Cardiac Monitor, ECG and Cauterization

8/6/2019 Cardiac Monitor, ECG and Cauterization

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Prepared by:

Glaiza Mae B. Olivar

SN-DOSCST



The cardiac monitor is a device thatshows the electrical and pressure

waveforms of the cardiovascular systemfor measurement and treatment.Parameters specific to respiratoryfunction can also be measured. Because

electrical connections are madebetween the cardiac monitor and thepatient, it is kept at the patient's

bedside.



Purpose:

The cardiac monitor continuously displays the

cardiac electrocardiogram (EKG) tracing.Additional monitoring components allowcardiovascular pressures and cardiac output to bemonitored and displayed as required for patient

diagnosis and treatment. Oxygen saturation of thearterial blood can also be monitored continuously.Most commonly used in emergency rooms andcritical care areas, bedside monitors can be

interconnected to allow for continual observationof several patients from a central display.Continuous cardiovascular and pulmonarymonitoring allows for prompt identification andinitiation of treatment.



Description:

The monitor provides a visual display ofmany patient parameters. It can be set to soundan alarm if any parameter changes outside of anexpected range determined by the physician.Parameters to be monitored may include, butare not limited to, electrocardiogram,

noninvasive blood pressure, intravascularpressures, cardiac output, arterial blood oxygensaturation, and blood temperature.

Equipment required for continuous cardiacmonitoring includes the cardiac monitor, cables,and disposable supplies such as electrodepatches, pressure transducers, a pulmonaryartery catheter (Swan-Ganz catheter), and anarterial blood saturation probe.



Preparation

As the cardiac monitor is most commonly usedto monitor electrical activity of the heart, the patientcan expect the following preparations. The sitesselected for electrode placement on the skin will beshaved and cleaned causing surface abrasion for bettercontact between the skin and electrode. Theelectrode will have a layer of gel protected by a film,which is removed prior to placing the electrode to theskin. Electrode patches will be placed near or on theright arm, right leg, left arm, left leg, and the centerleft side of the chest. The cable will be connected tothe electrode patches for the measurement of a five-

lead electrocardiogram. Additional configurations arereferred to as three-lead and 12-leadelectrocardiograms. If noninvasive blood pressure isbeing measured, a blood pressure cuff will be placedaround the patient's arm or leg.



The blood pressure cuff will be set to inflate manuallyor automatically. If manual inflation is chosen, the cuff willonly inflate at the prompting of the health care provider,

after which a blood pressure will be displayed. Duringautomatic operation, the blood pressure cuff will inflate attimed intervals and the display will update at the end ofeach measurement.

Disposable pressure transducers require a reference

to atmosphere, called zeroing, which is completed beforemonitoring patient pressures. This measurement will occuronce the patient is comfortably positioned since thetransducer must be level with the measurement point. Thepressure transducer will then be connected to the indwelling

catheter. It may be necessary for as many as four or fivepressure transducers to be connected to the patient.

The arterial blood saturation probe will be placed onthe finger, toe, ear, or nasal septum of the patient, providingas little discomfort as possible, while achieving a satisfactory

measurement.



Cardiac monitors display such vital signs as

heart rate, pulse, and blood pressure forpatients in the intensive care unit.



Aftercare

After connecting all equipment, the

health care provider will observe the monitorand evaluate the quality of the tracings, whilemaking size and position adjustments asneeded. The provider will confirm that the

monitor is detecting each heartbeat by takingan apical pulse and comparing the pulse to thedigital display. The upper and lower alarm limitsshould be set according to physician orders, and

the alarm activated. A printout may berecorded for the medical record, and labeledwith patient name, room number, date, time,and interpretation of the strip.



Normal results

The monitor will provide waveformsand/or numeric values associated with thepatient status. These may include, but arenot limited to, heart rate, arterial blood

pressure, central venous pressure,pulmonary artery pressure, pulmonarycapillary wedge pressure, left atrialpressure, cardiac output, arterial blood

saturation, and blood temperature.Furthermore, these values can be used tocalculate other values, or parameters, orused to diagnose and treat the patient's

condition.



Patient movement may causemeasurement errors; the patient will be

requested to remain motionless. Dependingon the mobility of the patient, assistanceshould be provided by the health careprovider prior to changing from a laying

down position to sitting or standing.As the patient's condition improves,

the amount of monitoring equipment maybe decreased. However, the

electrocardiogram and arterial bloodsaturation probe should be expect toremain attached until discharge isimminent.



� An electrocardiogram (ECG) is a test that records theelectrical activity of the heart.



How the Test is Performed

Y

ou will be asked to lie down. The healthcare provider will clean several areas on yourarms, legs, and chest, and then attach smallpatches called electrodes to the areas. It maybe necessary to shave or clip some hair so the

patches stick to the skin. The number ofpatches used may vary.

