Patient Preparation, Safety, and Infection Control
Preparing the patient
Confirm identity with two identifiers (full name plus date of birth or medical record number) before you touch the patient or the machine. Explain the procedure in plain language, obtain consent per facility policy, provide privacy, and position the patient supine with arms at the sides and legs uncrossed. Expose only the chest area needed. Keep the room warm and the patient covered - shivering produces somatic tremor artifact that can mimic arrhythmia.
Skin preparation
Clean, dry, hair-free skin gives the cleanest tracing. Clip excessive hair rather than shaving (shaving can abrade skin and create irritation). Cleanse with soap and water or alcohol and allow it to dry completely before applying electrodes; gently abrade oily skin with gauze. Lotions, powders, and sweat raise impedance and cause baseline wander and 60-cycle interference.
Electrical and physical safety
Use a properly grounded machine and a hospital-grade outlet; inspect cords and clips for damage and report defects. Never touch the patient during defibrillation or cardioversion, and follow policy about disconnecting leads. Raise and lock the bed, keep the floor dry, and route cables so they are not a trip hazard.
Infection control
Perform hand hygiene before and after every patient contact. Follow standard precautions: gloves whenever contact with blood, body fluids, non-intact skin, or contaminated equipment is possible. Disinfect reusable electrodes and cables between patients; single-use electrodes are never reused.
Traps
Questions test clip-versus-shave, alcohol drying time, and whether the technologist may interpret the tracing (technicians report, they do not diagnose). Also expect mastectomy or amputation items - adjust placement and document.
Rule of thumb: two identifiers, warm room, dry skin, clean hands.