ECG interference

ecg education patient safety perioperativenursing safety surgery Oct 23, 2023

So, the ECG trace suddenly looks different… how can you be sure the patient is safe? 🤔

Electrocardiography (ECG) is one of the 4 ANZCA standard monitors for general anaesthesia. It provides handy information about the electrical activity of the heart, including rate and rhythm.

Interference is common during surgery. It can be caused by anything from movement of the drapes to surgical diathermy. It’s essential that you know how to tell the difference between interference (known as artifact) and arrhythmias.

Try this 👇🏻

1️⃣ Check the pulse oximeter trace

If your ECG is all over the place, but you still have a normal pulse oximeter trace, it’s likely just artifact.

2️⃣ Check the blood pressure

A normal arterial line trace, or a current non-invasive blood pressure reading is also reassuring. Don’t forget you can always check the patient’s radial pulse if you’re not sure!

3️⃣ Check the waveform of the end-tidal CO2

An unchanged, regular, square waveform is a great indication that the cardiac output hasn’t changed significantly, so dangerous arrhythmias are unlikely.

For more information, including real examples of artifacts and arrhythmias, check out Lesson 3 of the Anaesthetic Assistant Starter Course.

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