- Normal adult pulse range
- 60–100 beats per minute. Below 60 = bradycardia; above 100 = tachycardia.
- Normal adult respiratory rate
- 12–20 breaths per minute.
- Normal adult oral temperature
- About 97.8–99.1°F, averaging ~98.6°F (37°C).
- Normal adult blood pressure
- Less than 120/80 mmHg is normal.
- Normal oxygen saturation (SpO₂)
- 95–100%.
- Five Rights of Delegation
- Right task, right circumstance, right person, right direction/communication, right supervision/evaluation.
- Who is accountable for a delegated task?
- The delegating nurse remains accountable; the PCT performs it and may decline a task outside their scope.
- Proper body mechanics for lifting
- Feet apart, bend the knees, keep the back straight, and lift with the legs — not the back.
- Gait belt — purpose
- A safety belt around the patient's waist that the PCT grasps to support a weight-bearing patient during transfer or ambulation.
- Weight-bearing vs non-weight-bearing transfer
- Weight-bearing: gait belt + body mechanics. Non-weight-bearing: a mechanical lift.
- Before any transfer, you must…
- Lock the bed and wheelchair wheels and put non-skid footwear on the patient.
- Fowler's position
- Semi-sitting with the head of bed raised ~45–60°; eases breathing and helps with eating.
- Supine position
- Lying flat on the back, face up.
- Prone position
- Lying flat on the stomach, face down.
- Lateral position
- Side-lying; relieves pressure on the back and sacrum.
- Sims' position
- Semi-prone on the left side; used for enemas and rectal procedures.
- Trendelenburg position
- Head lower than the feet (bed tilted); sometimes used for shock or hypotension per order.
- How often to reposition an immobile patient
- At least every 2 hours to prevent pressure injuries.
- Pressure injury — Stage 1
- Intact skin with non-blanchable redness over a bony area.
- Pressure injury — Stage 2
- Partial-thickness skin loss — a shallow open ulcer or blister.
- Pressure injury — Stage 3
- Full-thickness loss exposing fat (subcutaneous tissue).
- Pressure injury — Stage 4
- Full-thickness loss exposing muscle, tendon, or bone.
- Common pressure-injury sites
- Bony areas: sacrum, heels, hips, elbows, and the back of the head.
- Devices that prevent skin breakdown
- Air (alternating-pressure) mattresses, draw sheets, heel protectors, and frequent repositioning.
- ADLs (activities of daily living)
- Bathing, dressing, eating, toileting, grooming, and mobility.
- Types of bed baths
- Partial bath, full bed bath, and sitz bath (perineal soak).
- Perineal care direction (female)
- Always clean front to back to avoid contaminating the urethra.
- Foley catheter care goal
- Keep the bag below the bladder, the tubing free of kinks, and perform perineal/catheter care to prevent CAUTI.
- Passive range-of-motion (ROM)
- The caregiver moves the patient's joints for them; prevents contractures and stiffness.
- Intake and output (I&O)
- Measured fluid in (oral, IV) and out (urine, emesis, drainage), recorded in mL to track fluid balance.
- Oxygen delivery — nasal cannula
- Low-flow oxygen via two prongs in the nares; comfortable for low oxygen needs.
- Oxygen delivery — non-rebreather mask
- High-concentration oxygen via a mask with a reservoir bag and one-way valves.
- Oxygen safety
- Oxygen supports combustion — no open flames, keep away from heat sources, post 'oxygen in use' signs.
- Feeding tube types
- PEG (percutaneous endoscopic gastrostomy), G (gastrostomy), and NG (nasogastric) tubes.
- Aspiration precautions for tube feeding
- Keep the head of bed elevated (≥ 30–45°), watch for tubing kinks, and report complications.
- Incentive spirometer — purpose
- Encourages deep breathing to expand the lungs and prevent pneumonia/atelectasis after surgery.
