Prosedur Tindakan Pemasangan EKG ( Elektrokardiogram )

Notes: Prosedur Tindakan Pemasangan EKG (Elektrokardiogram)

1. Summary

This video from APPSKEP provides a practical demonstration and explanation of the procedure for applying an Electrocardiogram (EKG) or ECG. It is presented as a learning resource for nursing students, particularly in preparation for competency exams (UKOM). The video covers the necessary equipment, patient preparation, the step-by-step process of lead placement, and important considerations for ensuring an accurate and effective EKG recording.

2. Key Takeaways

* EKG is a non-invasive diagnostic test that records the electrical activity of the heart.

* Proper patient preparation, including explaining the procedure and ensuring comfort, is crucial.

* Accurate placement of EKG leads is essential for obtaining a reliable recording.

* The procedure involves cleaning the skin, applying electrodes, and connecting them to the EKG machine.

* Key anatomical landmarks are used to guide the correct placement of chest leads (precordial leads).

* It's important to monitor the patient for any adverse reactions during the procedure.

3. Detailed Notes

**I. Introduction and Purpose**

* Video Topic: Procedure for Applying an EKG (Electrocardiogram).

* Target Audience: Nursing students, especially for UKOM (Competency Exam) preparation.

* Source: APPSKEP channel.

* Purpose: To demonstrate and explain the practical steps involved in EKG application.

**II. Equipment Needed**

* EKG Machine (Electrocardiograph)

* EKG Electrodes (Adhesive pads)

* Alcohol Swabs (for skin preparation)

* Razor (if excessive hair is present)

* Gloves (for healthcare provider's protection)

* Conductive Gel/Paste (if not pre-gelled electrodes)

* Patient Chart/Record

**III. Patient Preparation**

* **Explanation:**

* Inform the patient about the procedure: what it is, why it's being done, and what to expect.

* Explain that it is a painless and non-invasive test.

* Reassure the patient and answer any questions.

* **Positioning:**

* Position the patient comfortably, usually lying down on their back (supine position).

* Ensure the examination area is accessible and private.

* **Skin Preparation:**

* Expose the areas where electrodes will be placed (chest, arms, and legs).

* Cleanse the skin with alcohol swabs to remove oils, sweat, and lotions, which can interfere with electrode adhesion and signal transmission.

* If there is excessive hair, it may need to be shaved to ensure good contact between the electrode and the skin.

**IV. Lead Placement (Detailed Steps)**

* **General Principles:**

* Electrodes are placed at specific points on the body to capture the electrical signals from the heart from different angles.

* Clean skin ensures good contact and reduces artifacts.

* Correct placement is crucial for an accurate interpretation of the EKG tracing.

* **Limb Leads (Bipolar Leads I, II, III and Augmented Leads aVR, aVL, aVF):**

* These leads monitor the electrical activity in the frontal plane.

* **Placement:** Typically applied to the wrists and ankles.

* Right Arm (RA)

* Left Arm (LA)

* Right Leg (RL) - Often serves as a ground electrode.

* Left Leg (LL)

* **Connection:** Connect the corresponding limb lead wires to the correct electrodes.

* **Precordial Leads (Chest Leads V1-V6):**

* These leads provide a cross-sectional view of the heart's electrical activity in the horizontal plane.

* **Placement Landmarks (Critical):**

* **V1:** 4th intercostal space, right sternal border.

* **V2:** 4th intercostal space, left sternal border.

* **V3:** Midway between V2 and V4.

* **V4:** 5th intercostal space, midclavicular line (directly below the nipple).

* **V5:** Anterior axillary line, same horizontal level as V4 (anterior to the armpit).

* **V6:** Midaxillary line, same horizontal level as V4 and V5 (directly under the midpoint of the armpit).

* **Connection:** Connect the precordial lead wires to the corresponding chest electrodes.

**V. EKG Machine Operation**

* Turn on the EKG machine.

* Ensure the leads are properly connected to the machine.

* Initiate the recording process as per the machine's instructions.

* The machine will then print or display the EKG tracing.

**VI. Post-Procedure Care**

* Remove the electrodes carefully to avoid skin irritation.

* Clean any residue from the skin.

* Ensure the patient is comfortable and assist them if needed.

* Document the procedure in the patient's chart.

* Review the EKG tracing for any obvious artifacts or abnormalities (though formal interpretation is done by a physician or qualified professional).

**VII. Important Considerations and Troubleshooting**

* **Artifacts:** Recognize and minimize sources of interference (patient movement, electrical interference, loose electrodes).

* **Patient Comfort:** Ensure the room temperature is comfortable and the patient is not experiencing pain.

* **Infection Control:** Use gloves and maintain aseptic technique where appropriate.

* **Accuracy:** Double-check lead placement before starting the recording.

**VIII. APPSKEP Resources**

* Social Media: Instagram handles provided for APPSKEP, Ask Bidan, Ask Bunda, ASNesia.

* Email: info@appskep.id

* Websites:

* ukom.appskep.id (UKOM Preparation Platform)

* cpns.appskep.id (CPNS Preparation Platform)

* WhatsApp Marketing: +62 852-7813-5376 (Wilda Dahlia)

* Encouragement: Wishes of success and benefit from the video.