Lesson 1Recognising and correcting common artefacts: movement, muscle tremor, baseline wander, AC interference, and poor contactThis lesson teaches how to spot common artefacts like movement, tremor, baseline wander, AC interference, and poor contact, along with step-by-step methods to identify and fix them prior to final recording for reliable results.
Spotting patient movement artefactHandling muscle tremor and shiveringFixing causes of baseline wanderMinimising AC and electrical interferenceEnhancing electrode contact qualityVerifying tracing after fixesLesson 2Escalation protocol when abnormal/dangerous tracing identified: notifying clinician, activating emergency response, and documenting communicationsThis lesson outlines the escalation process for dangerous or unexpected ECG results, covering whom to inform, how to trigger emergency responses, and accurate recording of communications and timings to ensure prompt action.
Defining abnormal and critical findingsInforming the responsible clinicianTriggering emergency response systemsRemaining with unstable patientsLogging times and contacts madeHanding over ECG and clinical detailsLesson 3Patient identification and verifying test request against medical record and referral detailsThis lesson addresses verifying patient identity, aligning the ECG request with the medical record and referral, assessing indications and contraindications, and resolving any mismatches to guarantee the right test for the right patient.
Using two unique patient identifiersAligning request to chart and wristbandConfirming indication and urgencyResolving discrepancies before testingRecording verification stepsLesson 4Room and equipment preparation: safety checks, infection control, electrical safety, and privacy setupThis lesson explains setting up the ECG room and equipment, encompassing infection control, electrical and cable safety inspections, privacy arrangements, and supply readiness to create 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 rhythmsThis lesson details modifications for obese patients and those with LVH, bundle branch block, or paced rhythms, including lead adjustments, technical configurations, and noting variants to aid precise 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 lesson covers essential ECG machine settings like paper speed, gain, filters, lead display, and calibration verification. It stresses when to tweak settings and how to confirm calibration for exact 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 lesson includes skin evaluation and preparation, such as shaving hair, mild abrasion, cleaning with suitable agents, and selecting appropriate electrodes to lower impedance and lessen 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 lesson reviews standard limb and precordial lead placements, important anatomical markers, and frequent errors. It highlights precise, repeatable positioning for high-quality, 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 lesson focuses on quick identification of STEMI, ventricular tachycardia, complete heart block, and asystole in resting ECGs, plus immediate responses, escalation routes, and basic safety measures for technicians.
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 lesson specifies post-test documentation needs, such as labelling, time stamps, report elements, storage, secure transmission to physicians, and quality assurance logs for traceability and audits.
Essential identifiers on each tracingRecording date, time, and operatorSummarising technical quality notesTransmitting ECG to physician systemsArchiving and backup proceduresCompleting QA and incident logs
