Difference between revisions of "STEMI-2017/C2/Introduction-to-Kallows-Device/English"
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− | <div style="margin-left:-0.035cm;margin-right:0cm;">Topic: KALLOWS - Positioning ECG leads, BP cuff and SpO2 probe | + | <div style="margin-left:-0.035cm;margin-right:0cm;">Topic: KALLOWS - Positioning ECG leads, BP cuff and SpO2 probe |
− | <div style="margin-left:-0.035cm;margin-right:0cm;">Contributor Name: Jerry David, STEMI Team, Coimbatore | + | <div style="margin-left:-0.035cm;margin-right:0cm;">Contributor Name: Jerry David, STEMI Team, Coimbatore |
− | <div style="margin-left:-0.035cm;margin-right:0cm;">Reviewed by: Nancy Varkey, Spoken Tutorial Project, IIT Bombay | + | <div style="margin-left:-0.035cm;margin-right:0cm;">Reviewed by: Nancy Varkey, Spoken Tutorial Project, IIT Bombay |
Keywords: STEMI Kit, NIBP, SpO2, ECG, Electrode, B.P cuff, Mobmon 12.0 | Keywords: STEMI Kit, NIBP, SpO2, ECG, Electrode, B.P cuff, Mobmon 12.0 | ||
Line 11: | Line 11: | ||
{| border=1 | {| border=1 | ||
|- | |- | ||
− | | | + | | '''''VISUAL CUE''''' |
| '''''NARRATION''''' | | '''''NARRATION''''' | ||
|- | |- | ||
Line 21: | Line 21: | ||
|| Learning Objectives | || Learning Objectives | ||
|| In this tutorial we will learn to - | || In this tutorial we will learn to - | ||
− | # | + | # Position '''ECG '''leads, '''B.P. '''cuff & '''SpO2''' |
− | # | + | # Take an '''ECG''' and |
− | # | + | # Check Blood Pressure and '''SpO2''' |
− | + | ||
|- | |- | ||
Line 34: | Line 33: | ||
|| Show Image | || Show Image | ||
|| The '''STEMI Kit''' consists of | || The '''STEMI Kit''' consists of | ||
− | * | + | * An '''Android Tab''' in a metal casing |
− | * | + | * '''Mobmon Device''' 12.0 |
− | * | + | * '''Bluetooth B.P. monitor''' |
− | * | + | * '''ECG electrodes''' |
− | * | + | * '''SpO2 probe''' |
− | * | + | * '''Wi-Fi Printer''' |
− | * | + | * Power Strip |
− | + | ||
|- | |- | ||
Line 65: | Line 63: | ||
|| Show image | || Show image | ||
|| This '''probe''' is made up of the following parts- | || This '''probe''' is made up of the following parts- | ||
− | # | + | # '''Oximetry probe/cable''' |
− | # | + | # '''Sensor''' |
|- | |- | ||
Line 83: | Line 81: | ||
|| Show image | || Show image | ||
|| While selecting a '''sensor''' site, priority should be given to an extremity free of - | || While selecting a '''sensor''' site, priority should be given to an extremity free of - | ||
− | # | + | # an '''arterial catheter''', |
− | # | + | # '''blood pressure cuff''' |
− | # | + | # or '''intravascular infusion line'''. |
− | + | ||
|- | |- | ||
Line 92: | Line 89: | ||
|| The typical sites for '''oximetry probe '''connections are - | || The typical sites for '''oximetry probe '''connections are - | ||
− | * | + | * For adults/ pediatrics: Finger, toe and pinna (top) or lobe of the ear. |
− | * | + | * For infants: Foot or palm of the hand and the big toe or thumb. |
− | + | ||
|- | |- | ||
− | || | + | || Show images as per narration |
|| '''Pls note: ''' | || '''Pls note: ''' | ||
− | * | + | * Reusable '''sensors''' may be used on the same site for a maximum period of 4 hrs, Make sure that the site is inspected routinely to ensure skin integrity. |
− | * | + | * Do not use wet or damaged '''sensors'''. They may cause burns during the '''electro surgery''' or when applying other electrical device. |
− | * | + | * Tissue damage/ burn can be caused by incorrect application or use of '''SpO2 sensor'''. |
− | * | + | * Do not twist unnecessarily or use excessive force when using, connecting, disconnecting or storing the '''sensor'''. |
− | * | + | * Loss of '''pulse signal''' can occur |
− | + | **if the '''sensor''' is too tight or | |
+ | **if there is excessive illumination from light sources such as surgical lamp, a '''bilirubin lamp''' or sunlight | ||
|- | |- | ||
Line 115: | Line 112: | ||
|| Show image | || Show image | ||
|| | || | ||
− | # | + | # Measure the patient's limb and select the proper '''cuff size'''. |
