Monitoring Patients During Stress Tests

Foundations of Stress Testing and the Technician's Scope

Stress tests evaluate the cardiovascular response to increased physical or pharmacological workload. While exercise using a treadmill or cycle ergometer is typical, pharmacological stress testing may be used when a patient cannot exercise adequately on a treadmill or cycle ergometer. Throughout the entire appointment, the supervising licensed provider interprets the stress test and makes clinical diagnoses. The role of the EKG technician centers on preparing the patient, placing leads, acquiring tracings, monitoring for artifact, and promptly reporting concerning findings.

Safety begins well before exercise starts. The technician verifies that informed consent has been obtained and documented according to facility policy. However, the provider is responsible for conducting the informed-consent discussion. The technician must also verify that resuscitation equipment, including a defibrillator, oxygen, and an emergency crash cart, is inspected and present in the stress lab. In the event of cardiac arrest or hemodynamic collapse, the technician's role is to call for emergency help, initiate CPR if indicated, and assist the provider.

Patient communication and comfort lay the groundwork for high-quality data. Preparing the patient includes advising them to wear comfortable walking shoes and loose-fitting clothing. Because physical exertion creates significant movement, thorough skin preparation is essential. The technician cleans the skin and performs gentle abrasion to decrease impedance, ensuring electrodes adhere firmly and signal resistance remains low.