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Introducing… the iECG! A Telemetry Monitor for the iPhone

The company AliveCor has created a portable heart monitor for the iPhone.   It is a single lead ECG that uses a simple 3-volt coin cell battery for power and sends all of its readings to your iPhone remotely.  The app on your iPhone then records, displays, and stores the ECG readings in your phone.   It can also transfer the readings to a secure server where specialists can review them remotely.

iECG

The FDA has approved use of this device for physicians and patients with a prescription for it.  It has been mentioned that it can and will possibly be used in local pharmacies and physician offices.  It is said to be much more cost-effective than the traditional 12-lead EKG’s that are currently being used.  The iECG AliveCor app and device is also extremely portable and flexible. 

One much discussed use for this new iECG is its ability to detect the arrhythmia atrial fibrillation.  In fact, it is said that many physician offices are using the device as a screening tool done by the office’s ancillary staff before the patient is even seen by the physician- almost like another vital sign.  This is because of the device’s ability to send the reading to a website that can automatically analyze and determine if the patient is having atrial fibrillation to a 97% accuracy per recent research.

The reason that the atrial fibrillation detection use is getting so much attention is because atrial fibrillation is “the most common heart rhythm problem and is responsible for almost one-third of all strokes.”

Atrial fibrillation causes the top chambers of the heart quiver or fibrillate.  Besides decreasing the efficiency at which the heart is able to pump blood, it also causes turbulence of the blood inside the heart’s atria.  The body sees this turbulence as almost like an injury and sends platelets there.  This accumulation of platelets causes clots to form in the atria.  These clots then get pumped through the heart and can get sent to the lung causing what’s called a pulmonary embolus or the brain causing a stroke.  Patients with atrial fibrillation most times get put on some kind of anticoagulant or “blood thinner” like Coumadin/Warfarin or Plavix.

Some symptoms of atrial fibrillation are dizziness or lightheadedness, fatigue, palpitations (the patient may state it feels like their heart is “fluttering”).   However, atrial fibrillation may also cause no symptoms in the patient at all – in this case this rhythm can go undetected and untreated and lead to one of the life-threatening complications mentioned above.  This is why using the new AliveCor iECG as a screening tool can be so useful.

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EKG or Telemetry- what’s the difference anyway?

Sometimes we hear the terms EKG and cardiac telemetry used interchangeably, but they can actually be very different. 

             Cardiac telemetry, what most nurses and monitor technicians use in the hospital setting to monitor their cardiac patients, is a remote-type of monitoring. 

VersaCare-Transmitter

Cardiac telemetry

             Patients requiring cardiac telemetry monitoring are usually admitted to the hospital for some kind of cardiac issue or are admitted for a different issue but have a history of some kind of cardiac disease.  They are usually hooked up to three to five electrodes wired to a small, portable battery pack or to a cardiac monitor in the case of the intensive care unit.  The cardiac electrical activity is then transmitted remotely to a central monitoring station – in most cases a nurses’ station or monitor room with a monitor technician.  Patients can be monitored for a few hours or for their entire hospital stay.

              Cardiac telemetry’s purpose is to monitor heart rhythm changes or a patient’s cardiac electrical activity over a period of time.

              An EKG, or 12-lead EKG as it is sometimes called, is a single diagnostic test that can be done in a hospital setting or in a physician’s office.  EKG’s can be used in the hospital setting for several reasons:

1) In an emergent situation for a patient having respiratory or cardiac signs and symptoms such as chest pain or sudden onset shortness of breath to determine if any heart damage is taking place and, if so, where part of the heart is being damaged.

2)  Sometimes physicians order EKG’s to be done as a one-time thing when the patient first comes to the hospital to diagnose any current cardiac issues or to get a baseline EKG to compare  to in case the patient runs into problems or has issues later on.

12 lead EK

12-Lead EKG machine

             For an EKG, the patient lays flat, six electrodes are placed on their chest, one on each arm, and one on each leg.  The patient lays still while the EKG reads the patient’s heart rhythm for a few seconds.  The EKG machine then prints out a reading for the physician to read and interpret.

            EKG’s and cardiac telemetry also differs in how many leads they use to look at the heart.  Think of leads like cameras or camera angles.  Each lead is a different camera angle taking a picture of the heart.

           EKG’s can usually look at twelve different angles of the heart while cardiac telemetry can usually only see five leads with only two visible on the monitor at one time.  However, remember that an EKG is just a snapshot, where as telemetry is monitored over a longer period of time.  Try comparing it to your camera:  it’s like taking a single snapshot of something from twelve different angles all at once or taking video of that same thing from five different angles over a 24-hour period.

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EKG Testing: Patient Types

An electrocardiogram (ECG or EKG) is known as a test that records electrical activity from the heart. This electrical stimulus test holds responsibility for heart and its electrical system‘reporting’ the heart’s coordinated beating. Any abnormalities or problems with the test recording indicate abnormal heart rhythms.