− | # | + | # As a general rule, '''cuff''' width should span approximately two - thirds of the distance between patient, elbow, shoulder. |
− | # | + | # Wrap the '''NIBP cuff''', preferably onto the left hand (on the '''brachial artery''') of the patient as shown in the figure. |
− | + | # The''' NIBP cuff''' must be wrapped tightly on the patient's limb for proper management. | |
|- | |- | ||
|| | || | ||
|| Press the '''Start''' button to activate '''Bluetooth BP Monitor.''' | || Press the '''Start''' button to activate '''Bluetooth BP Monitor.''' | ||
+ | |||
|- | |- | ||
− | || | + | || Show the images as per narration |
|| Pls note: | || Pls note: | ||
Inaccurate measurements may be caused by incorrect application or use such as- | Inaccurate measurements may be caused by incorrect application or use such as- | ||
− | + | * Placing the '''cuff''' too loosely on the patient | |
− | + | * Using incorrect '''cuff size''' | |
− | * | + | * Not placing the '''cuff''' at the same level of the heart |
− | * | + | * Leaky '''cuff''' or tube |
− | * | + | * Excessive patient motion. |
− | * | + | |
− | * | + | |
− | + | ||
|- | |- | ||
− | || | + | || Show the images as per narration |
|| Do not connect the '''SpO2 sensor '''and the '''B.P cuff '''to the same limb of the patient. | || Do not connect the '''SpO2 sensor '''and the '''B.P cuff '''to the same limb of the patient. | ||
− | |||
This is to avoid nuisance alarms. | This is to avoid nuisance alarms. | ||
Line 146: | Line 140: | ||
|| Show image | || Show image | ||
|| Make sure that while measuring the '''NIBP,''' the tube of the '''cuff''' is not blocked or tangled. | || Make sure that while measuring the '''NIBP,''' the tube of the '''cuff''' is not blocked or tangled. | ||
− | |||
− | |||
|- | |- | ||
|| | || | ||
|| Finally, let’s see how to position the '''ECG leads.''' | || Finally, let’s see how to position the '''ECG leads.''' | ||
+ | |||
|- | |- | ||
|| '''PATIENT PREPARATION''' | || '''PATIENT PREPARATION''' | ||
− | || Quality '''ECG''' rhythm can be obtained with good skin preparation and proper electrode placement. | + | || Quality '''ECG''' rhythm can be obtained with good skin preparation and proper '''electrode''' placement. |
+ | |||
|- | |- | ||
|| | || | ||
− | + | Show images as per narration one by one | |
|| The following must be done for good patient preparation- | || The following must be done for good patient preparation- | ||
− | # | + | # Clean '''electrode''' site and shave surface hair from chest |
− | # | + | # Gently rub the skin with spirit to remove outer epidermal layer and skin becomes lightly red. |
− | # | + | # Allow the '''electrode''' site to dry. |
− | # | + | # Remove dry '''gel''' from '''electrode''' surface, if any. |
− | # | + | # Place the '''electrodes''' on the flat non-muscular & non-hairy areas |
− | # | + | # Use good quality (highly conductive) fresh '''gel'''. |
− | # | + | # Apply sufficient quantity of gel on the '''electrode''' surface to establish good contact. |
− | + | ||
|- | |- | ||
|| Show image | || Show image | ||
|| Note: | || Note: | ||
− | + | Ensure that conductive portions of the | |
− | # | + | # '''electrodes, leads '''and''' cables ''' do not come into contact with any other conductive parts. |
− | + | # Do not use damaged '''electrode leads'''. | |
− | + | # Ensure that '''electrodes''' are not loosely applied. | |
− | do not come into contact with any other conductive parts. | + | # This will cause artifacts and will sound heart rate alarms, causing endless inconvenience. |
− | # | + | |
− | # | + | |
− | + | ||
|- | |- | ||
|| Show image | || Show image | ||
|| This is how the '''electrodes''' should be placed. | || This is how the '''electrodes''' should be placed. | ||
− | |||
− | |||
{| style="border-spacing:0;width:8.334cm;" | {| style="border-spacing:0;width:8.334cm;" | ||
Line 193: | Line 181: | ||
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| RA | | align=center| RA | ||
− | || Right intraclavicular area | + | || Right '''intraclavicular''' area |
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| LA | | align=center| LA | ||
