ECG Registration: Execution Algorithm

ECG registration
An electrocardiogram (ECG or EKG) is a register of the heart's electrical activity. ECG

recording is performed using an electrocardiograph (Heaco, Contec Medical Systems Co., LTD,
China) with a paper printer and personal computer software. Each lead records the potential
difference that exists between two specific points of the electric field of the heart, in which the
electrodes are installed.
In a practical lesson, students do not print the ECG on a paper tape, but register the result in
electronic form in the database of the ECG Synchronous V. 1.3.6 software. The advantage of this
type of information storage is the ability to create a database for dynamic monitoring and statistical
analysis, as well as the ability to remotely exchange information with specialists by e-mail.
In clinical practice, 12 Willson ECG leads are used, a record of which is mandatory for each
electrocardiographic examination of the patient: 3 standard leads, 3 reinforced unipolar leads from
the limbs and 6 chest leads.
To practice the skills of ECG registration in class, the following is required:
Station passport:
1. Room: spacious, bright, well-ventilated;
2. Furniture: 2 handling tables, functional bed, bed.
3. Technical equipment: electrocardiograph, laptop, tweezers, glass container.
4. Consumables: gauze napkins, 0.9% sodium chloride solution.
5. Simulation equipment: no need.
6. Staff: teacher 1, standardized patient - 1.
Execution algorithm:
Step 1: Explain to the patient the purpose and course of the procedure and obtain consent
for the procedure.
Oral accompaniment (for example): “Hello! I am your doctor, my name is Ivan Ivanovich.
Today we must examine your heart with a cardiogram. This is a safe and painless procedure - I will
put electrodes on your body for a few minutes. You will not feel anything unpleasant. Do you agree?
"
Progress. Only oral accompaniment.
Result. Patient's oral response: “Agree”
STEP 2 Enter the patient data into the computer recorder.

Oral accompaniment (for example): “Before we begin, please tell me what is your name?
How old are you? How tall are you? How much do you weigh? Thanks, done. "
Progress. The student includes the ECG Synchronous V. 1.3.6 program. Selects the “Instant
sample” command in the menu (Fig. 1). A window for entering patient data appears on the screen.
The student enters the patient data in the appropriate columns: last name and first name, age (full
years), gender, height and weight.
Fig. 1. Getting Started – «Instant Sample Command»

Fig. 2. Registration of patient data
STEP 3: Preparing the patient for the study.

Oral accompaniment (for example): “Please tell me, did you eat before the procedure? Have
you rested for 10-15 minutes before the study? Okay, please take off your clothes to your waist and
pull your pants over your shins. Lie down on the bed, keep your hands along the body".
Progress. Only oral support.
Result. The patient lies on a bed on his back, arms along the body, naked to the waist and
with bare legs.
STEP 4: Treat contact surfaces with 0.9% NaCl solution.

Oral support (for example): “Now I’ll moisten your hands, feet and chest for better skin
contact with the electrodes”.
Progress. A student takes tweezers with a gauze napkin, moistens with NaCl solution,
quickly wipes the patient’s inner surface of the wrist and ankles, and as the chest from the middle to
the left armpit.
Result. The patient's skin on the chest and extremities should remain well hydrated.
STEP 5: Set of electrodes (by Willson).
Oral accompaniment is not required.
Progress. The student imposes standard electrodes on the patient's limbs clockwise, with
clothespins up, with a metal plate inward, starting from the right hand:
- right hand - red
- left hand - yellow
- left leg – green
- right leg - black (grounding).
STEP 6: Installing 6 electrodes forming 6 chest leads of an ECG according to Willson:

Progress. The student imposes breast electrodes:
- V1 (or C1) - IV intercostal space in the right edge of the sternum
- V2 (or C2) - IV intercostal space in the left edge of the sternum
- V4 (or C4) - V intercostal space in the left mid-clavicular line
- V3 (or C3) - the midway between V2 and V4
- V5 (or C5)- V intercostal space in the left anterior axillary line
- V6 (or C6) - V intercostal space in the left mid-axillary line.
STEP 7: Ask the patient to relax, breathe calmly and not move. Announce the start of
registration.
Oral accompaniment: “Please lie calmly, relax, and do not move. Breathe calmly, as always.
I'm starting a recording. ”
Progress. Only oral accompaniment.
Result. The patient lies motionless, without creating obstacles for recording ECG.
STEP 8: Recording an ECG for 10 seconds under conditions of calm breathing.

Progress.
• The student clicks “OK” in the window to enter patient data (Fig. 2). A black millimeter grid and
yellow ECG lines appear on the screen (Fig. 3).
• A student puts “ticks” in the boxes for three filters (Fig. 3).
• The student presses “Start” - the yellow lines are replaced by green, the recording has begun (Fig.
3).
• According to the timer on the screen, the student records 10 seconds of recording, presses “Stop”
and “Exit” (Fig. 3).
• A window appears on the screen with measurements of the ECG wave analysis in the II standard
lead. The student clicks “OK” (Fig. 4).
• The student presses “12 ECG” - an ECG appears on the screen on a white millimeter background,
recorded at a speed of 25 mm / s (Fig. 5). The student changes the recording speed by 50 mm / s -
the final ECG recording appears on the screen (Fig. 5).
Fig. 3. ECG registration
Fig. 4. Analysis of ECG teeth in the II standard vision

Fig. 5. Registered ECG
Result. On the computer screen - registered ECG on a white millimeter background, recorded
at a speed of 50 mm / s.
STEP 9: Completion of registration.

Verbal support (for example): “The procedure for registering an ECG has been completed.
Now I will remove the electrodes from your body and you can get up and get dressed. ”Progress.
The student removes the electrodes in the same order in which they were applied: first from the
limbs, then from the chest. The chest electrodes are detached by moving to the side, squeezing the
pear and holding the patient's skin to reduce pain.
Result. Patient dressed, got out of bed.
STEP 10: Report the result.

Oral accompaniment (for example): “The result will be reported to you in half an hour after
decoding your ECG. Are you feeling normal? Was it painful or uncomfortable for you? If
everything is in order, then you can go. "
Progress. The student helps the patient to get dressed, escorts him to the door.
Result. The patient confirms that he is satisfied with how the procedure went and leaves
the room accompanied by the student.

ECG Registration: Execution Algorithm

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ECG registration

An electrocardiogram (ECG or EKG) is a register of the heart's electrical activity. ECG

STEP 2 Enter the patient data into the computer recorder.

Fig. 1. Getting Started – «Instant Sample Command»

STEP 3: Preparing the patient for the study.

STEP 4: Treat contact surfaces with 0.9% NaCl solution.

STEP 6: Installing 6 electrodes forming 6 chest leads of an ECG according to Willson:

STEP 8: Recording an ECG for 10 seconds under conditions of calm breathing.

Fig. 3. ECG registration

Fig. 4. Analysis of ECG teeth in the II standard vision

STEP 9: Completion of registration.

STEP 10: Report the result.

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