A-Step Performing Polysomnography 2: Recording And Monitoring

Front 1

Polysomnography is indicated for the ____ & _____

Back 1

routine diagnosis of multiple sleep disorders, and positive airway pressure titration, and even parasomnias or nocturnal seizure disorders

Front 2

Sleep disorders that a polysomnogram can indicate:

Back 2

sleep related breathing disorders, narcolepsy, and periodic limb movement disorder.

Front 3

Polysomnography is a

Back 3

multi-channel recording attended by a qualified sleep technologist

Front 4

What are the steps for performing polysomnography:

Back 4

Preparing to record the PSG
Testing the equipment
Monitoring patient & recording
Recognizing emergency situations

Front 5

When preparing to record the PSG, you

Back 5

Verify orders
Enter Patient data
Select montage

Front 6

When verifying orders make sure that the physician's orders are

Back 6

complete and correct

Front 7

Verify orders by interviewing the patient in order to

Back 7

Assess patient's understanding of the procedure; and to clarify information that may contradict the orders

Front 8

Any changes to the orders must be discussed with physician and

Back 8

documented.

Front 9

When verifying orders, make sure the correct ___, ___, and ____ have been applied or prepared for the study

Back 9

electrodes, sensors, and ancillary equipment

Front 10

Entering the patients data includes:

Back 10

name, DOB, other info required by your facility or acquisition system: referring physician, height, weight, neck circumf., unique identifier, meds, med. history

Front 11

Choose the correct montage for

Back 11

the study ordered

Front 12

There is often a standard montage prepared for these commonly performed tests:

Back 12

PSG, MSLT, CPAP titration, etc.

Front 13

Montages can be _____ for special orders

Back 13

customized for seizure montage or research protocols

Front 14

Test the Equipment by:

Back 14

1 Start the recording
2 Perform impedance check
3 Adjust settings
4 Calibrations
5 Artifact corrections

Front 15

When testing the equipment, calibration includes:

Back 15

Amplifier (electrical)calibration
Ancillary equip calibration
Biocalibration

Front 16

Each acquisition system will have a different procedure for starting a recording, it is often as simple as

Back 16

clicking a toggle icon; or viewing manufacturer's instructions

Front 17

Note that on many digital systems, there is a ____ mode

Back 17

non-recording

Front 18

Data acquired by a non-recording mode cannot be

Back 18

recovered

Front 19

There is often a safety check to ensure that a ____ recording is not accidentally stopped.

Back 19

live

Front 20

Make sure that the study is being recorded before

Back 20

beginning impedance checks and calibrations

Front 21

___ and ___ should be part of the record to verify the integrity of the recording.

Back 21

Impedance checks and calibrations

Front 22

Impedance is a measure of

Back 22

resistance to the flow of alternating current

Front 23

Impedance is measured in

Back 23

Ohms

Front 24

To produce the best waveforms, the impedance of the exploring and reference electrodes should be

Back 24

low and similar (matched) to each other

Front 25

Low impedance improves the flow of current, called

Back 25

conductance

Front 26

Low impedance maximizes ____ waveform

Back 26

amplitude

Front 27

Matching impedance of electrode pairs prevents

Back 27

the introduction of electrical interference

Front 28

Matching impedance of electrode pairs maximizes the effectiveness of the

Back 28

common mode rejection function of the amplifier

Front 29

Before performing calibrations, the tech checks the impedance of

Back 29

all possible electrode sites

Front 30

Impedances should be at or below the recommended level for the sleep facility, usually

Back 30

5-10 kilohms

Front 31

High impedance must be corrected before

Back 31

the recording starts

Front 32

Channels with high impedance in one or both electrodes in a pair can exhibit a variety of

Back 32

artifacts: 60 Hz interference, electrode popping, respiratory or movement artifact, ECG intrusion, and signal dropout

Front 33

High impedance in a reference electrode will affect all

Back 33

exploring electrodes paired with it

Front 34

High impedance in the ground can affect all

Back 34

channels

Front 35

The tech should us a _____ approach to find the source of high impedance

Back 35

systematic

Front 36

Common sources of high impedance include:

Back 36

inadequate skin prep; insufficient electrolyte; loose connection to patient; loose connection to headbox or amplifier; external electrical interference; broken electrode or wire

Front 37

Corrective action of inadequate skin prep:

Back 37

re-prep and re-abrade skin

Front 38

Corrective action of insufficient electrolyte (conductive paste or gel):

Back 38

refill electrode cup

Front 39

Corrective action of loose connection to patient:

Back 39

reapply electrode

Front 40

Corrective action of loose connection to headbox or amplifier:

Back 40

reconnect all wires and cables

Front 41

Corrective action of external electrical interference:

Back 41

identify and remove

Front 42

Corrective action of broken electrode or wire:

Back 42

replace electrode or wire

Front 43

Once the impedances have been tested and corrected, check the ___ and ___ of the signal in each channel

Back 43

appearance and range

Front 44

___ and ____ are set when the montage is selected, but may need to be adjusted on some channels

Back 44

Filters and sensitivities

Front 45

The ______ should not be on at the start of a study.