− | || Left intraclavicular area | + | || Left '''intraclavicular''' area |
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| V1 | | align=center| V1 | ||
− | || Fourth intercostal space at right border of sternum | + | || Fourth '''intercostal''' space at right border of '''sternum''' |
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| V2 | | align=center| V2 | ||
− | || Fourth intercostal space at left border of sternum | + | || Fourth '''intercostal''' space at left border of '''sternum''' |
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| V3 | | align=center| V3 | ||
Line 208: | Line 196: | ||
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| V4 | | align=center| V4 | ||
− | || Fifth intercostal space on left midclavicular line | + | || Fifth '''intercostal''' space on left '''midclavicular line''' |
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| V5 | | align=center| V5 | ||
− | || Fifth intercostal left anterior axillary line | + | || Fifth '''intercostal''' left '''anterior axillary line''' |
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| V6 | | align=center| V6 | ||
− | || Fifth intercostal left midaxillary line | + | || Fifth '''intercostal''' left '''midaxillary line''' |
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| RL | | align=center| RL | ||
− | || Right lower abdominal quadrant just above inguinal ligament | + | || Right lower '''abdominal quadrant''' just above '''inguinal ligament''' |
|- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | |- style="border:1pt solid #000000;padding-top:0cm;padding-bottom:0cm;padding-left:0.191cm;padding-right:0.191cm;" | ||
| align=center| LL | | align=center| LL | ||
− | || Left | + | || Left lower '''abdominal quadrant''' just above '''inguinal ligament''' |
|- | |- | ||
|} | |} | ||
|- | |- | ||
− | | | + | || Show the image |
|| Make sure the power cord and patient cable do not cross each other. | || Make sure the power cord and patient cable do not cross each other. | ||
+ | |||
|- | |- | ||
|| Show image | || Show image | ||
|| Switch on the '''Mobmon device''' by selecting power '''on/ off '''button on the side. | || Switch on the '''Mobmon device''' by selecting power '''on/ off '''button on the side. | ||
+ | |||
|- | |- | ||
|| STEMI App to be shown here | || STEMI App to be shown here | ||
|| Select '''ECG tab '''on the '''STEMI device '''to view the '''ECG''', in the '''ECG''' live steam page. | || Select '''ECG tab '''on the '''STEMI device '''to view the '''ECG''', in the '''ECG''' live steam page. | ||
+ | |||
|- | |- | ||
− | || | + | || Summary slide |
− | + | ||
− | + | ||
− | + | ||
− | + | ||
− | + | ||
|| Let us summarize. | || Let us summarize. | ||
− | |||
− | |||
− | |||
− | |||
+ | In this tutorial, we have learnt - | ||
+ | * how to position '''ECG leads, BP cuff '''and''' SpO2 probe.''' | ||
+ | * Take an''' ECG''' | ||
+ | * Check '''blood pressure '''and''' SPO2''' | ||
|- | |- | ||
|| Show STEMI INDIA slide | || Show STEMI INDIA slide | ||
|| '''STEMI INDIA''' | || '''STEMI INDIA''' | ||
− | * | + | * was set up as a ‘not for profit’ organisation |
− | * | + | * primarily to reduce delays in accessing appropriate care for heart attack patients |
− | * | + | * and reducing deaths due to heart attacks |
− | + | ||
|- | |- | ||
|| Show Spoken Tutorial Project Slide | || Show Spoken Tutorial Project Slide | ||
− | || Spoken Tutorial Project, IIT Bombay | + | || Spoken Tutorial Project, IIT Bombay is funded by NMEICT, MHRD, Govt. of India. |
− | For more details, please visit | + | For more details, please visit https://spoken-tutorial.org |
|- | |- | ||
|| Show THANK YOU slide | || Show THANK YOU slide | ||
|| This tutorial has been contributed by | || This tutorial has been contributed by | ||
− | * | + | * STEMI INDIA |
− | * | + | * and the Spoken Tutorial Project, IIT Bombay. |
This is Nancy Varkey signing off. Thanks for joining. | This is Nancy Varkey signing off. Thanks for joining. | ||
|- | |- | ||
|} | |} |
Latest revision as of 22:14, 1 July 2020
