IN SETTINGS:
      - Acute care hospital
    - Regional/Large hospital
    - Outpatient
    - Physician’s office

4.  PATIENT PRIVACY:
     - Charting/Documentation/Consents/Care Plans
     - Confidentiality of Information/HIPAA.

5.  GENERAL SKILLS:
     - Ordering Supplies
     - Universal Precautions/Infection Control

       Procedures
     - Advance Directives
     - National Patient Safety Guidelines
     - Vital Signs
     - Use of transfer/lift devices
     - Pain management
     - Caregiver/Patient Education
     - Emergency Procedures
     - Normal lab values
     - Pulse oximetry
     - Equipment QC

6.  ELECTROCARDIOGRAM:
     - Application of leads  
     - Interpretation
     - Monitoring
     - Arrhythmias

7.  CARDIOVASCULAR ELECTROPHYSIOLOGY:
     - Cardiac cycle
     - Electrical conduction system
     - Refractory
     - Polarization
     - Depolarization
     - Action Potential
     - Phase 0
     - Phase 4

8. EKG INTERPRETATION:     

     - Ventricular tachycardia
     - Ventricular fibrillation
     - Atrial fibrillation
     - Atrial tachycardia
     - Atrial flutter
     - Junctional escape rhythms
     - Asystole
     - PEA (pulseless electrical activity)
     - Normal sinus rhythm
     - Sinus tachycardia
     - Sinus bradycardia
     - Acute myocardial infarction patterns
     - Cardiac pacemakers
     - Wolff
     - Parkinson
     - White
     - First degree heart block
     - Second degree heart block
     - Type I - Type II  

9.  EKG TECHNIQUES AND RECOGNITION:
     - P, Q, R, S and T waves
     - ECG measurement
     - Baseline values
     - Time heart rate
     - Voltage
     - Axis/hexaxial system
     - Intervals
     - Segments
     - Complexes

     - Normal and abnormal ST segment

 

10. RECOGNITON OF RECORDING

      ERRORS/ARTIFACTS:
     - Incorrect standardization
     - Incorrect paper speed
     - Lead reversals
     - Incorrect lead placement
     - Electrical; interference
     - Somatic tremor
     - Wandering baseline

 

11. ECG, HOLTER AND STRESS TESTING

      INSTRUMENTATION:
     - Lidocaine
     - ECG Calibration methods
     - Oxygen
     - Single channel
     - Isuprel
     - Three channel

12. STRESS TEST TECHNIQUES AND CONTAINDICATIONS: Protocols
     - Bruce
     - Modified Bruce
     - Naught on

13. HOLTER MONITORING:
     - Preparation techniques
     - Lead placement
     - Interpretation
     - Recognition of artefact

14. OTHER:
     - Temporary pacemakers
     - Permanent pacemakers
     - Event monitors
     - Emergency medications    

15. CARDIAC MEDICATIONS:
     - Calcium channel blockers
     - Nitrates  
     - Cardiolyte
     - Dobutamine
     - Thallium
     - Antihypertensives
     - Beta blockers
     - Cardiac glycosides
     – Antiarrythmics
     - Epinephrine 
     - Atropine
     - Verapamil

16. ECG LEADS:
     - Bipolar leads
     - Unipolar leads
     - Precordial leads
     - Einthoven’s triangle and law

17. SKIN PREP:
     - Prep techniques
     - Shaving
     - Test interpretation
     - Alcohol prep
     - Calculation
     - Diaphoretic patients
     - Double product
     - Bicycle procedure
     - Ergometers
     - Legs
     - Treadmill
     - Arms
     - Pharmacologic
     - Dipryridamole