Cardiac monitoring

continuous or intermittent monitoring of heart activity, generally by electrocardiography, with assessment of the patient's condition relative to their cardiac rhythm.

1. CARDIAC MONITORING BY RAJEE RAVINDRAN

2. PURPOSE A device that shows the electrical and pressure waveforms of the cardiovascular system for measurement and treatment. Parameters specific to respiratory function can also be measured. DEFINITION Continuous cardiovascular and pulmonary monitoring allows for prompt identification and initiation of treatment.

3. TYPES OF MONITORS Non Ambulatory Monitors Ambulatory Monitors Holter Monitor 2. Event Recorder 3. Mobile Cardiac Telemetry (MCT)

4. 4. Insertable Cardiac Monitor (ICM)/Implantable Loop Recorder

5. DESCRIPTION

6. DEFIBRILLATOR Defibrillator is a device that delivers therapeutic dose of electrical energy (electric shock) to the affected heart (fibrillated heart or other shockable rhythm) to force the heart to produce more normal cardiac rhythm.

7. CARDIOVERSION AND DEFIBRILLATOR

8. CARDIOVERSION DEFIBRILLATOR Synchronised delivery of shock to the QRS complex Less energy shock Used in Stable patient Indications: Unstable atrial fibrillation, atrial flutter, atrial tachycardia and supraventricular tachycardias Non- synchronised delivery of shock randomly during the cardiac cycle. Used in Unstable patient High energy shock Indications: VF,VT

9. TYPES OF DEFIBRILLATOR 1. MANUAL EXTERNAL DEFIBRILLATOR BIPHASIC MONOPHASIC

10. 2. MANUAL INTERNAL DEFIBRILLATOR

11. 3. AUTOMATIC EXTERNAL DEFIBRILLATOR Semi Automatic AED AED Fully Automatic AED

12. 4. IMPLANTABLE CARDIOVERTER DEFIBRILLATOR ICD

13. 5. WEARABLE CARDIOVERTER DEFIBRILLATOR LIFE VEST

14. PREPARATION BEFORE PLACEMENT OF CARDIAC MONITORING Site preparation Electrode placement Connection of cable to electrode patches Placement of blood pressure cuff Placement of Saturation Probe

15. ECG Three electrode Five electrode Ten electrode WILLIAM EINTHOVEN TYPES OF ELECTRODE PLACEMENT TYPES OF LEADS Standard limb lead Augmented leads Precordial leads

16. ELECTRODE & LEAD

17. Standard leads form the points as what is known as Einthoven’s triangle

18. Precordial Leads

19. PULSE OXIMETRY A pulse oximeter uses two frequencies of light (red and infrared) to determine the percentage (%) of hemoglobin in the blood that is saturated with oxygen.

20. PaO2 Oxygen molecule dissolved in plasma SaO2 Oxygen bound to haemoglobin Each RBC contains approximately 270 million hemoglobin molecules Each hemoglobin molecule carries four heme groups

21. BLOOD PRESSURE DR. NIKOLAI KOROTKOFF Non Invasive BP Invasive BP

22. Pain Pain Petchiae,ecchymoses Limb edema Venous stasis, thrombophlebitis Peripheral neuropathy Hemorrahage , hematoma Arterial embolization Local infection Peripheral neuropathy Atriovenous fistula COMPLICATIONS OF BP MONITORING Non Invasive BP Invasive BP

23. RESPIRATORY RATE

24. SUMMARY AND CONCLUSION

25. EVALUATION

26. BIBLIOGRAPHY Luckmann and Sorenson, Medical Surgical Nursing: A psychological approach, W, B Saunders Company, 1978   Cahill, Matthew. Providing Cardiovascular Care . Springhouse, PA: Springhouse Corporation, 1996.   Marriott, Henry J. L. Pearls and Pitfalls in Electrocardiography : Pithy, Practical Pointers 2nd ed. Baltimore: Williams and Wilkins, 1998.   Milford, Cheryl, and Purvis, Gladys . Cardiovascular Care- In Nursing Procedures 3rd ed. Springhouse, PA: Springhouse Corporation, 2000.   Black, M Joyce, Medical Surgical Nursing : Clinical management of positive outcomes, Vol I and II, 8th edition, Saunders and Elsevier publications, 2009   Woods, Susan, and Sivarajan , Erika.  Cardiac Nursing  4th ed. Philadelphia: Lippincott, 2000.   http//:www.acc.org   https://www.encyclopedia.com/medicine