Topic: KALLOWS - Positioning ECG leads, BP cuff and SpO2 probe
Contributor Name: Jerry David, STEMI Team, Coimbatore
Reviewed by: Nancy Varkey, Spoken Tutorial Project, IIT Bombay
Keywords: STEMI Kit, NIBP, SpO2, ECG, Electrode, B.P cuff, Mobmon 12.0
VISUAL CUE | NARRATION | ||||||||||||||||||||||
Show Slide
Kallows STEMI Kit. |
Hello and welcome to this tutorial on the Kallows STEMI Kit. | ||||||||||||||||||||||
Learning Objectives | In this tutorial we will learn to -
| ||||||||||||||||||||||
Show Slide
Hardware Requirements |
To practise this tutorial, you will need the Kallows STEMI Kit. | ||||||||||||||||||||||
Show Image | The STEMI Kit consists of
| ||||||||||||||||||||||
Show image | This is the Mobmon device. | ||||||||||||||||||||||
Show image | It has a power button along with the charging port on the left side. | ||||||||||||||||||||||
Show image | And the SpO2 and ECG ports on the back side. | ||||||||||||||||||||||
Show image | This cable head has to be inserted into the ECG port on the Mobmon device. | ||||||||||||||||||||||
Show image | After connecting, secure the connection with the screws provided on either sides. | ||||||||||||||||||||||
Show image | Next, we will learn about the SpO2 probe. | ||||||||||||||||||||||
Show image | This probe is made up of the following parts-
| ||||||||||||||||||||||
Show image | Let’s now see how to position the SpO2 probe. | ||||||||||||||||||||||
Show image | Connect the oximetry probe/cable to the SpO2 connector on the Mobmon device. | ||||||||||||||||||||||
Show image | This is how it should look when connected. | ||||||||||||||||||||||
Show image | The patient's finger must be inserted right to the end of the sensor as shown in the figure. | ||||||||||||||||||||||
Show image | While selecting a sensor site, priority should be given to an extremity free of -
| ||||||||||||||||||||||
Show image | The typical sites for oximetry probe connections are -
| ||||||||||||||||||||||
Show images as per narration | Pls note:
| ||||||||||||||||||||||
NIBP CUFF PLACEMENT | Next, let’s learn how to position Blood Pressure cuff. | ||||||||||||||||||||||
Show image | Connect the cuff connector to NIBP Connector of the Bluetooth device. | ||||||||||||||||||||||
Show image |
| ||||||||||||||||||||||
Press the Start button to activate Bluetooth BP Monitor. | |||||||||||||||||||||||
Show the images as per narration | Pls note:
Inaccurate measurements may be caused by incorrect application or use such as-
| ||||||||||||||||||||||
Show the images as per narration | Do not connect the SpO2 sensor and the B.P cuff to the same limb of the patient.
This is to avoid nuisance alarms. | ||||||||||||||||||||||
Show image | Make sure that while measuring the NIBP, the tube of the cuff is not blocked or tangled. | ||||||||||||||||||||||
Finally, let’s see how to position the ECG leads. | |||||||||||||||||||||||
PATIENT PREPARATION | Quality ECG rhythm can be obtained with good skin preparation and proper electrode placement. | ||||||||||||||||||||||
Show images as per narration one by one |
The following must be done for good patient preparation-
| ||||||||||||||||||||||
Show image | Note:
Ensure that conductive portions of the
| ||||||||||||||||||||||
Show image | This is how the electrodes should be placed.
| ||||||||||||||||||||||
Show the image | Make sure the power cord and patient cable do not cross each other. | ||||||||||||||||||||||
Show image | Switch on the Mobmon device by selecting power on/ off button on the side. | ||||||||||||||||||||||
STEMI App to be shown here | Select ECG tab on the STEMI device to view the ECG, in the ECG live steam page. | ||||||||||||||||||||||
Summary slide | Let us summarize.
In this tutorial, we have learnt -
| ||||||||||||||||||||||
Show STEMI INDIA slide | STEMI INDIA
| ||||||||||||||||||||||
Show Spoken Tutorial Project Slide | Spoken Tutorial Project, IIT Bombay is funded by NMEICT, MHRD, Govt. of India.
| ||||||||||||||||||||||
Show THANK YOU slide | This tutorial has been contributed by
This is Nancy Varkey signing off. Thanks for joining. |