- TCDB exercises
- Turn, cough, and deep breathe — keep the lungs clear and prevent respiratory complications.
- Sequential compression devices (SCDs)
- Inflatable sleeves that squeeze the legs to prevent blood clots (DVT) in immobile patients.
- Antiembolism stockings
- Compression hose that promote venous return and help prevent deep vein thrombosis.
- Adult CPR compression-to-ventilation ratio
- 30:2 for a single rescuer (healthcare provider BLS).
- Adult CPR compression rate and depth
- 100–120 compressions per minute, at least 2 inches (5 cm) deep.
- When does the PCT begin CPR?
- When a patient is unresponsive and not breathing/pulseless — activate emergency response and start compressions.
- Critical value — what to do
- Report it to the assigned nurse immediately; it is a result far outside normal needing prompt action.
- Pain scale
- A 0–10 numeric scale (or faces scale) used to assess and report a patient's pain level.
- Edema
- Swelling from fluid buildup in tissue; recognize and report it, especially in the legs and feet.
- Signs of a wound infection
- Redness, warmth, swelling, pain, purulent (pus) drainage, and possibly fever — report them.
- Kübler-Ross five stages of grief
- Denial, anger, bargaining, depression, and acceptance (not a fixed order).
- Postmortem care
- Respectful care of the body after death — positioning, cleaning, and following facility/cultural policy.
- Patient rounding
- Regularly checking pain, positioning, personal needs, and proactive ADLs; supports safety and HCAHPS.
- Prioritizing patient needs
- Consider fall risk, elopement risk, rapid responses, and stat lab values; address the most urgent first.
- Removing a peripheral IV (PCT role)
- Performed when delegated and per policy: stop infusion, remove, apply pressure, and check the site.
- Therapeutic communication
- Active listening, open-ended questions, empathy, and silence to support a patient emotionally.
- Two-identifier rule before care
- Confirm the patient with name and date of birth — never the room or bed number.
- Weighing a patient
- Use the correct scale (standing, chair/wheelchair, or bed) and weigh at the same time/conditions for accuracy.
- Abnormal urine to report
- Dark, cloudy, bloody, foul-smelling, or very low output (oliguria) urine.
- HCAHPS
- Hospital Consumer Assessment of Healthcare Providers and Systems — a patient-experience survey; rounding helps scores.
- Splint application (immobility)
- Apply safely to immobilize a limb; check circulation, sensation, and movement distal to the splint.
- Aspiration
- Inhaling food, fluid, or secretions into the airway/lungs; prevent with upright positioning and precautions.
- Mastectomy-side blood pressure rule
- Do not take BP (or draw blood) on the arm of a mastectomy side — use the other arm.
- Two patient identifiers
- Full name and date of birth, verified against the order and wristband — never the room number.
- HIPAA
- The Health Insurance Portability and Accountability Act — protects patients' protected health information (PHI).
- PHI
- Protected health information — individually identifiable health data that must be kept private and secure.
- PCT scope of practice
- Provide delegated, supportive care under a nurse; do NOT diagnose, prescribe, interpret results, or treat.
- Mandated reporter
- A PCT must report suspected abuse or neglect based on reasonable suspicion — it is required, not optional.
- Types of abuse
- Physical, emotional/psychological, sexual, financial, and neglect.
- Patients' Bill of Rights
- Patients' rights including privacy, informed consent, respectful care, and refusal of treatment.
- Chain of command
- The facility's order of authority through which a PCT reports concerns and seeks direction.
- OSHA
- Occupational Safety and Health Administration — sets and enforces workplace safety standards.
- Safety Data Sheet (SDS)
- A document listing a chemical's hazards, safe handling, PPE, and first aid.
- RACE (fire response)
- Rescue, Alarm, Confine, Extinguish/Evacuate.
- PASS (fire extinguisher)
- Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side.
- Where to aim a fire extinguisher
- At the base of the flames, not the tops.
