How to do an ekg on a child

Pediatric Electrocardiogram (EKG) | Children's Hospital Colorado

Getting a pediatric electrocardiogram

A pediatric electrocardiogram (called an EKG or ECG for short) is a non-invasive heart test that graphically records the electrical activity of the heart in kids.

This test gives doctors information about the heart’s rhythm and whether the electrical activity is too fast, slow or irregular, and if the heart’s chambers are too large or overworked.

An EKG is painless and takes just a few minutes to complete and is the most common test performed in cardiology clinics for children and adults.

During an EKG, our expert will place a series of stickers on your child’s arms, legs and chest. Small wires connected to those patches lead to a machine that records their heart rhythm.

EKGs are available on a walk-in basis at many Children’s Hospital Colorado locations if your doctor has placed an order for one. An expert pediatric cardiologist reads all EKGs completed at Children’s Colorado.

Monitoring your child’s heart outside of the hospital

To record your child’s heart activity outside the hospital, ambulatory monitors, external devices that they can carry, are used. Ambulatory monitors allow doctors to look for evidence of heart problems that come and go or that are not apparent when a standard EKG is performed in the clinic or hospital. These monitors works best when your child has frequent symptoms or if there are symptoms your child may not be noticing.

About Holter monitors

The Holter monitor is a device similar to a pediatric electrocardiogram but is portable and worn by a patient away from the hospital or doctor's office. This device can continuously record heart rhythms and electrical activity over a 24- or 48-hour period. When we attach a Holter monitor to a patient, we place five stickers on the child’s chest that are connected to a small recording box about the size of a cell phone that the patient carries or wears for a specified amount of time.

The device records your child’s heart rate and rhythm continuously during various activities or symptoms. During the recording period, you keep a diary of your child's activities and symptoms. The healthcare team at Children’s Colorado then matches the recordings with the activities and symptoms that occurred while your child was wearing the monitor.

About Zio monitors

The Zio monitor is a device like a Holter monitor that continuously records heart rhythms for a longer period: 7 to 14 days. Instead of five small stickers on your child’s chest, it has a wireless patch monitor that is water resistant and can be worn for a full week. The healthcare team at Children’s Colorado then compares the recordings with activities and symptoms that occurred while wearing the monitor.

About event recorders

Event recorders are small devices used by patients over an even longer period (typically one month). Two or three sticky patches (called "electrodes") on the chest connect the wires to the event recorder. When the child or patient has a symptom, they press a button telling the device to record. We also have hand-held monitors without electrodes that can be used in certain situations.

Event recorders should be worn as much as possible every day to increase the chances of recording the child’s heart rhythm when they have symptoms.

Tips for your child’s EKG from other parents

Ask your nurse for a liquid adhesive remover to take home to help remove the test stickers.
If your child is older, encourage them to take off the stickers themselves. In some cases, this can be less stressful.
Once the stickers are off, use baby oil on a cotton ball to remove any excess stickiness.

Pediatric ECG Lead Placement – Pediatric Cardiology Center of Oregon

Pediatric Cardiology Center of Oregon (PCCO) has been at the forefront of medical care for children and adults with congenital heart disease since first opening its doors in 1986.

PCCO’s pediatric heart program has pioneered important advances in the treatment of congenital heart disease. Plus, our affiliation with Legacy Emanuel Hospital and the Randall Children’s Hospital means that our patients receive first-rate care in a state-of-the-art building designed and built specifically to promote a healing environment for children.

As part of our continuing effort to educate the broader community about our medical services and best practices for treating children with congenital heart disease, we thought we’d take a moment to go over the basics of pediatric ECG lead placement.

Americans may be more familiar with the acronym “EKG” (which derives from the German Elektrokardiogramm), but most medical practitioners use “ECG” (electrocardiogram) for the process of recording the heart’s electrical activity using electrodes.

The electrodes are placed at specific points on the patient’s skin in order to detect electrical changes in the heart that may indicate cardiac problems.

It’s the placement of the ECG leads (labeled with a V) that we’re focusing on here.

(Quick note: At PCCO, we follow adult guidelines for pediatric patients weighing 90 pounds or more. See below for infants, toddlers, and children weighing less than 90 pounds.)

