[AVOID COMMON MISTAKES IN REALIZATION OF A ELECTROCARDIOGRAM]. / Evitar errores comunes en Ia realización de unelectrocardiograma.

INTRODUCTION: The electrocardiogram (ECG) is a noninvasive technique to perform simple, economical, reproducible and provides valuable information that can be used to make the diagnosis of the patient and to guide clinical decisions. It is a diagnostic test used frequently as it can be done quickly, since it is done with a laptop and generally is always possible implementation in any field either primary care, specialty outpatient care. The diagnosis made by the ECG is considered valid in clinical practice, but is only effective if the electrodes are placed in the correct anatomical locations, if the hoses are properly attached to the electrodes, the registry maintains a good quality (the filters are used appropriate, interference and electrical noise are avoided) and ECG compares made by the same registration system (ECG 5 or 10 lead) for determining evolutionary changes (to determine changes in the ST segment during myocardial ischemia or assess the changes caused by reperfusion therapies). OBJECTIVE: To review the most common errors in electrocardiography, which are related to inappropriate placements of shunts, cross or exchange of patch cords limb leads, records of poor quality and comparisons of ECG serials made with different acquisition systems (10 vs 5 lead). CONCLUSIONS: We make the recommendations to prevent and avoid these scams that can lead to diagnosis and treatment with adverse outcomes for the patient.

[What do nurses think of pain associated with vascular functions?]. / Qué opinan las enfermeras sobre el dolor asociado a las punciones vasculares?

One of the most common techniques used by nurses in carrying out their clinical practice is the vascular puncture, commonly associated with pain bearable for the patient to a greater or lesser extent. For the past few years have been appearing in the pharmaceutical industry a series of local anesthetics can be used for vascular puncture to minimize or alleviate the pain. The increasing interest by nurses in this field is evidenced by the growing number of scientific articles published in this discipline, included in the Intravenous Therapy. During the Fourth National Congress of the Association of Intravenous Therapy Teams held in 2010 in Valencia went over to the Congress a survey to assess their knowledge and concerns about pain control in the punctures and the use of local anesthetics in the same.

[Ethyl chloride]. / Cloruro de etilo.

The control of symptoms in general and pain in particular, remains a current topic in scientific conferences and meetings, and discussed the recommendations of the Scientific Societies. Do not suffer unnecessary pain because the treatment is a right of every patient and facilitating action to control it, by nurses, is an expression of respect for that right. A common procedure nursing care consists of venous and arterial puncture for blood samples or to place catheters for different purposes, these procedures are painful for the patient and sometimes unpleasant by the need to perform them repeatedly. There are different relaxation techniques that can help to reduce this effect in the body but also have pharmacological interventions to help decrease the pain associated with vascular punctures. One of them, easy to use, quick to act and no side effects is the use of topical anesthesia by cold ethyl chloride.

[Is your patient correctly sedated? Monitoring patients by means of the bispectral index]. / Paciente está sedado, correctamente? Monitorización mediante el indice biespectral.

The use of sedatives is relatively frequent in hospital care. However the evaluation of the effects of sedatives continues to be carried out in a non-standardized manner. There are two forms to do so, either by use of subjective evaluation scales like Ramsay or RASS, among others, or by means of an objective evaluation instrument, the bispectral index or BIS, produced by Aspect. BIS monitoring permits medical personnel to measure objectively the degree of anesthesia. This technology make it possible to administer an adequate anesthesia to patients and thus prevent unnecessary overdoses, since the evaluation scales are ineffective on patients treated with muscle relaxants. BIS is especially recommended for patients who have undergone neurological surgery since it is essential to maintain a high degree of comfort plus an adequate sedation in order to practice an adequate clinical evaluation, avoiding an inappropriate sedation which could hide signs and symptoms.