- Joint Commission (JC)
- Accredits healthcare facilities and sets the National Patient Safety Goals.
- National Patient Safety Goals
- Joint Commission standards — including the two-identifier rule — to improve patient safety.
- Restraints — rules
- Use only with an order and per policy, as a last resort; check the patient frequently and document.
- Side rails and bed safety
- Lock beds and wheelchairs; raise side rails only when ordered; keep the bed low and the call light in reach.
- Incident/accident reporting
- Report and document any work-related accident or patient incident promptly per facility policy.
- Electronic health record (EHR)
- A digital patient chart; access only on a need-to-know basis and log off when done.
- Medical ethics
- Principles guiding conduct: beneficence, nonmaleficence, autonomy, justice, and confidentiality.
- Negligence
- Failure to provide the standard of care a reasonable person would, resulting in harm.
- Informed consent
- The patient's voluntary agreement to a procedure after being told the risks and benefits.
- Confidentiality
- Keeping patient information private; a HIPAA and ethical requirement.
- CLSI
- Clinical and Laboratory Standards Institute — sets lab standards including the order of draw.
- CLIA
- Clinical Laboratory Improvement Amendments — federal standards regulating laboratory testing quality.
- Incidental disclosure (HIPAA)
- An overheard disclosure despite reasonable safeguards is permitted; deliberate snooping is a violation.
- HIPAA violation examples
- Snooping in a record, discussing patients in public, or copying PHI to a personal device.
- Emergency/disaster preparedness
- Know facility codes and acronyms (RACE, PASS) and evacuation routes.
- Reporting a needlestick
- Wash the area, report immediately, and follow the facility's exposure-control plan.
- Workplace safety agencies
- OSHA (regulations), NIOSH (research), and CDC (guidelines).
- Standard precautions
- Treat every patient's blood and body fluids as infectious — hand hygiene and PPE for all patients, always.
- Most effective way to prevent infection spread
- Hand hygiene (washing or alcohol rub) — it breaks the chain of infection.
- Transmission-based precautions — three types
- Contact, droplet, and airborne — added for a known or suspected specific infection.
- Contact precautions
- Gown + gloves and dedicated equipment for MRSA, C. difficile, scabies, etc.
- Droplet precautions
- Surgical mask within ~6 feet for influenza, pertussis, mumps.
- Airborne precautions
- N95 respirator + negative-pressure room for tuberculosis, measles, varicella.
- C. difficile special rule
- Contact precautions AND wash with soap and water — alcohol rub does NOT kill the spores.
- Chain of infection — six links
- Agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host.
- Most common mode of transmission
- Contact (often via the hands of healthcare workers).
- PPE donning (put-on) order
- Gown → mask/respirator → goggles/face shield → gloves.
- PPE doffing (take-off) order
- Gloves → goggles/face shield → gown → mask/respirator (most contaminated off first).
- When to perform hand hygiene with PPE
- Before donning PPE and again after doffing it.
- HAI (healthcare-associated infection)
- An infection acquired while receiving care, e.g., UTI, MRSA, or C. difficile.
- MRSA
- Methicillin-resistant Staphylococcus aureus — antibiotic-resistant; requires contact precautions.
- Sharps disposal
- Drop point-first into a puncture-resistant sharps container; never recap a needle by hand.
- Red biohazard bag
- For contaminated waste (not sharps); follow OSHA and facility policy.
- Aseptic (medical asepsis) technique
- Practices that reduce the number and spread of microorganisms — clean technique and hand hygiene.
- Sterile (surgical asepsis) technique
- Keeping an area completely free of microorganisms for invasive or sterile procedures.
- Disinfecting equipment
- Clean reusable equipment before and after use and observe the disinfectant's contact (wet/dry) time.
- Exposure control plan
- The facility's written plan for responding to occupational bloodborne-pathogen exposure.
- When to wear gloves
- Whenever contact with blood, body fluids, mucous membranes, or non-intact skin is likely.
