Lesson 1Recognising and correcting common artefacts: movement, muscle tremor, baseline wander, AC interference, and poor contactTeaches recognition of common artefacts such as movement, tremor, baseline wander, AC interference, and poor contact, and provides systematic steps to troubleshoot and correct them before final recording to ensure reliable results.
Identifying patient movement artefactManaging 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 communicationsDescribes the escalation pathway when dangerous or unexpected ECG findings are seen, including who to notify, how to activate emergency response, and how to document communications and times accurately for patient safety.
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 detailsCovers confirming patient identity, matching the ECG request to the chart and referral, checking indications and contraindications, and resolving discrepancies to ensure the correct test is performed on the correct patient every time.
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 setupExplains preparing the ECG room and equipment, including infection control, electrical and cable safety checks, privacy measures, and readiness of supplies to ensure a safe, comfortable, and compliant testing environment for all.
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 rhythmsDetails adaptations for obese patients and those with LVH, bundle branch block, or paced rhythms, including lead placement adjustments, technical settings, and documentation of variants to support accurate interpretation in diverse cases.
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 checksExplains key ECG machine settings: paper speed, gain, filters, lead display, and calibration checks. Emphasises when to adjust settings and how to verify calibration for accurate measurements in clinical practice.
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 selectionCovers skin assessment and preparation, including shaving hair, gentle abrasion, cleaning with appropriate agents, and choosing suitable electrodes to minimise impedance and reduce artefact for better signal quality.
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, key anatomical landmarks, and common placement errors. Emphasises accurate, reproducible positioning to ensure diagnostic quality and comparability of ECGs across sessions.
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 rapid recognition of STEMI, ventricular tachycardia, complete heart block, and asystole on a resting ECG, and outlines immediate actions, escalation pathways, and basic safety steps for the technician in urgent situations.
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 logsOutlines required post-test documentation, including labelling, time stamps, report components, storage, secure transmission to the physician, and quality assurance logs to support traceability and audit in healthcare settings.
Essential identifiers on each tracingRecording date, time, and operatorSummarising technical quality notesTransmitting ECG to physician systemsArchiving and backup proceduresCompleting QA and incident logs
