MACP 323 - CH49 P49-2

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OSHA Guideline: Wash hands, have a biohazard waste bin, and sharps container nearby for use

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Procedure Goal: To monitor the electrical activity of a patient’s heart over a 24-hour period to detect cardiac abnormalities that may go undetected during routine electrocardiography or stress testing

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Ambulatory Monitoring PROCEDURE 49-2

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Materials: Patient chart/progress note; ambulatory monitor; battery; microchip, SD card, or small cassette; patient diary or log, if needed; alcohol; gauze pads; scissors; disposable electrodes; hypoallergenic tape; drape; electrocardiograph

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Transfer the data from the monitor to the patient’s chart according to office procedure and the manufacturer’s directions.

Step 18

Ensure that the unit is on and indicate the start time in the patient’s chart.

Step 13

Wash your hands and assemble the equipment.

Step 3

Drop the object directly into an approved puncture-proof container for sharps. Engage safety device, if indicated.

Step 4

Document the procedure.

Step 19

Insert a fresh battery and position the unit.

Step 10

Ask the patient to remove clothing from the waist up; provide a drape if necessary.

Step 2

Insert the SD card or other storage device and turn on the unit.

Step 12

Wash your hands.

Step 17

Identify the patient, introduce yourself, and explain the procedure.

Step 1

Schedule the patient’s return visit for the same time on the following day.

Step 15

If the patient’s body hair is particularly dense, don examination gloves and trim the areas where the electrodes will be attached using the scissors.

Step 5

Instruct the patient on proper use of the monitor and how to enter information in the diary. Caution the patient not to alter any diary entries; it is crucial to know what the patient is doing at all times.

Step 14

Tape wires, cable, and electrodes as necessary to avoid tension on the wires as the patient moves.

Step 11

Clean the electrode sites with alcohol or an approved skin prep solution and gauze

Step 6

Attach wires to the electrodes and peel off the paper backing on the electrodes. Apply electrodes at locations as indicated by the manufacturer’s instructions. Press firmly to ensure that each electrode is making good contact with the skin.

Step 8

On the following day, remove the electrodes, discard them, and clean the electrode sites.

Step 16

Assist the patient into a comfortable position (sitting or supine).

Step 4

Attach the patient cable.

Step 9

Rub each electrode site vigorously with a dry gauze square.

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