Lesson 1Recognising and correcting common artefacts: movement, muscle tremor, baseline wander, AC interference, and poor contactTeaches identification of common artefacts like movement, tremor, baseline wander, AC interference, and poor contact, with step-by-step methods to fix them before the final recording.
Identifying patient movement artifactManaging muscle tremor and shiveringCorrecting baseline wander causesReducing AC and electrical interferenceImproving electrode contact qualityRechecking tracing after correctionsLesson 2Escalation protocol when abnormal/dangerous tracing identified: notifying clinician, activating emergency response, and documenting communicationsExplains the escalation process for dangerous or unexpected ECG findings, including whom to inform, how to trigger emergency response, and accurate documentation of communications and timings.
Defining abnormal and critical findingsNotifying the responsible clinicianActivating emergency response systemsStaying with unstable patientsRecording times and contacts madeHandover of ECG and clinical detailsLesson 3Patient identification and verifying test request against medical record and referral detailsDeals with confirming patient identity, matching the ECG request with the medical record and referral, checking indications and contraindications, and sorting out any mismatches to ensure the right test for the right patient.
Using two unique patient identifiersMatching request to chart and wristbandConfirming indication and urgencyResolving discrepancies before testingDocumenting verification stepsLesson 4Room and equipment preparation: safety checks, infection control, electrical safety, and privacy setupCovers preparing the ECG room and equipment, with infection control, electrical and cable safety checks, privacy arrangements, and supply readiness for a safe, comfortable, and compliant testing space.
Daily ECG machine function checkInspecting leads and power cordsCleaning couch and high‑touch surfacesHand hygiene and PPE selectionPositioning screens and drapesStocking paper, electrodes, and gelLesson 5Recording special populations and technical variants: obese patients, left ventricular hypertrophy, bundle branch block, and paced rhythmsExplains adjustments for obese patients and those with LVH, bundle branch block, or paced rhythms, including lead placement changes, technical settings, and noting variants for proper interpretation.
Adjusting leads in obese patientsRecording in suspected LVHECG features of bundle branch blockCapturing paced rhythms accuratelyDocumenting nonstandard lead positionsNoting technical limitations on reportLesson 6ECG acquisition settings: filter, gain, paper speed, leads display, and calibration checksCovers key ECG machine settings like paper speed, gain, filters, lead display, and calibration checks. Stresses when to tweak settings and how to confirm calibration for precise measurements.
Standard paper speed and when to changeAdjusting gain for small or large signalsUsing muscle and baseline filters safelySelecting lead display formatsRunning a 1 mV calibration signalRecording settings on the ECG printoutLesson 7Skin preparation techniques: shaving, abrasion, cleaning, and electrode selectionIncludes skin assessment and preparation, such as shaving hair, light abrasion, cleaning with suitable agents, and selecting proper electrodes to lower impedance and cut down artefacts.
Inspecting skin for lesions or devicesShaving excessive chest hair safelyUsing abrasion to lower impedanceCleaning with alcohol or soapSelecting appropriate electrode typeEnsuring firm electrode adhesionLesson 8Standard ECG lead positions: limb leads, precordial leads V1–V6, and anatomical landmarksReviews standard limb and precordial lead positions, important anatomical landmarks, and frequent placement mistakes. Highlights precise, repeatable positioning for diagnostic quality and comparable ECGs.
Right and left limb lead placementLocating intercostal spacesCorrect V1 and V2 positioningPlacing V3–V6 along the chest wallAvoiding breast tissue displacement errorsChecking symmetry and consistencyLesson 9Immediate recognition of life-threatening patterns: STEMI, ventricular tachycardia, complete heart block, and asystole and immediate actionsFocuses on quick spotting of STEMI, ventricular tachycardia, complete heart block, and asystole on resting ECG, with immediate actions, escalation steps, and basic safety measures for technicians.
ECG criteria for STEMI detectionIdentifying ventricular tachycardiaRecognizing complete heart blockConfirming true asystole vs artifactImmediate actions and escalationDocumenting critical ECG eventsLesson 10Post-test documentation: report components, transmitting ECG to physician, storage, labelling, time stamps, and quality assurance logsDetails required post-test documentation like labelling, time stamps, report parts, storage, secure sending to the physician, and quality logs for traceability and audits.
Essential identifiers on each tracingRecording date, time, and operatorSummarizing technical quality notesTransmitting ECG to physician systemsArchiving and backup proceduresCompleting QA and incident logs
