What are the Tools of an EKG Technician?
The EKG is one tool in the bag of an EKG technician. There are other devices and tests that may be performed in the event the standard EKG does not provide sufficient analysis. These devices are small and may be transported by the patient during their normal daily activity. These two devices are the Holter Monitor and the Event Recorder.
A Holter monitor (also known as an ambulatory EKG) is a machine that continuously records a patient’s heart rhythms, usually over a 24-48 hour period. You will apply electrodes (small conducive patches) to the patient’s chest and attach them to a small recording monitor. The patient then carries the monitor in a pocket or around their neck or waist during the test period.
During the test, the patient will keep track of activities performed and how they feel. At the end of the 24-48 hour period, they will return the monitor to the doctor’s office.
The Holter monitor is used to see how the heart responds to normal activity, not just during the EKG at the doctor’s office. It is also used after major events such as a heart attack or to diagnose heart rhythm problems. Additionally, they may be used to monitor a patient after new medicine has been prescribed.
In the event the patient has symptoms that don’t occur very often, an even recorder device may be used to record when the activity occurs. The device is similar to a Holter monitor but it allows on-demand recording. So, when the patient realizes the symptoms are happening, they can push a button to record the event, and subsequently send to the doctor for analysis. Some event recorders are able to detect the symptoms occurring and automatically being recording. Even recorders are smaller than Holter monitors as they don’t need to store as much data. As an EKG technician, you’ll be expected to inform the patient of differences in the devices and how the patient should interact and use the device.
There are different types of event recorders.
- Autodetect Recorders – these small devices connect sensors on your chest via wires. As the name suggests, the device will detect an irregular activity of the heart, record, and send the data to the physician’s office.
- Postevent Recorders – these devices differ from the others in that there are no sensors on the patient’s chest. When an event is occurring the patient is instructed to start the device recording, usually by a button push, and hold it to their chest. This device is very small and can sometimes be worn like a wristwatch. The drawback to this device is it requires catching the symptoms and recording correctly when it happens. Missed data could be crucial to the physician’s ultimate analysis.
- Presymptom Memory Loop Recorders – These devices are constantly recording and erasing data. When an event occurs, the patient will press a button to stop the erasing functionality. This allows the physician to see what happened before, during, and after the event. These are also small devices often worn on the belt or in pockets and connect via wires to sensors on the chest.
- Implantable Loop Recorders – These devices are used for those cases where the other recorders are not supplying sufficient data. The small device is implanted under the skin with no wires or sensors. It can detect the event and record or be started by the patient depending on the particular device.
As you can imagine, sometimes it takes working the heart out a little bit before symptoms occur. For these situations you have the Stress Test. If you remember the episode of the Cosby Show where Cliff Huxtable was being checked by his doctor, then you have an idea what the stress test looks like. While it may be a little extreme in that particular case, it at least demonstrates the type of activity performed.
During the stress test, electrodes are attached to the patient’s chest and are monitored as they perform some level of exercise, usually on a treadmill. If the patient is unable to perform the exercise, there is also medication that may be administered to mimic the effect of exercise.
The stress test is used to detect problems such as abnormal changes in your heart rate or blood pressure, shortness of breath or chest pain, and abnormal heart rhythm or electrical activity.