| Problem | Possible causes | Solutions |
|---|
| False high-rate alarm | - Monitor interpreting large T waves as QRS complexes, which doubles the rate
| - Reposition electrodes to lead where QRS complexes are taller than T waves. Decrease gain, if necessary.
|
| | | - Place electrodes away from major muscle masses.
|
| False low-rate alarm | - Shift in electrical axis from patient movement, making QRS complexes too small to register
| - Reapply electrodes. Set gain so height of complex is greater than 1 millivolt.
|
| | | |
| | - Poor contact between electrodes and skin
| |
| Low amplitude | | |
| | - Poor contact between skin and electrodes; dried gel; broken or loose lead wires; poor connection between patient and monitor; malfunctioning monitor; physiologic loss of QRS amplitude
| - Check connections on all lead wires and monitoring cable. Replace electrodes as necessary.
|
| Wandering baseline | - Poor position or contact between electrodes and skin
| - Reposition or replace electrodes.
|
| | - Thoracic movement with respirations
| |
| Artifact (waveform interference) | - Patient having seizures, chills, or anxiety
| - Notify practitioner and treat patient as ordered. Keep patient warm and offer reassurance.
|
| | | |
| | - Electrodes applied improperly
| - Check electrodes and reapply, if needed.
|
| | | - Make sure cables don’t have exposed connectors. Change patient’s static-causing gown or pajamas.
|
| | - Electrical short circuit in lead wires or cable
| - Replace broken equipment. Use stress loops when applying lead wires.
|
| | - Interference from decreased room humidity
| - Regulate humidity to 40%.
|
| Broken lead wires or cable | | - Replace lead wires and fasten the lead wire and cable to the patient’s gown, making a loop.5
|
| | - Cables and lead wires cleaned with alcohol or acetone, causing brittleness
| - Clean cable and lead wires with soapy water. Don’t allow cable ends to become wet. Replace cables as needed.
|
| 60-cycle interference (fuzzy baseline) | - Electrical interference from other equipment in room
| - Attach all electrical equipment to common ground.
- Check plugs to make sure prongs arent loose.
|
| | - Patient’s bed improperly grounded
| - Attach bed ground to the room’s common ground.
|
| Skin excoriation under electrode | - Patient allergic to electrode adhesive
| - Remove electrodes and apply nonallergenic electrodes and nonallergenic tape.
|
| | - Electrode on skin too long
| - Remove electrode, clean site, and reapply electrode at new site.
|
Troubleshooting identifying cardiac monitor problems