Lesson 1Digital storage and print copies: filenames, EMR upload, privacy considerationsExplains how to name, store, and transmit ECG files, upload to EMR systems, print copies when needed, and maintain patient privacy and data security as per Kenyan health regulations.
Standardized ECG filename conventionsSaving and backing up digital tracingsUploading ECGs into the EMR systemWhen and how to print paper copiesProtecting PHI on screens and printoutsSecurely discarding test or extra copiesLesson 2Quality checks: recognising and correcting lead reversal, low amplitude, baseline wander, muscle tremorTeaches how to perform quality checks before and after recording, recognise lead reversal patterns, low amplitude signals, baseline wander, and muscle tremor, and apply fixes quickly.
Pre-recording visual lead checkRecognizing limb lead reversal patternsIdentifying chest lead misplacement signsCorrecting low amplitude QRS complexesReducing baseline wander artifactsAddressing muscle tremor on the tracingLesson 3Exact electrode placement: limb leads (RA/LA/RL/LL) and precordial leads V1–V6 anatomical landmarksProvides precise anatomical landmarks for limb and precordial electrodes, ensuring consistent RA, LA, RL, LL, and V1–V6 placement for accurate, reproducible 12-lead ECG tracings.
Standard limb electrode locationsAvoiding bony and muscular prominencesLocating the fourth intercostal spacePlacing V1 and V2 at the sternum edgesPositioning V3 to V6 along the chest wallAdjustments for female and obese patientsLesson 4Communicating the procedure simply: scripts for consent and explanationProvides practical language and scripts to explain the ECG procedure, obtain consent, reduce anxiety, and adapt for children, elders, and patients with limited health literacy or language barriers.
Plain-language explanation of ECG purposeScript for verbal consent and questionsReassuring anxious or fearful patientsAdapting explanations for pediatricsCommunicating with hearing impairmentUsing interpreters and translated materialsLesson 5Step-by-step lead application and cable management to minimise pull and artefactDetails a systematic approach to applying all 12-lead electrodes, routing and securing cables, and checking connections to reduce tension, prevent lead pull, and minimise motion artefacts.
Pre-procedure equipment and cable inspectionSequence for limb lead placement and checksSequence for chest lead placement and checksCable routing paths to reduce tensionSecuring cables to prevent tug and pullFinal connection check before recordingLesson 6ECG machine settings: standard paper speed (25 mm/s), gain/amplitude (10 mm/mV) and filter settingsReviews standard ECG machine settings, including paper speed, gain, and filters, and explains when and how to adjust them, verify calibration marks, and document any changes.
Default paper speed and when to change itStandard gain and low voltage adjustmentUse and risks of diagnostic filtersChecking calibration pulse and grid marksPediatric and tachycardia setting tweaksDocumenting nonstandard settings usedLesson 7Patient identification and verification: identifiers, allergies, medication reconciliationCovers safe patient identification using multiple identifiers, allergy and fall-risk checks, medication reconciliation, and documentation to ensure the right patient gets the right ECG.
Primary and secondary patient identifiersVerifying ID bands and EMR dataScreening for allergies and sensitivitiesMedication list and reconciliation basicsHandling confused or nonverbal patientsDocumenting verification steps in recordsLesson 8Patient positioning: supine posture, pillow use, arm/leg placement to reduce artefactCovers correct patient positioning for resting ECG, including supine posture, pillow use, arm and leg placement, and strategies to reduce muscle tension and motion artefacts.
Standard supine position requirementsHead, neck, and pillow adjustmentsArm placement to limit muscle tensionLeg and foot positioning for comfortPositioning for dyspnea or orthopneaMaintaining stillness during recordingLesson 9Common artefact sources and troubleshooting: movement, loose electrodes, AC interference, tremor, respirationExplores frequent ECG artefact sources, how they appear on tracings, and structured troubleshooting steps to correct movement, loose electrodes, AC interference, tremor, and breathing issues.
Visual recognition of common artifactsCorrecting patient and limb movementDetecting and fixing loose electrodesReducing AC and electrical interferenceManaging tremor and shivering artifactHandling respiration and baseline shiftsLesson 10Skin preparation techniques: shaving, abrasion, alcohol use, contraindicationsFocuses on preparing the skin to improve electrode contact, including shaving hair, gentle abrasion, alcohol use, and recognising contraindications or sensitive skin.
Inspecting skin and selecting sitesClipping or shaving excessive hairUsing abrasion pads safelyCleaning with alcohol or soap wipesAlternatives for fragile or burned skinManaging sweating or oily skinLesson 11Labelling, annotation and adding clinical context on the tracing (patient details, date/time, position, meds)Describes best practices for labelling ECG tracings with patient identifiers, date and time, body position, and relevant clinical notes for accurate diagnosis.
Required identifiers on every tracingRecording date, time, and time zoneNoting patient position and activityDocumenting key symptoms and historyListing recent cardiac medicationsFlagging technical issues on the strip