- Hand hygiene with visibly soiled hands
- Wash with soap and water; alcohol rub is for hands that are not visibly soiled.
- CLSI order of draw
- Blood culture → light blue (citrate) → red/gold (serum) → green (heparin) → lavender (EDTA) → gray (fluoride).
- Why follow the order of draw?
- To prevent additive carryover from one tube contaminating and skewing the next.
- Light-blue tube
- Sodium citrate additive; coagulation tests (PT/PTT). Must be filled completely.
- Red / gold (SST) tube
- Clot activator (and gel in SST); serum chemistry tests.
- Green tube
- Heparin additive; plasma chemistry tests.
- Lavender (purple) tube
- EDTA additive; hematology and CBC.
- Gray tube
- Sodium fluoride additive; glucose and lactate testing.
- Which tube is drawn first?
- Blood culture bottles — to protect sterility.
- Preferred venipuncture site
- The median cubital vein in the antecubital fossa (front of the elbow).
- Tourniquet time limit
- No longer than 1 minute, to avoid hemoconcentration and skewed results.
- Venipuncture
- Drawing blood from a vein using an evacuated tube system, a winged (butterfly) set, or a syringe.
- Capillary puncture sites
- Fingerstick in adults; heelstick in infants.
- Hematoma
- Blood pooling under the skin — from a needle through the vein or pressure not held; release tourniquet and apply pressure.
- Petechiae
- Tiny red spots on the skin; may indicate a clotting problem.
- Syncope during a draw
- Fainting; stop the draw, lower the head, stay with the patient, and prevent a fall.
- Nerve injury sign
- Sharp, shooting pain or tingling; remove the needle immediately and report.
- Hemolysis
- Rupture of red blood cells that ruins a specimen — a preanalytical error from rough handling/technique.
- QNS
- Quantity not sufficient — too little specimen to test; recollect.
- When to label specimens
- At the bedside, immediately after collection — never before, never away from the patient.
- Specimen label must include
- Patient name, date of birth, date and time of collection, and the collector's identifier.
- Chain of custody
- Documentation tracking a specimen from collection to testing for forensic, blood-alcohol, and drug-screen samples.
- Fasting requirement
- Some tests (e.g., glucose, lipids) require the patient to fast; verify before drawing.
- Basal state
- The patient's resting metabolic state (early morning, ~12 h fast) required for certain tests.
- Blood culture collection
- Disinfect the site thoroughly (asepsis) and draw into sterile bottles first to avoid contamination.
- Specimen handling requirements
- Some specimens need protection from light, a specific temperature, or prompt delivery (time-sensitive).
- Nonblood specimens
- Urine, stool, sputum, and semen; explain collection to the patient and label correctly.
- Order-of-draw memory aid
- 'Boys Love Ravishing Girls in Lavender Gowns' — Blue, Light/serum (Red), Green, Lavender, Gray.
- Vascular system basics for phlebotomy
- Veins carry blood toward the heart; arteries away. Phlebotomy uses superficial veins.
- CLIA-waived testing QC
- Quality control performed for simple, waived tests to ensure accurate results.
- Avoid drawing from which arm?
- An arm with an IV, a dialysis fistula/graft, or on a mastectomy side.
- 12-lead EKG — number of electrodes
- 10 electrodes: 4 limb + 6 chest (precordial). They produce 12 views (leads).
- SA node
- The sinoatrial node — the heart's natural pacemaker in the right atrium; fires 60–100/min.
- Cardiac conduction pathway
- SA node → AV node → bundle of His → bundle branches → Purkinje fibers.
- P wave
- Atrial depolarization (the atria contracting).
- QRS complex
- Ventricular depolarization (the ventricles contracting).
- T wave
- Ventricular repolarization (the ventricles recovering).
- Standard EKG paper speed
- 25 mm/s.
- Standard EKG sensitivity (standardization)
- 10 mm = 1 mV.
