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In most clinical settings, EKG machines are used to detect heart abnormalities in adults, but for those who work with children, it is important to know the differences in what is considered “normal” for these tests. Just like the heart rate of a child is dissimilar to that of an adult, the parameters to be studied in an electrocardiogram are also different. Children also develop common arrhythmias that may not be seen in adults, so their treatment options will vary.

EKG machines still study the same waveforms (P, QRS and T) in a child’s heart, because the conduction pathways are the same, and the approach to analyzing these signals doesn’t change from child to adult. Even the mechanisms of arrhythmias occur similarly in adults and children. However, there are important differences in how these ECG results are understood and interpreted.

For example, children shift from right ventricular dominance as newborns into left ventricular dominance by the time they reach their first birthday. Another major difference in the ECG interpretation for children is the type of arrhythmias (abnormal rhythms) that are most commonly seen. The most common ones include bradycardia, sinus arrhythmia, and supraventricular tachycardia. Adults are more likely to see results such as atrial fibrillation or flutter, and ventricular tachycardia, which are rarely seen in a child’s EKG results.
Each of these conditions must be carefully studied, in relation to how it may affect children differently than adults. Pediatric EKG tests should only be evaluated by individuals who are aware of these differences may impact the ultimate diagnosis and treatment of the patient.

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In a recent news release from the American Association of Critical Care Nurses (AACN), comes a strong recommendation for helping to prevent medication induced heart problems. The AACN has had concerns about the prevention of TdP (Torsade de Points), a rare problem with the heart’s rhythm that can cause a sudden drop in blood pressure. TdP can also cause patients to faint or lead to sudden cardiac arrest or ventricular fibrillation.

Their recommendation is that patients who are being treated with certain medications undergo testing on an EKG machine regularly. These medications include intravenous antibiotics, anti-arrhythmia drugs and some antipsychotics. The reason for frequent EKG testing is some of these drugs can prolong the Q-T interval of the heart. When patients undergo regular monitoring, caregivers can become aware of this abnormality immediately and act upon it.

Studies have shown that when a patient is monitored continuously on an EKG machines, TdP can be detected more readily, as well as other cardiac irregularities that may lead to arrhythmia. When these TdP symptoms are recognized, it is possible to stop administering that the culprit drugs before any serious conditions arise.
In addition to including a list of drugs that may cause TdP (alone or in combination with other drugs), the AACN statement makes the following recommendation AACN says that any at-risk TdP patient should receive ongoing ECG testing to guide physicians in managing the outcome of a drug-induced extended Q-T interval, and provide immediate treatment at its onset. This way, if the warning signs are recognized on the EKG machine’s monitor, cardiac arrest can be avoided.

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Ever since the discovery that living tissue has certain electronic properties, researchers began searching for a way to measure these signals. But it was the early research into the “electromotive effect” in 1787 by Aloysio Luigi that ultimately brought forth the development of the electrocardiogram, or EKG machine. In his experiments, he was able to prove that living tissues, muscles in particular, can generate electricity. When other scientists started investigating this effect, it wasn’t long before the discovered the electronic potential of a beating heart. Eventually, after Willem Einthoven introduced the string galvanometer, it was finally possible for these impulses to be measured.

When the signal created by the heart was applied to a string galvanometer, it caused the string to move, and the resulting deflections were recorded as a graph on paper. This early version of the EKG machine was first used in 1903 and it wasn’t long before large-scale manufacturing began throughout the world. One of the first companies to make these machines was Edelmann and Sons (Munich, Germany). The electrocardiogram was later made in the US by the Hindle Instrument Company.
Since the early 20th century, many improvements have been made to the design of the EKG machine, including the decreased size of the electromagnet. These advances have made it possible for EKGs to be done in mobile emergency units. Another major improvement was the ability for doctors to attach the machine’s electrodes directly to the skin, rather than submerging them in jars containing sodium chloride solution. Amplifiers have also been added, which have improved the quality of the electronic signal. With the introduction of computer interfaces and microelectronics, today’s EKG machines look quite a bit different from the early models, but they are no more accurate than Einthoven’s original model.

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