Back 45

60 Hz notch filter

Front 46

When should a 60 Hz notch filter be used?

Back 46

to attempt to improve a signal without haveing to wake the patient

Front 47

EMG sensitivities or gains may need to be adjusted, but should not be changed after

Back 47

patient calibrations

Front 48

Adjust sensitivities or gains on the ECG signal so that all components of the waveform can be

Back 48

identified

Front 49

Make sure the polarity of signals is

Back 49

correct

Front 50

Adjust sensitivities or gains on respiratory channels to

Back 50

maximize the waveform without signal blocking.

Front 51

Calibration is a procedure for making sure that each channel responds appropriately to

Back 51

a standard input

Front 52

Calibration allows you to check the performance of the equipment and set the _________ on quantitative channels

Back 52

the measurement scale

Front 53

Three types of calibration:

Back 53

Amplifier calibration
Ancillary equipment cal
Biocalibration

Front 54

Amplifier calibration is also known as

Back 54

machine or electrical calibration

Front 55

In amplifier calibration, a ____ is sent through each channel of the amplifier

Back 55

set voltage (for ex: 50 uV)

Front 56

The waveform that results from amplifier calibration should look ______ in channels with the same _______________

Back 56

identical in channels with the same filter and sensitivity settings

Front 57

In amplifiers calibration, ________ are external to the amplifier, and do not receive the ______.

Back 57

DC inputs
voltage input

Front 58

An amplifier channel that does not process the standard signal correctly needs to be

Back 58

replaced

Front 59

Some amplifiers are _____, but most often, when it doesn't process the standard signal correctly,the whole amplifier will need to be replaced to correct a bad channel

Back 59

modular

Front 60

Ancillary equipment that is recorded on a _________ needs to be calibrated to ensure accurate measurements

Back 60

DC channel

Front 61

Ex. of ancillary equipment that is recorded on a DC Channel:

Back 61

Oximeter
Capnograph
PAP devise

Front 62

See manufacturer's instructions on how and when to _____ ancillary equipment

Back 62

calibrate

Front 63

___________may or may not need to be performed before every PSG

Back 63

Ancillary equipment calibrations

Front 64

Biocalibration (or patient calibration) is the process of

Back 64

testing to ensure that each sensor can accurately detect physiological changes

Front 65

Biocalibrations are done by

Back 65

having the patient respond to standard instructions, and examining the ouptut

Front 66

When there is an inadequate response to biocalibrations, the tech

Back 66

does a systematic check to determine the source of the problem

Front 67

After a problem is corrected in biocalibration, the maneuver is

Back 67

repeated

Front 68

In biocalibration, the tech must lable each maneuver

Back 68

in sync with the patient's response

Front 69

In biocalibration, the patient should be lying in the ____ position, with ____ connected, the ____ on, and ____ closed

Back 69

supine
headbox
light
door

Front 70

During biocalibration, make sure the patient can hear and understand you by testing

Back 70

the intercom system

Front 71

Each lab will have a standard set of _____ and _____ for checking the signal quality of each channel in a montage.

Back 71

maneuvers and labels

Front 72

In biocalibration, the set of maneuvers and labels will change for

Back 72

different types of tests.

Front 73

Bio-close your eyes and relax

Back 73

EC, wait 30 sec

Front 74

Bio-Open your eyes

Back 74

EO, wait 30 sec

Front 75

Bio-Keeping your head still and moving only your eyes, look left, right and then back to center.

Back 75

[L] [R]

Front 76

Bio now look up, and down

Back 76

[U] [D]

Front 77

Bio-close your eyes, then blink 5 times

Back 77

[B5]

Front 78

Bio-Grit your teeth

Back 78

[GT]

Front 79

Bio-smile

Back 79

[SM]

Front 80

Bio-with the right leg only, point and flex your toes up, then down,. Repeat for the left leg.