- V1 electrode position
- 4th intercostal space, right sternal border.
- V2 electrode position
- 4th intercostal space, left sternal border.
- V4 electrode position
- 5th intercostal space, left midclavicular line.
- Wandering baseline artifact
- Slow up-and-down drift from movement, breathing, or loose/dried electrodes; re-prep skin and replace electrodes.
- Somatic (muscle) tremor artifact
- Fuzzy, erratic spikes from shivering or tension; relax and reposition the patient.
- AC / electrical (60-cycle) artifact
- Uniform thick fuzz from nearby electrical equipment or crossed wires; unplug devices, uncross leads, check grounding.
- Ventricular fibrillation (VF)
- A chaotic, quivering baseline with no organized QRS — life-threatening and shockable; start CPR.
- Ventricular tachycardia (VT)
- A fast, wide-complex rhythm; life-threatening — escalate immediately.
- Asystole
- A flat line with no electrical activity (cardiac standstill); treat with CPR, not a shock.
- PCT's role in EKG
- Recognize and report dysrhythmias and escalate dangerous ones — but do NOT diagnose.
- Skin prep for EKG
- Clean and dry the skin, remove hair where it blocks an electrode, for good contact and a clean tracing.
- Special EKG patients
- Pediatric, mastectomy, amputation, right-sided heart, and posterior chest need modified placement.
- Signs of cardiopulmonary compromise
- Chest pain, shortness of breath, fainting, or an ominous rhythm — stay with the patient and call for help.
- Bradycardia vs tachycardia
- Bradycardia is a heart rate under 60/min; tachycardia is over 100/min.
- Body systems the CPCT/A should know
- Cardiovascular, respiratory, musculoskeletal, nervous, digestive, urinary, integumentary, and endocrine systems.
- Myocardial infarction (MI)
- A heart attack — blocked blood flow to heart muscle; signs include chest pain, shortness of breath, and diaphoresis.
- Congestive heart failure (CHF)
- The heart can't pump effectively, causing fluid backup — edema, shortness of breath, and weight gain.
- COPD
- Chronic obstructive pulmonary disease — long-term airflow limitation; patients may need low-flow oxygen.
- Diabetes mellitus
- Impaired blood-glucose regulation; watch for and report hypo- or hyperglycemia.
- Hypoglycemia signs
- Shakiness, sweating, confusion, and rapid pulse from low blood sugar — report promptly.
- CVA (stroke) — FAST
- Face drooping, Arm weakness, Speech difficulty, Time to call for help.
- Apical pulse
- Heart rate counted with a stethoscope at the apex of the heart for one full minute.
- Radial pulse
- The pulse felt at the wrist (radial artery), commonly used for a routine pulse.
- Orthostatic (postural) hypotension
- A drop in blood pressure on standing; rise the patient slowly to prevent falls.
- Korotkoff sounds
- The sounds heard with a stethoscope while measuring blood pressure — first sound = systolic, last = diastolic.
- Pulse oximeter
- A device clipped on a finger that measures oxygen saturation (SpO₂) noninvasively.
- Restraint alternatives
- Frequent rounding, bed/chair alarms, low beds, and addressing needs — try these before restraints.
- Fall prevention
- Call light in reach, bed low and locked, non-skid footwear, clear path, and frequent rounding.
- Logrolling
- Turning a patient as one unit to keep the spine aligned (e.g., after spinal injury).
- Dangling
- Sitting a patient on the edge of the bed before standing to prevent dizziness/falls.
- Drainage types
- Serous (clear), sanguineous (bloody), serosanguineous (mixed), and purulent (pus).
- Ostomy care
- Care of a surgical stoma (e.g., colostomy); the PCT may assist but does not irrigate it.
- Emesis
- Vomiting; observe and report the amount, color, and content.
- Sputum
- Mucus coughed up from the lungs; note color/consistency and collect specimens as ordered.
