ECG Troubleshooting Flashcards

What is the most common cause of a wandering baseline on an ECG?

Answer: Patient movement or poor electrode contact

Wandering baseline is most commonly caused by patient movement, respiratory motion, or poor electrode-skin contact. Proper skin preparation and electrode placement minimize this artifact.

What should you do if the ECG shows 60-cycle (60 Hz) interference?

Answer: Check for nearby electrical equipment and ensure proper grounding

60 Hz interference creates a thick, fuzzy baseline caused by nearby electrical equipment. Solutions include ensuring proper grounding, unplugging nearby devices, and checking cable integrity.

Why is skin preparation important before applying ECG electrodes?

Answer: To reduce impedance and improve signal quality

Cleaning the skin with alcohol and lightly abrading removes oils, dead skin cells, and debris that increase electrical impedance, resulting in cleaner ECG signals.

What happens if limb lead electrodes are placed on the wrong limbs?

Answer: The ECG tracing will show incorrect or inverted waveforms

Incorrect lead placement produces misleading ECG patterns that can mimic pathology, such as lead reversal producing apparent axis deviation or inverted complexes.

How can you distinguish artifact from true ventricular fibrillation?

Answer: Check the patient's pulse and consciousness level

Always assess the patient clinically. If the patient is awake and responsive with a chaotic-looking ECG, it's likely artifact. True V-fib causes immediate loss of consciousness and pulse.

What is the significance of lead reversal on a 12-lead ECG?

Answer: It can mimic pathological conditions and lead to misdiagnosis

Lead reversal can produce ECG patterns that mimic pathology such as dextrocardia, lateral MI, or right axis deviation, potentially leading to unnecessary interventions.