Lesson 1Recognizing and correcting common artifacts: movement, muscle tremor, baseline wander, AC interference, and poor contactLearn to identify common artefacts like movement, tremors, baseline wander, power interference, and bad electrode contact, with step-by-step fixes to get clean recordings before finishing.
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 communicationsLearn the escalation steps for dangerous ECG findings, including who to alert, how to call for emergency help, and accurately recording all 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 detailsMaster confirming patient identity, checking ECG requests against patient files and referrals, reviewing indications and risks, and sorting any mismatches to ensure the right test for the right person.
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 setupGet the room and ECG gear ready with infection control, electrical and cable safety checks, privacy screens, and supplies in place for a safe, comfortable 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 rhythmsAdapt techniques for overweight patients, those with enlarged left ventricles, bundle branch blocks, or pacemaker rhythms, including lead adjustments, machine settings, and noting variations for proper reading.
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 checksUnderstand ECG machine settings like paper speed, gain, filters, lead views, and calibration. Know when to tweak them and how to confirm they're correct for reliable results.
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 selectionAssess and prep skin by shaving hair, light rubbing, cleaning properly, and picking the right electrodes to cut down resistance and 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 landmarksReview limb and chest lead positions, body landmarks, and frequent errors. Focus on precise placement for quality ECGs that can be compared reliably.
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 actionsQuickly spot heart attack patterns, fast ventricular rhythms, full heart block, or flatline on ECGs, and know instant actions, who to call, and safety steps.
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, labeling, time stamps, and quality assurance logsHandle post-test paperwork with labels, timestamps, report details, secure sending to doctors, storage, and quality logs for tracking and checks.
Essential identifiers on each tracingRecording date, time, and operatorSummarizing technical quality notesTransmitting ECG to physician systemsArchiving and backup proceduresCompleting QA and incident logs
