Chapter 14: Observations
Skip chapter table of contents and go to main content
Post‐procedural considerations
Immediate care
Once the ECG is complete, it must be interpreted by a competent and trained healthcare professional so that any changes that might require urgent medical attention are identified and appropriate action taken (Peate and Wild [157], SCST [183]). If the patient had any cardiac symptoms at the time of the recording, such as chest pain or palpitations, this should be noted on the tracing and brought to the immediate attention of a senior member of the nursing or medical staff (SCST [183]). Examples of a normal 12‐lead ECG and some important types of abnormal ECG tracing are shown in Figure 14.19.
Figure 14.19 (a) Normal electrocardiogram tracing. Abnormal electrocardiogram tracings: (b) first‐degree AV block, (c) atrial fibrillation, (d) ventricular tachycardia and (e) ventricular fibrillation. Source: Reproduced from Tortora and Derrickson ([198]) with permission of John Wiley & Sons.
Documentation
It is good practice for the reviewer, who may be a doctor or senior nurse, to document their interpretation of the ECG directly onto the ECG and to sign and date it or the equivalent if using electronic documentation. Once reviewed, the ECG should be filed in the patient's medical notes. Nurses should document in the nursing notes when the ECG was recorded, who was asked to review it and the time the ECG was reviewed; they should also indicate whether it was normal or, if abnormal, what further action was taken (Adam et al. [2], Blows [21], SCST [183]).
