TRAINING SESSION BY BME

NORTHWEST GENERAL HOSPITAL

CARDIAC MONITOR
Patient monitors measure, record, distribute and display combinations of biometric values such as heart rate, SPO2,
blood pressure, temperature and more. High-capability, multi-function monitors are typically used in hospitals and
clinics to ensure a high-level of quality patient care.
Parameters of cardiac monitor
Heart rate (60-100bpm)
Heart rate is the speed of the heartbeat measured by the number of contractions (beats)
of the heart per minute (bpm).
Spo2
The saturation of arterial blood with oxygen as measured by pulse oximetry, 
expressed as a percentage.
Pulse
Your pulse is your heart rate, or the number of times your
heart beats in one minute. Pulse rates vary from person to person.
ECG LEADS PLACEMENT
CARDIAC MONITOR
Precautions
• Before connecting the leads clean the skin with alcohol swabs to remove layers
of dead skin.
• Apply Gel to connect the leads.
• 3lead (Red, Yellow, blue/green) is the basic one used in patient monitor.
• Using E.C.G to measure the electric activity of the heart.
• Measuring the heart rate, classifying different types of arrhythmias in the shape
of pqrst wave.
CARDIAC MONITOR
• Causes of noise
• Motion artifacts (displacement of leads, movement of any subject near the patient).
• When the filter settings are turned off.
• Power line interference.
• EMG noise is also caused due to the presence of muscles near the leads.
• Alarm limits
• ECG alarms must be appropriately set and turned on at all times depending on the requirement of the
patient the limit for systolic pressure in some monitors may vary some have 160 others might have 180 .
• If the range of the patient is high or low from the normal b.p the alarm is triggered therefore the patient is
treated accordingly.
TUTORIAL ON CARDIAC MONITOR

• https://www.youtube.com/watch?v=rG7Rnr8Y6mk&t=18s
B.P MEASUREMENT
• Direct method :IBP
• Invasive (intra-arterial) blood pressure (IBP) monitoring is a commonly used technique in
the Intensive Care Unit (ICU) and is also often used in the operating theatre. 
This technique involves direct measurement of arterial pressure by inserting a cannula
needle in a suitable artery. The cannula must be connected to a sterile, fluid-filled system,
which is connected to an electronic patient monitor.
• The components of an intra-arterial monitoring system can be considered in three main
parts:
- the measuring apparatus
- the transducer
- the monitor.
• Indirect method:NIBP(non-invasive blood pressure)
• This method includes placing a cuff according to the arm size of patient and
measuring the blood pressure accordingly.
• Settings of the monitor
• Adult (120 Systolic ,80 Diastolic)
• Peads (87–105 Systolic, 53–66 Diastolic)
• Neonates. (60–90Systolic,20-60 Diastolic)
• Systolic
• When the heart is actively beating (an event called “systole”), it is ejecting blood
out into the arteries. This dynamic ejection of blood into the arteries causes the
pressure within the arteries to rise. The peak blood pressure reached during active
cardiac contraction is called the systolic blood pressure.
• Diastolic pressure
• The diastolic blood pressure is the pressure the blood exerts within the
arteries in between heartbeats, that is, when the heart is not actively ejecting
blood into the arteries.
• Precautions of taking NIBP
• Check the cuff.
• Connect the cuff properly.
• Adjust the size of cuff according to the patient’s age.
• Spo2.
• Measures oxygen rate.
• Precautions of taking Spo2.
• Check the probe.
• Check the led light.
• Connect the probe properly, patient should not move for making accurate
readings.
• Limited or no vibrations.
• Temperature.
• Invasive and non-invasive temperature measurement.
• Measured orally, auxiliary and via ear drum.
• Respiration.
• Measured via impedance, temperature of the patient.
• Measured through E.C.G leads.
DEFIBRILLATOR
• Used to remove the fibrillation of the heart beat.

• Types
• Monophasic (360J)
• Biphasic (200J).
DEFIBRILLATOR
TUTORIAL ON DEFIBRILLATOR

• https://www.youtube.com/watch?v=zE6FVR5mgpI
ECG MACHINE
• The electrocardiogram, is a non-invasive diagnostic test that evaluates your
heart's electrical system to assess for heart disease. It uses flat metal electrodes
placed on your chest to detect the electrical charges generated by your heart as it
beats, which are then graphed.
• Purpose of Test
• An ECG detects your heart's electrical rhythm and produces what's known as a
tracing, which looks like squiggly lines. This tracing consists of representations
of several waves that recur with each heartbeat, about 60 to 100 times per minute.
ECG MACHINE
• Conditions
• There are a number of conditions that can be detected when your doctor checks your pulse, such as
tachycardia (rapid heart rate), bradycardia (slow heart rate), and arrhythmia (irregular heart rate).
• Limitations
• The ECG reveals the heart rate and rhythm only during the few seconds it takes to record the
tracing. If an arrhythmia (heart rhythm irregularity) occurs only intermittently, an ECG might not
pick it up, and ambulatory monitoring may be required.
• Timing
• If you are having an ECG as part of a doctor's visit, anticipate needing an extra 10 to 15 minutes for
the test.
ECG MACHINE TUTORIAL

• https://www.youtube.com/watch?v=qlr0Jgj9IdE
SUCTION MACHINE
• Used to remove substances such as blood, saliva, mucus, and vomit from a person's airway.
• Equipment and Supplies Needed
• Preparing the Patient for Suctioning
• Caregiver Training
• Suctioning the Patient: It is common and perfectly acceptable to use clean versus sterile
technique during suctioning in the home environment. Clean, non-sterile disposable gloves
should be used when performing nasal tracheal deep suctioning. Gloves may not be
necessary when using the tonsil tip suction device
• preventive Maintenance • Daily – Clean filters – Clean air vents – Disinfect jars, tubing,
other components that come into contact w/ patient fluids between each use in solution of
water, detergent, and disinfectant.
SUCTION MACHINE
INFUSION PUMP
• An infusion pump infuses fluids, medication or nutrients into a patient's
 circulatory system. It is generally used intravenously.
• Infusion pumps can administer fluids in ways that would be impractically
expensive or unreliable if performed manually by nursing staff. For example,
they can administer as little as 0.1 mL per hour injections (too small for a
drip),
SYRINGE PUMP
• A syringe driver or syringe pump is a small infusion pump (some include
infuse and withdraw capability), used to gradually manage small amounts of
fluid (with or without medication) to a patient.
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