Back 80

[RF] [LF]

Front 81

Bio-hum

Back 81

[HM]

Front 82

Bio-take three breaths through your mouth only

Back 82

[MTH]

Front 83

Bio-take three breaths through your nose only

Back 83

[NSE]

Front 84

Bio-take a deep breath and hold it, wait 10 sec and breathe normally

Back 84

[HB]

Front 85

During biocalibration, visually verify the accuracy of the

Back 85

position sensor

Front 86

During biocalibration, verify the integrity of the

Back 86

oximetry signal

Front 87

A sample of the EEG with eyes open and eyes closed will show

Back 87

different waveforms and assist with state recognition

Front 88

Most patients will show ______ with their eyes open

Back 88

fast, law voltage mixed frequency

Front 89

When checking the EEG channels, the tech should look for a change to ____ when the eyes are closed.

Back 89

alpha frequency (8-13 Hz or cycles per second)

Front 90

Checking the EEG, not all patients have _______, and the precise cycles per second (CPS)
will vary from patient to patient

Back 90

alpha

Front 91

When checking the EEG, it is important to get a large sample of

Back 91

eyes open, and eyes closed

Front 92

When checking the EEG, the tech should look for ___ and ____ in the EEG during calibration

Back 92

artifacts and patient generated variations

Front 93

The patient may have muscle artifact intruding into the EEG from

Back 93

increased muscle tension in the scalp.

Front 94

Muscle tension in the scap should subside as the patient ___, but can sometimes persist after ___________.

Back 94

falls asleep
sleep onset

Front 95

Shivering can also cause a ______.

Back 95

fast frequency artifact

Front 96

When shivering causes a fast frequency artifact, the tech should

Back 96

adjust the temp or offer extra blankets

Front 97

Older patients may show _____ EEG, or ________

Back 97

lower voltage EEG, or slower frequency waves

Front 98

Patients with degenerative brain disease, and patients on some medications, may show

Back 98

slower frequency, higher amplitude waves

Front 99

When checking the EOG channels, the tech must verify that the eye electrode channels (E1 and E2) show

Back 99

adequate response when the patient moves their eyes.

Front 100

In EOG< adequate eye movements are needed to

Back 100

assist in stage recognition

Front 101

What are the recommended EOG derivations?

Back 101

E1-M2 (E1 placed 1 cm below left outer canthus)
E2-M2 (E2 placed 1 cm above the right outer canthus)

Front 102

In EOG derivations, vertical eye movements will show

Back 102

out-of-phase deflections

Front 103

In EOG derivations, horizontal eye movements will show

Back 103

in-phase deflections

Front 104

Alternate EOG derivations are:

Back 104

E1-FP2 (E1 1 cm below and 1 cm lateral to the left outer canthus)
E2-FP2 (E2 1 cm below and 1 cm lateral to the right outer canthus)

Front 105

During the alternate EOG derivation (where both E1 & E2 down) vertical eye movements will show

Back 105

in-phase deflections

Front 106

During the alternate EOG derivation (where both E1 & E2 down) horizontal eye movements will show

Back 106

out-of phase deflections

Front 107

Patients with a glass eye do not demonstrate EOG signals because the don't have

Back 107

movement, or the tissue to create the electrical gradient that allows the detection of movement

Front 108

When checkin the EOG, the tech should document any unusual

Back 108

findings.

Front 109

____ electrodes should be placed to record chin EMG.

Back 109

3

Front 110

Describe where to place the three chin EMG electrodes:

Back 110

1 cm above the inferior edge of the mandible
2 cm below and 2 cm right of midline
2 cm below and 3 cm left of midline

Front 111

What does the standard chin EMG derivation consist of

Back 111

either of the electrodes below the mandible referred to the electrode above the mandible. The other electrode is a backup to allow continued display of EMG activity if 1 of the primary electrodes malfunctions.

Front 112

The chin EMG is needed to assist in _____recognition.

Back 112

sleep stage recognition

Front 113

The tech must verify that the chin channel shows ___ when the patient moves the mouth or jaw.

Back 113

increased amplitude

Front 114

The gain and sensitivity may need to be adjusted, in the chin EMG, if the amplitude is

Back 114

too low during wakefulness

Front 115

Changes in the gain or sensitivity (of chin EMG) should not be made ____

Back 115

after the initial channel calibration

Front 116

An artifact-free ECG signal is necessary for ____ & ______.

Back 116

accurate diagnosis and patient safety

Front 117

When checking the ECG channel, make sure that all components of the _____ signal can be identified.