ECG Basics

V1 4th intercostal space to the right of the sternum (about ½ inch to 1 inch from the midline)
V2 4th intercostal space to the left of the sternum (about ½ inch to 1 inch from the midline)
V3 Midway between V2 and V4
V4 5th intercostal space at the midclavicular line (at the nipple line)
V5 Anterior axillary line at the same level as V4 (where the ribs curve back)
V6 Midaxillary line at the same level as V4 and V5 (should be below the armpit)

Extra Pediatric Leads for 15 Lead

Right side of chest:

V3R Midway between V1 and V4R
V4R 5th intercostal space at the midclavicular line (about nipple line)

Left side of chest:

V7 after V6

For infants, toddlers, and children under 90 lbs, measuring rib spaces is not usually possible.

V1 Nipple line to the right of the sternum (about ½ inch from the midline)
V2 Nipple line to the left of the sternum (about ½ inch from the midline)
V3 Midway between V2 and V4
V4 Below the nipple at the midclavicular line
V5 Anterior axillary line at the same level as V4 (about where the ribs curve back)
V6 Midaxillary line at the same level as V4 and V5 (should be below the armpit)

Extra Pediatric Leads for 15 Lead

Right side of chest:

V3R Midway between V1 and V4R

V4R Below the nipple at the midclavicular line

Left side of chest:

V7 after V6

For all ECGs, limb leads should be placed on the limbs — not the torso.

Arm leads should be placed just above the elbows.

Leg leads should be placed between the knee and ankle.

One final tip: If computer interpretation reads “Right Superior Axis Deviation” or “Northwest Axis,” be sure to check the limb leads.

PCCO operates outreach clinics throughout Oregon and Southwest Washington, so we’re never too far away.

Contact Pediatric Cardiology Center of Oregon for more information on our world-class pediatric care and to find a location near you.

How is an ECG done for children? - DocDoc.ru

Parents of young children are worried about how ECG is done to children, at what age ECG is done and what are the features of conducting in children of different ages. ECG is an affordable, safe and harmless method for diagnosing the functioning of the heart. Therefore, before the doctors, the question of how often an ECG can be done to a child is not worth it.

Electrocardiography is an essential diagnostic tool for children from birth. The first study is done in the maternity hospital, the next at 1 month, at 1 year, and then according to the schedule of preventive examinations. If the baby has a deviation in the work of the heart, then the frequency of examinations is determined by the attending physician. Electrocardiography is prescribed not only for suspected pathology, but also before surgery, for admission to competitions, before going to a sports camp, sanatorium, etc. In this regard, it is useful to know how long the ECG is valid in order to make an examination in a timely manner. In most cases, the ECG is valid for one month, but in some cases, the requirements for analyzes include a period of 10-14 days.

How do they do it?

The general scheme for performing electrocardiography is to attach electrodes to the child's skin, which transmit the pulses of the heart to a device that processes the signals. For several minutes of recording signals, the baby should lie still and the parents have a question how to make an ECG for a child a year old, because at this age children are very mobile. For children up to a year and one-year-olds, special electrodes are used that are well attached to the skin, but do not damage it. For infants, there is a belt for attaching sensors, this allows you to swaddle the baby after fixing the electrodes. It is really difficult to take an ECG for a one-year-old child, it is important for parents to be close to the child, distract him and try to make sure that the baby is not afraid.

An alternative diagnosis is ECHO-KG, i.e. ultrasound examination of the heart. If the child cannot lie still for several minutes on an ECG, then ultrasound is technically easier to do.

If you are concerned about any health problem, sign up for a diagnosis. The success of treatment depends on the correct diagnosis.

What is better ECG or ultrasound for a small child?

It is impossible to answer unequivocally, since these surveys complement each other. Appointments are made by a pediatric cardiologist, as the doctor is able to assess the risks and the degree of need for a particular study. Sometimes a doctor prescribes an ECG with a load or an ECG with an orthostatic test to a child, which is also a load. The task of such an examination is to assess how the child's heart copes with the physical load on the body. The load is created by exercise or running, so it is usually used for children over five years old. An orthostatic test or an oblique test involves a sharp change in the position of the body of a small patient. The child begins to do an ECG in the supine position, then they are asked to get up from the couch, continuing to record the impulses of the heart. Thus, violations in the functioning of the cardiovascular system are detected. Also, for such an examination, there is a special table that changes position from horizontal to vertical along with the patient, who is fixed with straps.

Is it possible to do an ECG for a child with a cold, cough and runny nose? And also, is it possible to do the procedure for a baby at a temperature?

Doctors recommend waiting for the child to recover, as coughing and fever can affect the heart rate and distort the result. In addition, sick children are capricious and restless, which interferes with the diagnosis. If there is no urgent need to do an ECG, it is better to postpone the examination for a while.

This article is posted for educational purposes only, does not replace a doctor's appointment and should not be used for self-diagnosis.

09 April 2020

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