- Decubitus ulcer
- Another name for a pressure injury (bedsore).
- Anti-embolism — contraindication
- Do not apply compression to a leg with a known clot (DVT).
- Range of motion — active vs passive
- Active: the patient moves the joint; passive: the caregiver moves it for them.
- Hospice care
- Comfort-focused (palliative) care for terminally ill patients; the PCT supports comfort and coping.
- Bariatric patient care
- Use appropriate equipment and extra staff; protect skin folds and use safe handling.
- Documentation rule
- Chart objective, factual, timely observations; correct errors with a single line and initials — never erase.
- Reporting vs recording
- Report = tell the nurse verbally (urgent); record = document in the chart.
- Daily weight purpose
- Tracks fluid status (e.g., in CHF); weigh at the same time, scale, and clothing each day.
- Aspiration precaution position
- Sit the patient upright (high Fowler's) for meals and tube feedings.
- Catheter-associated UTI (CAUTI)
- A common HAI; prevent with perineal care, a closed system, and keeping the bag below the bladder.
- Beneficence
- The ethical duty to act in the patient's best interest (do good).
- Nonmaleficence
- The ethical duty to do no harm.
- Autonomy
- Respecting a patient's right to make their own care decisions.
- Advance directive
- A legal document stating a patient's care wishes if they can't speak for themselves (e.g., living will).
- DNR order
- Do Not Resuscitate — a physician order to withhold CPR; honor it per policy.
- Assault vs battery
- Assault = threatening harm; battery = actual unwanted physical contact.
- Defamation
- Harming a reputation: libel (written) or slander (spoken).
- False imprisonment
- Restraining or confining a patient without consent or order (e.g., improper restraint use).
- Standard of care
- The level of care a reasonably prudent worker would provide in the same situation.
- Liability
- Legal responsibility for one's actions, including negligence.
- Cultural competence
- Providing respectful care that accounts for a patient's culture, language, and beliefs.
- Interpreter use
- Use a trained/medical interpreter (not family) for patients with limited English when possible.
- HIPAA minimum necessary
- Access and share only the PHI needed to do the job.
- Workplace violence response
- Follow facility codes, protect yourself and patients, and call for help/security.
- Ergonomics
- Designing tasks and using technique to reduce strain and prevent injury.
- Body substance isolation
- Treating all body substances as infectious — the basis of standard precautions.
- Medical terminology — '-itis'
- Suffix meaning inflammation (e.g., dermatitis = skin inflammation).
- Medical terminology — 'brady-'
- Prefix meaning slow (e.g., bradycardia = slow heart rate).
- Medical terminology — 'tachy-'
- Prefix meaning fast (e.g., tachycardia = fast heart rate).
- Medical terminology — 'hypo-' / 'hyper-'
- Hypo- = below/low; hyper- = above/high.
- Tuberculosis precautions
- Airborne — N95 respirator and a negative-pressure room.
- Influenza precautions
- Droplet — a surgical mask within about 6 feet.
- MRSA precautions
- Contact — gown and gloves; dedicated equipment.
- Hand hygiene before and after
- Perform before and after every patient contact — the single most important infection-control measure.
- Surgical (sterile) field rules
- Keep sterile items above waist level, in view, and never reach over the field; 1-inch border is non-sterile.
- Bloodborne pathogens
- Pathogens carried in blood — e.g., HIV, hepatitis B (HBV), hepatitis C (HCV).
- Hepatitis B vaccine
- Offered to at-risk healthcare workers under OSHA to prevent HBV infection.
- Engineering controls
- Devices that reduce exposure — sharps containers and safety-engineered (retractable) needles.
- Work-practice controls
- Safe behaviors that reduce exposure — no recapping, hand hygiene, proper PPE.
- Reservoir examples
- People, contaminated equipment, water, and surfaces where pathogens live and multiply.
