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Skip to 0 minutes and 13 seconds On completing your ECG and ensure the adequacy of the trace and the clarity and all your patient’s details are correct, it would now actually be time to actually remove the leads from the patient. So I just sort of gently remove them. I normally start with the limb leads, then move my way onto the chest leads. Then lift the leads clear of your patient. Try not to tangle them, pop them onto the machine and then the bit that’s sometimes a little uncomfortable for the patient is just removing the electrodes, so just be gentle. Everyone’s skin integrity is different, and we wouldn’t want to occasion any skin damage.

Skip to 0 minutes and 56 seconds Obviously, you can see Mark is just gently wincing there, and its authentically such, because obviously it does hurt, so you just want to be gentle, hold the skin taut as you pull the electrode away. And I find it useful to keep the sheet that I’ve taken my original electrodes on just to apply them to it and then that way you don’t find lots of electrodes later on stuck into your bed, and these will be disposed of in your nearest clinical waste bin. Obviously, at this point Mark has actually been extremely good to allow us to do this. You would then assist your patient to sit up. Are you OK Mark to get up? Assisting as necessary. How are you feeling?

Skip to 1 minute and 39 seconds Fine, thank you. Not dizzy or lightheaded? No. OK. Would you like to swing your legs around to the side of the bed there, and I’m just going to lower the bed lightly for you, and then feel free to get dressed again. That’s it. Thank you. And then the final point is actually just to clean your machine. So just remove the ECG out of the way so you don’t get it wet, because you want it to be ready for the next patient that’s going to come along. So what I’m going to do in the first instance is just dispose of everything that I was using during the ECG preparation process. Take that off the machine.

Skip to 2 minutes and 17 seconds If I had used a razor for removing any extra hair, I’d ensure that I dumped it into the sharps box there, so we’re safe in terms of no sharps injuries. And then we’re going to switch off the machine.

Skip to 2 minutes and 32 seconds And I’m going to clean the leads.

Skip to 2 minutes and 51 seconds Then wipe the cable back towards the machine. You’ll just need to hold onto it for a few moments. I’ll wipe the surface and the keyboard, most importantly, because obviously you’ve been touching your patient and then touching the equipment and other sundries around the bed space, so it’s really important that you wipe and clean around.

Skip to 3 minutes and 16 seconds Pop the alcohol gel back at the back there, ready for the next patient. Then wipe your little storage area here to make sure it’s clean and ready for restocking.

Skip to 3 minutes and 31 seconds If you’re going to use the machine immediately on another patient, you would need to get a paper towel and just dry the surfaces, but in view the fact I’m not going directly on to the next patient, I can allow it to air dry, but just make sure your leads are not tangled, and I’ll tend to just actually rest them across the machine here so they don’t tangle up, bring that to the side, get rid of that.

Skip to 3 minutes and 58 seconds Just decontaminate my hands from the cleaning process, and then I’m just going to restock the machine so it’s ready for the next patient. So, again, I will replace some detergent salt water wipes, a couple of disposable razors should we need them again, some gauze for drying and abrading the skin lightly, alcohol swabs for removing excess lipids from the skin there and moisturising creams and, again, a good supply of your electrodes.

Skip to 4 minutes and 31 seconds And the final thing, as what we would normally do, is actually apply a green strip to this machine– various trusts have other colours– to denote who cleaned the machine, what time, and what date, then this can be wheeled back to its original port of storage and plugged into the mains, most importantly, so the battery is always fully charged and the machine is ready for use.

Post-procedure considerations

In our fifth and final video of our ‘How to record an ECG’ series, Clinical Simulation Specialist, Jasmine Burnett, talks us through the post-procedure considerations required when doing a standard ECG recording.

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This video is from the free online course:

ECG Assessment: an Introduction for Healthcare Providers

St George's, University of London