In our Stroke Unit, either our internal medicine specialist or the dayshift neurologist performs the ECG visit for all patients whose ischemia is etiologically undetermined. This involves the following steps on our Philips monitor system:
- Call up the patient’s window
- Make sure the “Afib” alarm is set on the “Arrhythmiealarme” page
- Alarms: Look at all alarms in the last 24-72 hours
- For any interesting alarm call up the rhythm strip. If necessary, compare RR-intervals using the ruler gadget (left mouse click in the rhythm strip, hold and measure, let go, then click on the new ruler, moving it over the other QRS-complexes)
- Trends: Call up the “Trends” page: look at sudden surges in heart rate. If you found one, click into the timeline to mark the time, then move over to the “Kurve” page to look at the rhythm strip for that time.
- Rhythm strips: Using the “Kurve” page, click arbitrarily into the timeline to sample the ECG, looking out for arrhythmia. If necessary, perform the RR-check