The EKG is one the most common test used to identify cardiovascular conditions. Testing for heart and blood vessel disorders with an electrocardiogram (EKG) is non-invasive. The EKG will show the physician if the patient’s heart is damaged or short of oxygen.
The medical assistant is responsible for obtaining a good-quality EKG without avoidable artifacts. An artifact is an abnormal signal that reflects electrical activity other than the patient’s heart during the cardiac cycle. The medical assistant must make sure that the patient stays still during the EKG exam, there are no mechanical problems with the EKG machine, and there is no other equipment in the room that can interfere with the EKG.
What is an EKG?
The EKG is one of the most valuable diagnostic exams for evaluating the electrical pathways through the heart. An EKG exam measures the electrical activity of the heartbeat. With each beat, an electrical impulse travels through the heart, and the wave causes the muscle to squeeze and pump blood from the heart. The EKG can measure how fast the heart beats and how well the chambers conduct electrical energy.
Why Perform an EKG Exam?
An EKG exam is a quick and painless way for a physician to check the patient’s heart rhythm, identify whether blood is flowing to the heart properly and diagnose a heart attack. The EKG also identifies abnormalities of the heart, the orientation of the heart in the chest, and increased thickness of the heart muscle which would suggest a cardiovascular disorder.
Preparing A Patient for an EKG?
Before performing the EKG, the medical assistant will want to make sure that no other equipment will cause any electric interference or avoidable artifacts.
The medical assistant will explain the procedure to the patient, answering any questions the patient may have. The patient will be asked to remove all items that may interfere with the EKG and lay down on the table on their back. The medical assistant will ask the patient to breathe normally while laying still. The medical assistant will then clean the patient’s skin with rubbing alcohol where the electrodes will be placed and apply the electrodes in the proper positions.
The EKG has 12 leads that produce a two-dimensional record of the impulse waves. Each lead records the electrical impulse through the heart from a different angle, allowing the physician to properly visualize the heart and identify any abnormalities. The EKG cables will then be attached to the electrodes. The medical assistant will enter the patient data into the EKG machine and the EKG tracing will begin. All artifacts are identified and eliminated. After the EKG is complete, the medical assistant will remove the electrodes and allow the patient to get dressed. Finally, the medical assistant will record the procedure on the patient’s chart to be included in the patient’s electronic health record.
How is an EKG Interpreted by the Physician?
Whether weak or strong, fast or slow, each heartbeat produces an electrical current that can be measured with an EKG machine. The physician examines the waveforms associated with the cardiac cycle and will measure the PR Interval, PR Segment, ST Segment and Ventricular Activation Time. To measure these variables, the physician will measure the waves labeled with letters P, Q, R, S, T, and U. The elements that are considered from these measurements include rate, rhythm, axis, hypertrophy, ischemia, infarction.
- Rate – how fast the heart is beating
- Rhythm – regularity of cardiac cycles and intervals
- Axis – position of the heart and direction of electrical movement through the heart.
- Hypertrophy – size of the heart
- Ischemia – decrease in blood supply to an area of the heart
- Infarction – death of heart muscles resulting in loss of function.
When Does a Medical Assistant Learn to Administer an EKG?
Learning how to perform an EKG exam is taught during a medical assisting program at a vocational school. Students will perform EKGs under the supervision of instructors. The student will prepare both the patient and the EKG machine in order to learn how to perform the EKG with the no avoidable artifacts. The student will also learn how to record the EKG in the patient’s chart.
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