Lesson 1Recognising and correcting common artefacts: movement, muscle tremor, baseline wander, AC interference, and poor contactThis lesson teaches how to identify common artefacts like movement, tremor, baseline wander, AC interference, and poor contact, and gives step-by-step ways to fix them before completing the recording.
Spotting patient movement artefactHandling muscle tremor and shiveringFixing causes of baseline wanderReducing AC and electrical interferenceImproving electrode contact qualityChecking tracing after fixesLesson 2Escalation protocol when abnormal/dangerous tracing identified: notifying clinician, activating emergency response, and documenting communicationsThis lesson describes the steps to take when dangerous or unexpected ECG findings appear, including who to inform, how to start emergency response, and how to accurately record communications and times.
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 detailsThis covers confirming patient identity, matching the ECG request to the chart and referral, checking indications and contraindications, and sorting out any differences to make sure the right test is done on 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 setupThis explains preparing the ECG room and equipment, including infection control, electrical and cable safety checks, privacy measures, and readying supplies to ensure a safe, comfortable, and proper testing environment.
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 rhythmsThis details adjustments for obese patients and those with LVH, bundle branch block, or paced rhythms, including lead placement changes, technical settings, and noting variants to aid accurate 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 checksThis explains key ECG machine settings: paper speed, gain, filters, lead display, and calibration checks. It stresses when to adjust settings and how to confirm calibration for correct 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 selectionThis covers skin assessment and preparation, including shaving hair, gentle abrasion, cleaning with suitable agents, and choosing 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 landmarksThis reviews standard limb and precordial lead positions, key anatomical landmarks, and common placement mistakes. It emphasises accurate, repeatable positioning for good 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 actionsThis focuses on quick spotting of STEMI, ventricular tachycardia, complete heart block, and asystole on a resting ECG, and outlines immediate actions, escalation paths, and basic safety steps for the technician.
ECG criteria for STEMI detectionIdentifying ventricular tachycardiaRecognising complete heart blockConfirming true asystole vs artefactImmediate actions and escalationDocumenting critical ECG eventsLesson 10Post-test documentation: report components, transmitting ECG to physician, storage, labelling, time stamps, and quality assurance logsThis outlines required post-test documentation, including labelling, time stamps, report components, storage, secure sending to the physician, and quality assurance logs to support tracking and checks.
Essential identifiers on each tracingRecording date, time, and operatorSummarising technical quality notesTransmitting ECG to physician systemsArchiving and backup proceduresCompleting QA and incident logs