The patches are connected by wires to amachine that turns the heart's electrical

signals into wavy lines, which are often printedon paper. The test results are reviewed by thedoctor.



How to Prepare for the Test

Make sure your health care providerknows about all the medications you aretaking, as some can interfere with testresults.

Exercising or drinking cold waterimmediately before an ECG may cause falseresults.



How the Test Will FeelAn ECG is painless. No electricity is

sent through the body. The electrodes mayfeel cold when first applied. In rare cases,some people may develop a rash orirritation where the patches were placed.



Why the Test is Performed

An ECG is used to measure:� Any damage to the heart

� How fast your heart is beating and whether it isbeating normally

� The effects of drugs or devices used to controlthe heart (such as a pacemaker)

� The size and position of your heart chambers

An ECG is a very useful tool fordetermining whether a person has heartdisease. Your doctor may order this test if youhave chest pain or palpitations.



Normal Results

�Heart rate: 60 to 100 beats per

minute�Heart rhythm: consistent and even



What Abnormal Results Mean� Abnormal ECG results may be a sign of

� Abnormal heart rhythms (arrhythmias)� Cardiac muscle defect

� Congenital heart defect

� Coronary artery disease

� Ectopic heartbeat

� Enlargement of the heart� Faster than normal heart rate (tachycardia)

� Heart valve disease

� Inflammation of the heart (myocarditis)

� Changes in the amount of electrolytes (chemicals inthe blood)

� Past heart attack

� Present or impending heart attack

� Slower than normal heart rate (bradycardia)



Risks

There are no risks. No electricity is sent

through the body, so there is no risk of shock.

Considerations

The accuracy of the ECG depends on thecondition being tested. A heart problem may notalways show up on the ECG. Some heart conditionsnever produce any specific ECG changes.

If you have had a heart attack or have heartdisease, you may need more than one ECG. Your

doctor will tell you when you need the next one.There is no reason for healthy people to haveyearly ECG testing unless they have a family orpersonal history of specific heart diseases or othermedical conditions that affect the heart.



The practice was once widespread for treatment ofwounds. Its utility before the advent of antibioticswas effective on several levels:� useful in stopping severe blood-loss and

preventing exsanguination

� to close amputations,

� useful in preventing infections, including complicationsfrom septicemia.

Actual cautery is a term referring to the white-hotiron³a metal generally heated only up to a dull red glow³that is applied to produce blisters, to stop bleeding ofa blood vessel, and other similar purposes.

The main forms of cauterization used today inthe first world are electrocautery and chemical cautery³where both are, for example, prevalent in the removal ofunsightly warts. Cautery can also mean the branding of ahuman, either recreational or forced.Accidental burns can be considered cauterization as well.



ElectrocauteryElectrocauterization is the process of

destroying tissue using heat conduction from ametal probe heated by electric current. Theprocedure is used to stop bleeding from smallvessels (larger vessels being ligated) or for cuttingthrough soft tissue. Unlikeelectrocautery, electrosurgery is based on

generation of heat inside tissue, using electriccurrent passing through the tissue itself, and whenused to stop bleeding, is technically referred to aselectrocoagulation. Electrosurgery techniques areused in the treatment of skincancers via electrodessication and curettage.

Electrocauterization is preferable tochemical cauterization because chemicals canleach into neighbouring tissue and cauterizeoutside of the intended boundaries.



Chemical cautery

Many chemical reactions can destroy tissue

and some are used routinely in medicine, mostcommonly for the removal of small skin lesions(i.e. warts or necrotized tissue) or hemostasis. Thedisadvantages are that chemicals can leach intoareas where cauterization was not intended. For this

reason, laser and electrical methods are preferable,where practical. Some cauterizing agents are:

� Silver nitrate: Active ingredient of the lunar caustic, astick that traditionally looks like a large match-stick. Itis dipped into water and pressed onto the lesion to becauterized for a few moments.

� Trichloroacetic acid

� Cantharidin: An extract of the blister beetle that causesepidermal necrosis and blistering; used to treat warts.



Nasal cauterizationIf a person has been having frequent nose

bleeds, it is most likely caused by an exposed

blood vessel in their nose. Even if the nose is notbleeding at the time, it is cauterized to preventfuture bleeding. The different methods ofcauterization include burning the affected areawith acid, hot metal or lasers. Such a procedure isnaturally quite painful. Sometimes liquidnitrogen is used as a less painful alternative,though it is less effective. In the few countriesthat permit the use of cocaine for medicinalpurposes, it is occasionally used topically to makethis procedure less uncomfortable; cocaine being

the only local anesthetic which alsoproduces vasoconstriction, making it ideal forcontrolling nosebleeds. More modern treatmentuses Silver Nitrate, a local anesthetic is appliedand the procedure is generally painless. The nosemay run for up to a week after the procedure.



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Cardiac Monitor, ECG and Cauterization

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