NVQ evidence

James was a 52 year-old gentleman who had been admitted with chest pain. As part of his admission, he required an electrocardiogram. I introduced myself to James and asked him if he did not mind me undertaking an ECG. I explained the procedure to him. He asks if it was going to hurt. I told him it would not. He consented.

Procedure.
I carry out the following procedure, explaining each step before I carried it out:-

I asked James to lie down and making him comfortable. My manner was calm as to put him at ease.

I asked him to unbutton his shirt and placed the ECG stickers in the following places:-
Chest leads
Lead One-4th intercostal space right of centre of midline.
Lead two-4th intercostal space left of centre of midline fit.
Lead three-I left this lead until I had placed lead four. This was placed directly in the middle of leads two and four.
Lead four-5th intercostal space, mid-clavicle
Lead five-5th intercostal space, anterior axilla.
Lead six-5th intercostal space, mid-axilla
Limb leads
Arms:-I asked James to place his arms relaxed by side, it and placed the stickers on the palm side of his wrists. Each sticker was at exactly the same place on the arm as the other.
Legs:-the I placed the stickers on top of his legs at the same parent on each leg. I placed listed where there was little subcutaneous fat has to aid conduction.


I checked the ECG machine:-
I switched it on to see if it is working properly
I checked the paper supply to see if it was not going to run out.
I checked that the leads were not broken and
I attach the leads to the appropriate sticker explaining what I was doing to James.
I ensured that the filter was switched on.


I asked James to lie very still while I took the reading

When the reading was produced, I checked to see that:-
were no life threatening rhythms ,
was no wonder in the tracing,
was no interference in the tracing.

I asks James if he was in pain at all or if he had any discomfort. He said he was not.
I placed a sticker on the ECG tracing for James, having checked it against his name and date of birth. I also wrote on the tracing that James was pain free at time of the ECG as well as the filter being selected.

I then told James that it was my role to show the ECG to the doctor. I told him also that I was not able to interpret his ECG at this level.
It had took the ECG, with James's notes, to show the doctor. The doctor looked at the ECG and said that were there were no acute changes on it. He recorded this on the ECG and signed it.
I returned James. I turned off the machine, removed the leads, removed the stickers, asks him this to do up his shirt and made sure that James was comfortable. I left James comfortable and happy. He had a the call bell to hand and knew how to use it.
I recorded that I had taken an ECG in James' care plan.
I made sure that the ECG machine was put away properly in that the leads were not untidy and mixed up. I made sure that there were stickers for the next person to use it. I pluged in the machine and saw that it was charging.