The patient talks during the ECG. What artifact could occur?
a. Somatic tremor
b. AC interference
c. Interrupted baseline
d. Wandering baseline
The correct answer and explanation is :
The correct answer is d. Wandering baseline.
Explanation:
When a patient talks during an electrocardiogram (ECG), one of the most common artifacts that can occur is a wandering baseline. This artifact occurs due to the movement of the patient’s body, including the chest, diaphragm, and muscles, as a result of the patient’s speech or breathing. As the patient talks, their chest and abdominal muscles move slightly, which can cause shifts or drifts in the baseline of the ECG tracing. This motion is picked up by the electrodes and leads to a wandering, erratic baseline that distorts the heart’s electrical signals.
Here’s why other options are less likely:
- a. Somatic tremor: This artifact is typically caused by muscle contractions or tremors (often from shivering or involuntary muscle movements), and it results in rapid, high-frequency spikes on the ECG. It’s more associated with conditions like shivering or tremors rather than talking.
- b. AC interference: AC interference is caused by electrical signals from nearby devices or improperly grounded equipment. It typically appears as regular, sharp spikes on the ECG tracing, which is different from the erratic baseline caused by speech.
- c. Interrupted baseline: This occurs when there is a disconnection or problem with one of the leads. It causes a flat, straight line on the ECG, which is not typically the result of the patient talking.
The wandering baseline caused by talking can often be reduced by asking the patient to remain still and avoid speaking during the ECG. Ensuring proper electrode placement and reducing movement can help minimize this artifact and provide a clearer reading of the heart’s electrical activity.
Here is an illustration showing an ECG tracing with a wandering baseline artifact, which occurs when a patient talks during the ECG. You can clearly see how the baseline shifts erratically compared to a normal, steady ECG waveform.