Parents/Care givers should be encouraged to document activities in theĪfter the prescribed time, the Holter Monitor is removed from the child and, together with the Event’s record, returned to RCH Diagnostic Cardiology, Ground Floor, reception A3.Ensure the Record Box is in a carry pouch while the child is ambulating to ensure dots remain attached.Signals from such devices may affect recording. It is also recommended to avoid the following: electric blankets and magnets. The child is allowed to go about normal activities of daily living, however they must avoid getting the Holter Monitor wet, therefore no showers or baths.The child as an inpatient may leave the ward if clinically stable and approved by medical and nursing team.The child as an inpatient can have continuous cardiac monitoring by the bedside if clinically indicated while a Holter Monitor is attached.The Record Box should be checked once a shift to ensure the time and “recording” message is visible on the box.The nurse should make the EMR order indicating time of attachment and time to take off. Documentation of this information should occur in EMR Orders. For the inpatient with a Holter Monitor, nurses must document the time of attachment and the prescribed time to take off.Once the Holter Monitor is attached to the patient it must stay on the patient for the prescribed time, 24-72hrs.Holter Monitors may be attached within an inpatient or outpatient setting.Extra mefix tape may be secured over the electrodes to reinforce attachment. The chest may be cleaned with normal saline/warm soapy water to remove any oily residue, or hair on the chest may need to be shaved, to ensure the electrodes stick well. Prior to attaching the electrodes the skin must be clean, dry and hair free. ![]() A Cardiac Technician is responsible for attaching the Holter Monitor.Nurses will be able to acknowledge the EMR Holter Monitor order in IP Summary and further view this order either in the EMR Chart Review Activity or ADT Navigator Activity. The Cardiology team will order the Holter Monitor on EMR.The Cardiologist will determine the length of time the Holter Monitor should be left on.ECHO, 12-15 lead ECG, blood test and/or exercise stress test. Holter Monitor’s may be used in conjunction with other diagnostic tests, i.e.A Holter Monitor will be attached to a child of any age, who, as per Cardiology team, requires further cardiac testing.Echo – Echocardiogram is an ultrasound test of the heart, helping to evaluate heart structure and blood flow.Some common childhood arrhythmias include SVT, Long QT, Atrioventricular Heart Block, bradycardia, ectopic beats. Event Card– Small booklet to highlight the time of Holter Monitor attachment and removal, and to record activities of the child while the Holter Monitor is attached.ECG – Electrocardiogram is a diagnostic tool that measures and records the electrical activity of the heart via electrodes placed on the skin.The Record Box will indicate it is working by displaying the time and a “recording” message on the screen. Record Box: The box records and stores continuous heart rhythm data transmitted by the electrodes. ![]() Components include 3 electrodes and a Record Box. Cardiac Holter Monitor: Referred to in this clinical guideline as ‘Holter monitor’, is a small ambulatory, portable ECG device.This clinical guideline applies to children requiring a Holter monitor during inpatient admission, children being discharged home with a Holter monitor and/or children having a Holter monitor applied during an outpatient clinic. To provide guidance on the management and troubleshooting of Holter Monitors. The benefit of ambulatory ECG lies in its ability to examine continuously a patient over an extended period of time, permitting patient ambulatory activity while examining electrocardiographic activity in changing environmental situations (both physical and psychological). Determine the effectiveness of anti-arrhythmic medications.Record arrhythmias that occur, providing diagnostic information about the type of arrhythmia, how long it lasts, and what might trigger it. ![]()
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