Chapter 25Medical Testing
Health Care Science Technology
Copyright © The McGraw-Hill Companies, Inc.
Chapter 252 Copyright © The McGraw-Hill Companies, Inc.
Objectives
Describe the role and responsibilities of an electrocardiography technician.
Explain the role and responsibilities of a cardiovascular technologist.
Identify two or more cardiovascular diagnostic tests.
Chapter 253 Copyright © The McGraw-Hill Companies, Inc.
Objectives (cont.)
Contrast the roles and responsibilities of the electroencephalography (EEG) technologist and the electroneurodiagnostic technologist.
Explain the purpose of an electroencephalogram.
Successfully complete 1 medical testing procedure.
Chapter 254 Copyright © The McGraw-Hill Companies, Inc.
Careers in Medical Testing 25-1
Electrocardiography Technician Cardiovascular Technologist EEG and END Technologists
Chapter 255 Copyright © The McGraw-Hill Companies, Inc.
Careers in Medical Testing
Career opportunities are excellent, including the four most common occupations:– Electrocardiography (ECG) technician.– Cardiovascular technologist.– Electroencephalography (EEG)
technologist.– Electroneurodiagnostic (END)
technologist.
Chapter 256 Copyright © The McGraw-Hill Companies, Inc.
Electrocardiography Technician
Uses an electrocardiograph to record the electrical activity of the heart as a tracing.
Electrocardiograms help diagnose and evaluate cardiovascular disease.
Determines if the tracing is accurate and prepares a report for the physician.
Chapter 257 Copyright © The McGraw-Hill Companies, Inc.
Electrocardiography Technician (cont.)
Job Responsibilities– Perform a safe and
accurate ECG.– ECG monitor
technicians evaluate the electrical tracings on a monitor.
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Electrocardiography Technician (cont.)
Exercise Electrocardiography– Also known as stress test or treadmill test.– Job responsibilities
Provide client safety.Provide instructions to client.Monitor the client by taking blood pressure.Observe for pain, discomfort, fatigue, or difficulty
breathing.Apply and remove electrodes.
Chapter 259 Copyright © The McGraw-Hill Companies, Inc.
Electrocardiography Technician (cont.)
Ambulatory Monitoring– Tracings are recorded on a
client who is ambulatory. Often a Holter monitor is used.
– Job responsibilities Apply and remove the
ambulatory monitor. Provide client education. Ensure results are placed in the
client’s chart. Maintain the equipment.
Chapter 2510 Copyright © The McGraw-Hill Companies, Inc.
Cardiovascular Technologist
May need up to 4 years of education and training.
Works directly with cardiologists in clinics, hospitals, physician’s offices, medical centers, and mobile diagnostic units.
Chapter 2511 Copyright © The McGraw-Hill Companies, Inc.
Cardiovascular Technologist (cont.)
Job Responsibilities– May assist physicians with heart
surgery, implantation of pacemakers, and invasive tests such as angioplasty and cardiac catheterization.
– Some specialize in performing ultrasound on the heart and blood vessels in the test called an echocardiogram.
Chapter 2512 Copyright © The McGraw-Hill Companies, Inc.
Cardiovascular Technologist (cont.)
Cardiovascular Testing– A cardiovascular technician needs:
A thorough understanding of the anatomy and physiology of the cardiovascular system.
An ability to work with computers and other technical equipment.
Chapter 2513 Copyright © The McGraw-Hill Companies, Inc.
Cardiovascular Technologist (cont.)
Cardiovascular Testing (cont.)
– Cardiac CatheterizationThis test looks at the structures of the
heart.A small tube is threaded through the
client’s blood vessels to the heart, where pressure is measured and dye is injected.
Chapter 2514 Copyright © The McGraw-Hill Companies, Inc.
Cardiovascular Technologist (cont.)
Cardiovascular Testing (cont.)
– Balloon angioplasty A catheter with a
balloon on its end is inserted into a blood vessel; then the balloon is inflated to expand the blood vessel.
Chapter 2515 Copyright © The McGraw-Hill Companies, Inc.
Cardiovascular Technologist (cont.)
Job Responsibilities– Review and record the client’s history.– Perform diagnostic tests.– Monitor heart rate, blood pressure, and
ECG.– Inform the physician if something appears
wrong.– Use discretion and judgment when
performing duties.
Chapter 2516 Copyright © The McGraw-Hill Companies, Inc.
EEG and END Technologists
The title END is more commonly used, as it most accurately describes the occupation.
Other important terms are:– Electroencephalography – recording
the electrical activity in the brain. – Electroneurodiagnostic – evaluating
the electrical activity of the nervous system.
Chapter 2517 Copyright © The McGraw-Hill Companies, Inc.
