Medical Assistant Prep / Unit 22 MAS 547 review, 2 to 3 minutes
A Cold, Nervous Patient
The idea
This case is constructed for this course. It shows how careful preparation addresses the most common reasons a tracing comes out noisy, before the very first recording is attempted on a patient who is cold and frightened.
In practice
An older woman arrives for an ECG on a cold morning. She is shivering slightly and says she hates tests. Her hands are tense on the table edge. The medical assistant knows that shivering and muscle tension can put fuzz on a tracing, so she prepares for both. She offers a warm blanket and adjusts the room temperature. Then she explains the whole test slowly, emphasizing that it is painless and sends no electricity. She invites the patient to rest her arms at her sides, supported on the table, instead of gripping the edge, and places a pillow under her knees for comfort. She notices that the patient's skin is dry and slightly oily from lotion. She cleans each electrode site carefully, checks that every electrode is firmly attached, and asks the patient to set aside her phone. She waits until the patient's breathing has settled and her hands are relaxed. Then she asks her to stay still and records. The tracing is clean on the first attempt.
Where people slip
Artifact is best handled by prevention: warmth, relaxation, good skin contact and electronics out of the way. Preventing it takes less time than recording, troubleshooting and recording again, and it is kinder to an anxious patient, who does not have to lie through a second or third attempt. The few extra minutes she spent before pressing record were the most efficient part of the visit.
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