- Portal of entry examples
- Broken skin, mucous membranes, and the respiratory or urinary tract.
- Disinfectant contact (dwell) time
- The time a surface must stay wet with disinfectant to kill pathogens — follow the label.
- Sharps container — when to replace
- Before it overfills (about ¾ full); never overstuff it.
- Spill of body fluid
- Wear PPE, contain and disinfect per policy, and dispose of waste as biohazard.
- Evacuated tube system (ETS)
- A vacuum tube + holder + double-ended needle — the most common venipuncture method.
- Winged (butterfly) set
- A small needle with tubing for small or fragile veins (hand, elderly, pediatric).
- Antecubital veins (order of choice)
- Median cubital first, then cephalic, then basilic (basilic last — near the nerve and artery).
- Needle gauge
- The smaller the gauge number, the larger the needle bore (e.g., 21G is larger than 23G).
- Common venipuncture angle
- Insert at about 15–30 degrees, bevel up.
- Order-of-draw reason — citrate
- If drawn after another additive, carryover changes the blood-to-citrate ratio and invalidates coagulation tests.
- Lipemic specimen
- A cloudy, fatty specimen — often from a non-fasting patient when fasting was required.
- Icteric specimen
- A specimen with high bilirubin (yellow); a patient/disease factor, not a collection error.
- Centrifuge
- Spins a tube to separate serum/plasma from cells; let serum tubes clot first.
- Serum vs plasma
- Serum = liquid after clotting (no anticoagulant); plasma = liquid with an anticoagulant, cells removed.
- Fistula/graft caution
- Never apply a tourniquet or draw blood from an arm with a dialysis fistula or graft.
- Edematous arm
- Avoid drawing from a swollen (edematous) area — results are unreliable.
- Hemoconcentration
- Falsely elevated values from a tourniquet left on too long (> 1 minute) or excessive fist pumping.
- Capillary order of draw
- Different from venous: blood gases first, then EDTA (lavender), then other additives, then serum.
- Heelstick site (infant)
- The medial or lateral plantar (bottom) surface of the heel — avoid the center/arch.
- Requisition form
- Lists the ordered tests and patient info; verify it matches the patient's two identifiers.
- Tourniquet placement
- About 3–4 inches above the intended puncture site.
- Concentric circles cleaning
- Clean a venipuncture site from the center outward (especially for blood cultures).
- Post-draw site care
- Apply firm pressure until bleeding stops; apply a bandage and check for a hematoma.
- Implied consent
- Consent inferred from a patient's actions (e.g., extending the arm for a draw).
- Limb electrode placement
- One on each arm and each leg (the right-leg electrode is the ground).
- V3 electrode position
- Midway between V2 and V4.
- V5 electrode position
- Left anterior axillary line, level with V4.
- V6 electrode position
- Left midaxillary line, level with V4 and V5.
- Electrodes vs leads
- Electrodes are the sensors on the skin; leads are the calculated views (12 leads from 10 electrodes).
- Calibration mark
- The square standardization mark confirming 1 mV = 10 mm; check it before recording.
- Half standardization
- Sensitivity reduced to 5 mm/mV when complexes are too tall to fit the paper.
- Paper speed 50 mm/s
- A faster speed sometimes used to spread out fast rhythms for clarity.
- PR interval (normal)
- 0.12–0.20 seconds — the time for the impulse to travel from atria to ventricles.
- QRS duration (normal)
- Less than 0.12 seconds; a wide QRS suggests a ventricular origin.
- EKG equipment maintenance
- Clean the machine and cables, replace electrodes, and check for frayed wires regularly.
- 3-lead vs 5-lead vs 12-lead
- 3- and 5-lead are used for continuous monitoring; 12-lead is the full diagnostic resting EKG.
- Normal sinus rhythm
- Regular, 60–100/min, with an upright P wave before every QRS.
- Crossed lead wires
- A cause of AC/electrical interference — uncross them to clean up the tracing.
