CARDIAC MONITORING.pptx

Presentation about cardiac monitoring

1. AHAMMED NASEEM 3 rd YEAR BSC NURSING ALMAS COLLEGE OF NURSING CARDIAC MONITORING

2. DEFINITION Cardiac monitor is a device that shows the electrical activity and pressure wave form of cardiovascular system for measurement and treatment . Parameters specific to respiratory system also be measured

3. PURPOSES Continuously monitor cardiac rhythm, heart rate, BP, respiratory rate, SPO 2 and also temperature Used for continuous observation of critically ill patients in emergency department as well as critical care department Continuous cardiac monitoring help for prompt identification and initiation of treatment for cardiac arrythmias and other conditions that affect on respiratory or cardiovascular system It is useful for observation of post-operative patients, patient with severe electrolyte imbalances and other unstable patients

4. INDICATIONS Chest pain Palpitation Acute coronary syndrom {STEMI, NSTEMI , Unstable angina} Following major surgeries especially cardiac and neuro surgeries Major trauma Post cardiac or respiratory arrest Acute medical conditions such as pulmonary embolus, drug overdose, electrolyte imbalances etc Unexplained syncope Shock unconscious patients Critically ill patients

5. FUNCTIONS OF CARDIAC MONITOR Continuous monitoring of vital signs and cardiac and pulmonary rhythm along with ECG Alert when patients vital signs are going above or belove of pre-set values Provide rhythm strip to document evidence of arrythmias

6. BASIC FEATURES OF CARDIAC MONITOR STATIC BEDSIDE CARDIAC MONITOR SYSTEM ECG detected from patient electrode and transmitted to monitor via monitor lead cable Display ECG rhythm continuously ECG may duplicated to a central console monitoring system Some system incorporated computerized software to recognize life threatening cardiac arrythmias and alert

7. TELEMETRY MONITORING Portable wireless cardiac monitoring system Allow transmission of the ECG without requiring the patient to be attached to a static monitor A patient standard chest electrodes and leads are connected to small portable monitor trans- mitter Cardiac rhythm is transmitted to receiver unit at central monitoring station where the rhythm is displayed continuously Suitable for ambulatory cardiac patients requiring ongoing ECG monitoring

8. EQUIPMENT REQUIRED Cardiac monitor Cardiac table Pressure transducer and BP cuff ECG leads and electrodes SPO2 probe Alcohol/ dry gauze Temperature probe

9. PROCEDURE All electrical equipment are grounded to avoid electrical shock and artifact Turn on monitor and connect the cables to the monitor (if not already attached) according to colour code or instruction by the manufacturer Open the electrode package and attach an electrode to each lead wire Explain the procedure to patient and bystander and obtain consent Wash hands and , provide privacy to the patient and ensure that patient is in clean and dry place to avoid electrical shock

10. Expose the site for SPO2 probe, temperature probe and chest leads Rub the selected site using washcloth or gauze pad briskly until it turn to redden but care should be taken to avoid damage to the skin Death skin cells are removed in this manner there by promote better electrical conduction Patient who are extremely hairy may need to be shaved prior to application of electrode An alcohol pad is used to clean the site Area should be completely dry before applying electrode alcohol shouldn’t trapped beneath the electrode it may leads to skin breakdown Place electrodes in appropriate position the each side of electrode is pushed against the skin and pull gently to ensure it is properly attached, repeat over every electrodes

11. Should press two fingers on electrode in a circular pattern to affix the gel and stabilize the electrode then repeat on each electrode To avoid the potential artifact don’t place electrode over bony prominence or hairy areas Place SPO2 probe on finger Place temperature probe according to hospital policy Place BP cuff connected to the monitor on upper arm

12. ELECTRODE PLACEMENT SITES

13. AFTER CARE After placing all electrodes observe the monitor and evaluate the quality of tracing , making size and position adjustment as needed Should confirm that the monitor is detecting each heart beat by taking apical pulse and compare it with monitor reading The upper and lower alarm of each vitals are set according to hospital policy and activate the alarm A rhythm strip should be recorded for medical record and label with patient’s name, age, hospital ID along with date and time

14. NURSES RESPONSIBILITY Asses patients condition and need for cardiac monitoring If indicated explain the procedure and obtain informed consent Obtain all equipment needed and arrange at bedside Ensure that all electrical equipment are grounded Explain the procedure to the bystander and ask the patient to relax Do the procedure Confirm the monitor detecting each heart beats by taking apical pulse and compare it with monitor readings Evaluate the quality of tracing of electrodes and make adjustments as needed

15. COMPLICATIONS Potential risk for electrolyte imbalances Potential risk for skin breakdown at electrode placement site Patient may allergic to adhesive used or the electrode may have been left on the skin too long Electrodes should be be removed and new electrodes are applied using hypoallergic electrode if necessary