Back 117

cardiac

Front 118

When checking the ECG channel, make sure the signal has the correct

Back 118

polarity

Front 119

When checking the ECG channel, check that the waveform has the correct polarity for the

Back 119

selected lead placement.

Front 120

What is the recommended ECG Lead?

Back 120

A single modified ECG Lead II using the torso electrode placement is recommended.

Front 121

When checking the leg EMG channels, the tech must verify that each leg channel shows

Back 121

increased amplitude when the patient flexes his foot or tow

Front 122

When checking leg EMG channels, the gain or sensitivity may need to be adjusted if

Back 122

the amplitude is too low during the maneuver

Front 123

The amplitude of the channel must be large enough to discriminate a leg movement from ____

Back 123

baseline (rest).

Front 124

The gain or sensitivity of leg EMG channels should not be changed

Back 124

after the initial channel calibration

Front 125

When checking leg EMG channels, make sure that the movement occurs in the

Back 125

correct channel (left or right)

Front 126

When checking leg EMG channels, if the deflection is in the wrong channel, the electrodes can simply be

Back 126

switched at the headbox

Front 127

When checking the snore sensor channel, the tech must verify that there is

Back 127

an adequate response to the instruction to make noise (hum, cough, snore, etc.)

Front 128

When checking the snore sensor channel, There should be a ____ from baseline when there is a hum, cough, snore, etc.

Back 128

large increase

Front 129

When checking the snore sensor channel, the gain may need to be adjusted to

Back 129

visualize soft snores or noises in this channel

Front 130

When checking the snore sensor channel, a constant high amplitude signal may indicate

Back 130

a broken sensor or external pressure on the sensor

Front 131

When checking airflow channels, the tech must verify that there is an

Back 131

adequate response in airflow channels to respiratory maneuvers

Front 132

An oronasal thermal sensor channel detects

Back 132

both nasal and mouth-only breathing

Front 133

A nasal pressure channel (NAF) can detect

Back 133

only nasal breathing

Front 134

When checking airflow channels, gains or sensitivities may need to be adjusted to

Back 134

visualize inspiration and expiration

Front 135

When checking airflow channels, make sure that the signal is not

Back 135

blocking so that subtle airway obstruction can be detected

Front 136

When checking respiratory effort channels, the tech must verify that there is an

Back 136

adequate response in effort channels to respiratory maneuvers, especially to "hold your breath".

Front 137

When checking respiratory effort channels, gains or sensitivities may need to be adjusted, or ____, to fully visualize ______

Back 137

or the effort sensors themselves may need to be loosened, tightened, or moved, to fully visualize inspiration and expiration

Front 138

When checking respiratory effort channels, patients with neuromuscular or respiratory disease may demonstrate

Back 138

reduced effort signal outputs

Front 139

When checking the oximetry channel, the technologist must verify

Back 139

that the SaO2 sensor is working and displaying correctly on the recording

Front 140

When checking the oximetry channel, lower than normal saturation should be verified with a

Back 140

backup or portable oximeter

Front 141

When checking the oximetry channel, Consistent readings of 100% indicate

Back 141

a malfunctioning sensor or oximeter, or that the oximeter needs to be recalibrated

Front 142

When checking the oximetry channel, intermittent data can indicate

Back 142

a loose or broken sensor

Front 143

When checking the body position channels and position sensors are used, the tech must _____ verify that the patient is

Back 143

Visually verify that the patient is in the position indicated on the recording

Front 144

When checking the body position channels, documentation of all position changes will be _______ if sensors are not used, or are ______

Back 144

manually enetered;
incorrect

Front 145

When monitoring the patient and the recording, the technologist is responsible for these 6 things:

Back 145

1 Maintaining an artifact-free recording
2 Observing the patient
3 Assisting patient as needed
4 Monitoring channels for significant changes
5 Documenting all interventions and notable events
6 Recognizing emergency situations and intervening

Front 146

When monitoring the patient, documentation is

Back 146

required information; and for schedules

Front 147

When monitoring the patient for artifact, look for

Back 147

patient emergencies and arrhythmias

Front 148

When monitoring the patient for stage changes, look for

Back 148

sleep onset and REM onset

Front 149

When monitoring the patient for seizures, look for

Back 149

desaturations and abnormal behaviors

Front 150

Artifact is the

Back 150

intrusion of undesired or non-biological signals into the PSG

Front 151

The tech must be able to discriminate artifact from

Back 151

genuine physiological signals

Front 152

All channels must be routinely checked for the presence of

Back 152

artifact

Front 153

Be aware of patient's sense of privacy and security by

Back 153

knocking before entering and informing the patient of what you are doing

Front 154

In some cases it's best not to disturb the patient:

