Recording, Transmitting and Maintaining EKG Equipment

Standard Machine Settings and Patient Preparation

Before obtaining an electrocardiogram (EKG), the medical assistant must verify that the machine is configured to standard settings. The standard paper speed for a resting 12-lead EKG is 25 mm per second, and the standard amplitude or gain setting is 10 mm per millivolt. When the machine prints, it generates a standard calibration mark that measures 10 mm in height and 5 mm in width. These baseline parameters ensure that providers can accurately evaluate the timing and size of the heart's electrical events.

Patient positioning directly influences the quality of the tracing and patient comfort. Position the patient supine for a resting EKG whenever it is tolerated. However, if the patient exhibits signs of respiratory distress, allow a more upright position to ease breathing and promptly alert the provider. Once positioned, instruct the patient to lie still, breathe normally, and avoid talking during the recording, as any movement can disrupt the electrical signal.

Occasionally, unique patient circumstances require a change in the machine settings. A provider may request increasing the paper speed to 50 mm per second to spread out waveforms during extreme tachycardia. Conversely, if QRS complexes are exceptionally tall and overlap each other, the gain setting may be adjusted to half-standard at 5 mm per millivolt. Any intentional alteration from standard speed or gain settings must be noted directly on the EKG tracing so the provider is aware of the modification during evaluation.