Q.Visit a hospital to study how to take ECG, stress test, measurement of BP, etc.

An ECG is recorded through four limb and six chest electrodes; a stress test records the ECG and blood pressure while the person exercises on a treadmill; blood pressure is measured with a sphygmomanometer cuff on the upper arm and a stethoscope over the brachial artery.

Suggested plan.

1. ECG - note the patient lying still, the four limb electrodes (two arms, two legs) and six chest electrodes, and the paper speed. Identify the P wave, QRS complex and T wave on the strip, and the P-R, Q-T and R-R intervals (section 8.17); calculate the heart rate from the R-R interval.
2. Stress test - observe the ECG and BP being recorded first at rest and then at increasing treadmill speed and slope, and why the test is stopped (target heart rate reached, chest pain, ECG changes). Note what a reduced blood supply to the heart muscle looks like on the trace.
3. Blood pressure - the cuff at heart level on the upper arm, inflation until the brachial pulse disappears, slow release, the first Korotkoff sound (systolic) and the point at which the sounds disappear (diastolic); normal about 120/80 mmHg (section 8.16).
4. Report - a labelled sketch of the electrode positions, a copy or drawing of one normal ECG cycle, the BP procedure step by step, and the normal and abnormal values for each.