Heart attacks are likely to also change the electrical impulses derived from the test. Therefore, the electrocardiogram sometimes helps diagnose these heart attacks, in addition to the aforementioned abnormal heart rhythms, and aids doctors in deciding which treatments to use for various heart-related problems.

The EKG examination

To perform the test, no major preparation is required. The EKG technician performs the test by placing sensors or electrodes with conductive gel applied onto a patient’s chest, arms and legs. The leads then collect and measure electrical activity from the heart, from the sensor’s different angles, as the heart beats.

Patients have to lie still during the examination, which allows the technician or examiner to accurately measure the electrical activity.

During this process, the electrical activity gets recorded, later examined by a cardiologist. Although patients are advised to report any type of chest pains during the exam, most patients don’t have to restrict physical activity following the completion of the exam.

EKG patients who need close EKG monitoring

Patients are advised to get an electrocardiogram performed if they’re experiencing chest pains or other cardiovascular problems. Due to the nature of this test, there are specific types of patients that may better benefit using the tool to detect their cardiovascular issues.

Some patients need constant, close monitoring for their EKG rhythms. The types of patients who benefit from getting frequent electrocardiograms include:

  • Patients who may have experienced abnormalities in their heart rate and/or rhythm. Abnormalities in heart rate may indicate the onset of issues potentially affecting the heart’s regular functions.
  • Patients who have experienced a heart attack and/or stroke in the past. Electrocardiograms help check the heart’s condition following the onset of the aforementioned conditions. This further monitors the damage impacting the heart.
  • People who may be at risk of heart-related conditions. Diabetes, high blood pressure and heart disease can affect the heart in detrimental ways. This helps doctors quickly diagnose any underlying problems as they’re detected.
  • People who are over the age of 40. People in this age bracket may be at risk of age-related heart conditions and other cardiovascular abnormalities. Some doctors may advise patients around that age to have a regular electrocardiogram as a part of their annual checkup.
  • People who suffer from chronic conditions or diseases. Sometimes, debilitating immune disorders like HIV and AIDS can affect how the heart functions. Electrocardiograms help detect issues with the heart, allowing doctors to diagnose treatment options to prevent the further aggravation of those diseases.

Why get an electrocardiogram?

Electrocardiograms are perhaps the most common cardiac test. It’s a powerful tool used to screen a variety of cardiovascular conditions and abnormalities. They can detect heart rate and rhythm, abnormalities in its electrical impulses, heart complications from heart attacks and the thickening of the heart’s muscles, in addition to the onset of coronary artery disease.

Since the device used to perform the test is readily available at various medical facilities, it’s simple to perform and relatively inexpensive. Patients who aren’t experiencing any issues, however, aren’t advised to get an electrocardiogram unless advised.

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How Are EKG Courses Typically Taken for Nurses?

What are the training options?

Heart disease and other heart-related health conditions are becoming more and more prevalent now than ever before.  There are nurselearnmany different factors that may cause people to be more at risk than others.  Despite those circumstances, the major issue at hand here is that this calls for more healthcare professionals to be trained on how to identify and address these issues before they become fatal.

 

Physicians and surgeons have been trained over the years in more advanced techniques and procedures that could be used to diagnose and treat these conditions, but even nurses have been able to expand their own knowledge through specialized training.  One particular area of training that seems to be getting the most attention in recent years is the performance of electrocardiograms (also known as EKGs).  There are several different ways that nurses can receive training in order to become experts at administering this particular type of examination.

Through the Hospital

 

One way that nurses can train to become experts at performing EKGs for their patients is through the hospitals in which they work.  Most hospitals and even private practice clinics throughout the country offer different training and continuing education courses to their employees in order to make sure that they are fully trained efficiently in as many areas as possible.  In most cases, nurse practitioners, head nurses and physicians will be the ones that will handle this training since they all have acquired a sufficient amount of experience in this area throughout their careers.

Through a University

 

Another way that nurses can get this type of training is by taking a course that is offered by a local university, community college or trade school.  In most cases, they would need to pay tuition expenses for these courses instead of receiving discounted rates or even free training by going through their hospitals.  However, these educational courses provide classroom instruction and hands-on training to make sure that each nurse is able to get the knowledge and experience that they need in order to be used more within the workplace.  Since they already work within a hospital, they will be able to learn much quicker than other students that are not employed nurses simply because of the increased amount of on-the-job training that they will receive.

Through an Online Website

 

Advancements in technology have opened up a third method of effective training that was not available two decades ago – the Internet.  There are several credible websites that have been approved and licensed to provide training on administering this particular test through an online course as well.  This is a very convenient option, especially for nurses that are unable to schedule time out of their busy lives to attend school or even a course within a hospital.

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