EEG and END Technologists (cont.)
Job Responsibilities– Perform tests that evaluate the spinal cord,
the nervous system, and sleep.– Usually employed in:
Acute care hospitals. Neurologists’ offices. Some ambulatory care facilities. Newborn nurseries. Sleep study laboratories. Operating rooms. Epilepsy research centers.
Chapter 2518 Copyright © The McGraw-Hill Companies, Inc.
EEG and END Technologists (cont.)
The electroencephalogram– Records the electrical impulses of the brain,
producing a record called the electroencephalogram.
– The END technologist obtains the client’s medical history, then applies electrodes to the head.
– The END technologist corrects errors on the tracing that are caused by interference during the EEG.
Chapter 2519 Copyright © The McGraw-Hill Companies, Inc.
Section 25-1Apply Your Knowledge
List some invasive procedures the cardiovascular technologist might help perform.
Answer:
Angioplasty, cardiac catheterization, heart surgery, and implantation of pacemakers.
Chapter 2520 Copyright © The McGraw-Hill Companies, Inc.
Medical Testing Procedures 25-2
Recording an ElectrocardiogramAnatomy and Physiology of the
HeartBackground for Recording an
ECGTwelve-Lead ECGECG MachinesECG Machine Controls
Chapter 2521 Copyright © The McGraw-Hill Companies, Inc.
Recording an Electrocardiogram
An electrocardiogram (ECG tracing):– Determines how well the heart is pumping and
contracting.– Checks for problems with the flow of electricity
through the heart.– Diagnoses changes in the heart rhythm.– Checks for abnormal heart changes before surgery.– Assists in evaluating a person’s health after age 40.– Monitors or evaluates individuals with heart
conditions.
Chapter 2522 Copyright © The McGraw-Hill Companies, Inc.
Anatomy and Physiology of the Heart
Sinoatrial (SA) node. Atrioventricular (AV)
node. Bundle of His (AV
bundle). Bundle branches. Purkinje fibers
(network).
Chapter 2523 Copyright © The McGraw-Hill Companies, Inc.
Background for Recording an ECG
The technician must understand the heart’s electrical conduction system.
Each contraction of the heart muscle is controlled by electrical impulses.
The pattern of current is recorded by the ECG machine.
Chapter 2524 Copyright © The McGraw-Hill Companies, Inc.
Background for Recording an ECG (cont.)
The ECG Waveform– The deflections on a tracing rise
above or fall below a straight line.
– This line is known as an isoelectric line, or baseline.
– Positive deflections go up, negative ones go down.
– Each wave represents specific activity in the heart.
Chapter 2525 Copyright © The McGraw-Hill Companies, Inc.
Twelve-Lead ECG
Gives a recording of the electrical activity within the heart.
Attaching the leads and electrodes:– Six leads are attached to the chest
electrodes.– Four leads are attached to electrodes on
the arms and legs.– The 10 lead wires produce 12 different
lead circuits.
Chapter 2526 Copyright © The McGraw-Hill Companies, Inc.
Twelve-Lead ECG (cont.)
Working with Electrodes– Reusable electrodes – plates and
bulbs.– Disposable electrodes – used to
reduce possible contamination.
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Twelve-Lead ECG (cont.)
Proper Handling and Storage– Keep unused electrodes in a sealed
plastic bag.– Check the expiration date.– Ensure the gel has not dried.– Always check electrodes before you
use them.
Chapter 2528 Copyright © The McGraw-Hill Companies, Inc.
ECG Machines
Single-Channel ECG – monitors 12 leads individually.
Multichannel ECG – produces all 12 leads by recording 3 leads at once.
Chapter 2529 Copyright © The McGraw-Hill Companies, Inc.
ECG Machines (cont.)
Other Types of ECG Machines– Some perform functions such as
computerized measurement and analysis, storage, and communication.
Chapter 2530 Copyright © The McGraw-Hill Companies, Inc.
ECG Machine Controls
Speed.Gain.Artifact filter.Computerized controls.Standardizing with the stylus.Lead selector.
Chapter 2531 Copyright © The McGraw-Hill Companies, Inc.
Section 25-2Apply Your Knowledge
How many wires are used in a 12-lead ECG?
Answer: 10.
Chapter 2532 Copyright © The McGraw-Hill Companies, Inc.
Procedures in Student Text
25A Recording an Electrocardiogram
Chapter 2533 Copyright © The McGraw-Hill Companies, Inc.
Chapter 25 Credits
Slide 6 Geoff Butler
Slide 7 Geoff Butler
Slide 9 Geoff Butler
Slide 10 Chip Henderson/Index Stock Imagery
Slide 26 Geoff Butler
Slide 28 Geoff Butler
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