Back 154

to limit variables in research study, to limit intrusion on the patient's natural sleep pattern, and if there are built-in backups

Front 155

In some cases it's best not to disturb the patient:

Back 155

to limit variables in research study, to limit intrusion on the patient's natural sleep pattern, and if there are built-in backups

Front 156

When an artifact is detected, the tech must

Back 156

determine the source and then formulate a corrective action

Front 157

When the tech corrects a detected artifact, it is called

Back 157

troubleshooting

Front 158

When the tech corrects a detected artifact, it is called

Back 158

troubleshooting

Front 159

The tech must develop a systematic approach to troubleshooting that allows ____ and _____ of al possible sources of artifact

Back 159

identification and eliminating

Front 160

The tech must develop a systematic approach to troubleshooting that allows ____ and _____ of al possible sources of artifact

Back 160

identification and eliminating

Front 161

With more ____, techs become more proficient at recognizing the cause of special artifacts

Back 161

experience

Front 162

With more ____, techs become more proficient at recognizing the cause of special artifacts

Back 162

experience

Front 163

When an artifact is detected, the tech must

Back 163

determine the source and then formulate a corrective action

Front 164

When an artifact is detected, the tech must

Back 164

determine the source and then formulate a corrective action

Front 165

The technologist monitors patient activity via

Back 165

video and audio equipment, or direct observation

Front 166

Video output is often recorded simultaneously with the

Back 166

PSG

Front 167

Be aware of patient's sense of privacy and security by

Back 167

knocking before entering and informing the patient of what you are doing

Front 168

Simultaneous recording allows the correlation of observed behaviors with

Back 168

one or more physiological parameters

Front 169

It is important to verify that the PSG recordings correlates with

Back 169

the visual observations

Front 170

The technologist monitors patient activity via

Back 170

video and audio equipment, or direct observation

Front 171

When the tech corrects a detected artifact, it is called

Back 171

troubleshooting

Front 172

Video output is often recorded simultaneously with the

Back 172

PSG

Front 173

Simultaneous recording allows the correlation of observed behaviors with

Back 173

one or more physiological parameters

Front 174

The tech must develop a systematic approach to troubleshooting that allows ____ and _____ of al possible sources of artifact

Back 174

identification and eliminating

Front 175

Simultaneous recording allows the correlation of observed behaviors with

Back 175

one or more physiological parameters

Front 176

With more ____, techs become more proficient at recognizing the cause of special artifacts

Back 176

experience

Front 177

It is important to verify that the PSG recordings correlates with

Back 177

the visual observations

Front 178

The technologist monitors patient activity via

Back 178

video and audio equipment, or direct observation

Front 179

Video output is often recorded simultaneously with the

Back 179

PSG

Front 180

It is important to verify that the PSG recordings correlates with

Back 180

the visual observations

Front 181

When observing the patient, the tech monitors the audio output from the

Back 181

test room

Front 182

When observing the patient, it is important to listen for the presence of quality of _______, and verify that they are

Back 182

snoring or other sounds of airway obstruction, and verify that they are represented on the recording

Front 183

Any external noise that affects the patient's sleeping environment should be

Back 183

documented (ie sirens, thunder, etc)

Front 184

The technologist must listen for communication from the patient like:

Back 184

sleep talking or requests for help or assistance

Front 185

During the night the tech looks for changes in

Back 185

each channel

Front 186

When checking the body position channels and position sensors are used, the tech must _____ verify that the patient is

Back 186

Visually verify that the patient is in the position indicated on the recording

Front 187

Notable changes in channels are

Back 187

documented on the recording and on a log sheet

Front 188

When checking the body position channels, documentation of all position changes will be _______ if sensors are not used, or are ______

Back 188

manually enetered;
incorrect

Front 189

During EEG, the tech documents

Back 189

sleep stage changes;
arousals;
seizure activity;
alpha intrusion

Front 190

During EOG, the tech documents

Back 190

eye movements in NREM;
slow eye movements (SEMS)
Rapid eye movements (REMS)

Front 191

When monitoring the patient and the recording, the technologist is responsible for these 6 things:

Back 191

1 Maintaining an artifact-free recording
2 Observing the patient
3 Assisting patient as needed
4 Monitoring channels for significant changes
5 Documenting all interventions and notable events
6 Recognizing emergency situations and intervening

