2.50
Hdl Handle:
http://hdl.handle.net/10755/162642
Type:
Presentation
Title:
The Effects of Head-of-Bed Positioning on the Electrocardiogram
Abstract:
The Effects of Head-of-Bed Positioning on the Electrocardiogram
Conference Sponsor:Emergency Nurses Association
Conference Year:1999
Author:Cynthia, , Wright
Contact Address:OEOB Room 105, White House Medical Unit, Washington, DC, 20502
Contact Telephone:USA
Co-Authors:Patricia Gonce Morton, Darwin B. Childs, Rebecca S. Miltner
Purpose: Electrocardiograms (EKGs) are frequently recorded on patients in the emergency department. Depending on the condition and comfort of the patient, the EKG is often recorded with the head-of-bed (HOB) in various positions. The purpose to this study was to determine the effect of HOB positioning on electrocardiograms axis, intervals, and waveform configurations, which are used in the diagnosis of many cardiovascular diseases. A second purpose was to examine if the effects of HOB positioning differed in individuals with known coronary artery disease (CAD) versus those with no known CAD.

Design: A descriptive study was conducted using a 3 (position) by 2 (CAD versus no known CAD) repeated measures design.

Setting: This study was conducted in an urban teaching hospital located in Maryland.

Sample: A convenience sample of 40 subjects with twenty (12 males and 8 females) with a mean age of 62, had CAD validated by history. Twenty (11 males and 9 females) with a mean age of 35, had no known CAD. Exclusion criteria included bundle block, pacemakers, atrial flutter and age less than 21.

Methodology: Subjects had EKGs recorded with the HOB in three positions, o, 45, and 90 degrees. The order of position was randomly selected. All EKGs were obtained by a single researcher and interpreted by a physician blinded to the study's purpose and participant position.

Results: Axis decreased significantly (p.000) as the HOB was elevated. Post hoc testing showed significant differences in axis between supine and 45 degrees elevation and between supine and 90 degrees elevation. Six of twenty participants with CAD experienced axis changes, shifting from normal axis (0 to 90 axis degrees) in the supine position to left axis deviation (0 to -90 axis degrees) at 90 degrees elevation. T waves became flattened or inverted in inferior diagnostic EKG leads at 90 degrees (p. 044). In lead III, 6 or 20 non-CAD participants had flattened or inverted T waves at 90 degrees that were not apparent at 45 or 0 degrees. While the data regarding T wave changes is statistically significant, clinically it would be interpreted as normal deviation. For QT or QRS intervals, ST segment elevation and the presence/absence of Q waves, no significant differences were found between the three HOB positions. The pattern of change in HOB positioning was consistent for both CAD and non-CAD patients.

Conclusions: The data suggests that patients can be placed in a position of comfort for recording the EKG. However, the potential for axis shift, which can indicate abnormal pathology, should be realized. [Research Paper Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Effects of Head-of-Bed Positioning on the Electrocardiogramen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162642-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Effects of Head-of-Bed Positioning on the Electrocardiogram</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1999</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cynthia, , Wright</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">OEOB Room 105, White House Medical Unit, Washington, DC, 20502</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Patricia Gonce Morton, Darwin B. Childs, Rebecca S. Miltner</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Electrocardiograms (EKGs) are frequently recorded on patients in the emergency department. Depending on the condition and comfort of the patient, the EKG is often recorded with the head-of-bed (HOB) in various positions. The purpose to this study was to determine the effect of HOB positioning on electrocardiograms axis, intervals, and waveform configurations, which are used in the diagnosis of many cardiovascular diseases. A second purpose was to examine if the effects of HOB positioning differed in individuals with known coronary artery disease (CAD) versus those with no known CAD.<br/><br/>Design: A descriptive study was conducted using a 3 (position) by 2 (CAD versus no known CAD) repeated measures design.<br/><br/>Setting: This study was conducted in an urban teaching hospital located in Maryland.<br/><br/>Sample: A convenience sample of 40 subjects with twenty (12 males and 8 females) with a mean age of 62, had CAD validated by history. Twenty (11 males and 9 females) with a mean age of 35, had no known CAD. Exclusion criteria included bundle block, pacemakers, atrial flutter and age less than 21.<br/><br/>Methodology: Subjects had EKGs recorded with the HOB in three positions, o, 45, and 90 degrees. The order of position was randomly selected. All EKGs were obtained by a single researcher and interpreted by a physician blinded to the study's purpose and participant position.<br/><br/>Results: Axis decreased significantly (p.000) as the HOB was elevated. Post hoc testing showed significant differences in axis between supine and 45 degrees elevation and between supine and 90 degrees elevation. Six of twenty participants with CAD experienced axis changes, shifting from normal axis (0 to 90 axis degrees) in the supine position to left axis deviation (0 to -90 axis degrees) at 90 degrees elevation. T waves became flattened or inverted in inferior diagnostic EKG leads at 90 degrees (p. 044). In lead III, 6 or 20 non-CAD participants had flattened or inverted T waves at 90 degrees that were not apparent at 45 or 0 degrees. While the data regarding T wave changes is statistically significant, clinically it would be interpreted as normal deviation. For QT or QRS intervals, ST segment elevation and the presence/absence of Q waves, no significant differences were found between the three HOB positions. The pattern of change in HOB positioning was consistent for both CAD and non-CAD patients.<br/><br/>Conclusions: The data suggests that patients can be placed in a position of comfort for recording the EKG. However, the potential for axis shift, which can indicate abnormal pathology, should be realized. [Research Paper Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:39Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:39Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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