The screen may show no reading, a fluctuating numerical value or waveform, or a reading that does not correspond with the clinical picture. One of the most common reasons for the alarm to go off is because one of the sensors isn’t receiving information. Although the alarm may indicate a serious issue such as a sudden drop in O2 saturation or BP, it is important to note that just because the alarm is going off doesn’t always mean that there is a clinical problem. If any of the vital signs fall outside of the range of normal, the patient monitor will alert clinicians by sounding an alarm and flashing an alert on the screen. Respiratory Waveform: The “RESP” waveform on the monitor is useful for clinicians to monitor for any respiratory issues such as apnea or dyspnea. Each peak of the SpO2 waveform should correlate with a heartbeat on the ECG waveform at the same intervals, since oxygenated blood is being pumped out of the heart with each heartbeat. SpO2 Waveform: The SpO2 waveform allows clinicians to determine whether there are any issues with circulation or peripheral perfusion. For resources to review lead placements, check out the CanadiEM Frontline Primer or this blogpost by Life in the Fast Lane for an in-depth explanation. If you have any concerns regarding a patient’s cardiac function, get a 12-lead ECG! Knowing the proper lead placements for 5-point cardiac monitors and 12-lead ECGs is also an important skill for junior learners in the ED. Instead, it is most useful for guiding acute resuscitations or managing arrhythmias, since it can give you some information on the electrical activity of the heart and its level of function. What the Lines Mean:ĮCG Readout:The ECG readout on the patient monitor is not intended for detailed ECG analysis as it typically only represents one lead (most commonly lead II). However, this number isn’t very accurate, especially as the patient’s breathing goes faster or slower. It is reported in breaths per minute, with normal values between 12 and 20. Respiratory Rate (RR): Look for the patient’s respiratory rate under “RR” on the patient monitor. A normal O2 saturation is 95% or greater however, it is important to remember that some populations such as those with COPD have a lower normal cutoff. Oxygen Saturation (SpO2): The patient’s oxygen saturation will be located on the monitor under “SpO2” and is a measure of the amount of oxygen in the patient’s blood. A normal adult has a resting heart rate between 60-100 bpm.īlood Pressure (BP): The patient’s blood pressure is typically presented on the screen under “SYST” or “SYS” for systolic and “DIAS” or “DIA” for diastolic. The number will be identified by a “HR” or “PR” (pulse rate) beside or just above it and is presented in beats per minute (bpm). Heart Rate (HR): Typically, the heart rate is presented at the top of the monitor in green.
The typical layout includes the numerical vital signs on the right and the waveforms on the left, giving you a general overview of the patient’s real-time vitals. Knowing the basics of patient monitor interpretation and ECG lead placement can make a junior clerk a valuable member of the Emergency Department team.
HEART MONITOR MACHINE HOW TO
There are so many numbers, waveforms, and sounds – how are you supposed to know what is what? When you’re in a busy Emergency Department, it is important to be familiar with what a typical patient monitor looks like and how to interpret all of the components. Patient monitors can be overwhelming early in your training when you’re not quite sure what you’re looking at. He reminds you to check the patient monitor when you go in there to look for any abnormalities and to record a new set of vitals on the chart. It’s your first day as a clerk in the Emergency Department and your staff has asked you to see an 80 year old patient with known COPD presenting with increasing shortness of breath.
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