Front 192

During chin EMG, the tech documents

Back 192

bruxism;
atonia

Front 193

When monitoring the patient, documentation is

Back 193

required information; and for schedules

Front 194

When monitoring the patient for artifact, look for

Back 194

patient emergencies and arrhythmias

Front 195

During ECG, the tech documents

Back 195

arrhythmias

Front 196

When monitoring the patient for stage changes, look for

Back 196

sleep onset and REM onset

Front 197

When monitoring the patient for seizures, look for

Back 197

desaturations and abnormal behaviors

Front 198

Artifact is the

Back 198

intrusion of undesired or non-biological signals into the PSG

Front 199

The tech must be able to discriminate artifact from

Back 199

genuine physiological signals

Front 200

All channels must be routinely checked for the presence of

Back 200

artifact

Front 201

Monitor LEG EMG for

Back 201

periodic limb movements in sleep (PLMS); and other leg movements while awake or asleep

Front 202

Monitor snore channel for changes in

Back 202

sound level or quality

Front 203

Monitor position because

Back 203

position changes can worsen SRBD and cause artifact; and patient should be observed in supine position, particularly during REM sleep

Front 204

Monitor respiratory channels for

Back 204

sleep related breathing disorders (SRBD);
mouth breathing;
nasal obstruction

Front 205

Monitor oximetry for

Back 205

oxyhemoglobin desaturations

Front 206

The tech is responsible for documenting all pertinent information that might assist in

Back 206

the diagnosis and treatment of a sleep problem

Front 207

Typically, the tech fills out a log at _______, as well as whenever ______.

Back 207

regular intervals

notable events occur

Front 208

Document that start and end of all periods you are in the patient's

Back 208

room

Front 209

Without proper documentation, a long period of patient-tech communication can look like

Back 209

insomnia

Front 210

The tech compiles the most relevant information in a

Back 210

summary report

Front 211

All reports must be ___ and ___ by the tech

Back 211

signed and dated

Front 212

The tech must be able to recognize patient emergencies that can be identified on the PSG including:

Back 212

Dangerous arrhythmias;
Seizure activity;
Significant hypoxemia

Front 213

Dangerous Arrhythmias would include:

Back 213

Profound sinus bradycardia, or asystole of >3 sec
Second degree heart block
Third degree (complete) heart block
Ventricular fibrillation
Ventricular tachycardi

Front 214

The tech must be able to recognize abnormal ____ and _____ in the EEG that can indicate seizure activity

Back 214

waveforms and patterns

Front 215

Abnormal waveforms and patterns in the EEG that can indicate seizure activity include:

Back 215

Spikes;
Spike and wave;
Rhythmic bursts

Front 216

Spikes, spike and wave and rhythmic bursts are abnormal waveforms that constitute emergency situations primarily when

Back 216

paired with clinical evidence of seizure activity

Front 217

Each facility will have a policy for intervention of seizure activity depending on the

Back 217

length of the seizure activity and clinical symptoms

Front 218

Use __ guidelines to assure patient safety while waiting for emergency personnel

Back 218

BLS-Basic Life Support

Front 219

The tech regularly monitors the recording for significant desaturations in SaO2 which indicates

Back 219

hypoxemia

Front 220

SaO2 Saturations below a level defined by the medical director will require intervention, which can include:

Back 220

Calling on-call physician for orders;
Initiating standing orders for supplemental oxygen;
Notifying emergency personnel, and initiating BLS protocols

Front 221

The important points to remember about detecting and managing patient emergencies are:

Back 221

know and recognize potential emergencies;
Initiate emergency protocols;
protect the patient;
continue to monitor patient for problems;
Document observations and problems

Front 222

After recognizing a potential emergency, make sure the patient is in a ____ & ___ position, for example

Back 222

safe and comfortable;
dizzy patient should sit or lie down

Front 223

After recognizing a potential emergency, observe the patient by checking for

Back 223

skin pallor, sweating, gait problems, change in speech, confusion, and abnormal movements

Front 224

After recognizing a potential emergency, ask patient about symptoms, including details about

Back 224

severity, onset (new or recurring), and duration of chest pain, shortness of breath; dizziness; and confusion or disorientation

Front 225

After recognizing a potential emergency, keep the monitoring equipment running until

Back 225

the patient leaves the laboratory

Front 226

Once an emergency is identified, the tech should follow the labs emergency protocol, which may include:

Back 226

Initiating Basic Life Support;
Contacting the on-call physician or emergency team;
Transferring the patient to an emergency area or facility