|
Basics of Bio Signals and recordings in Electronic Medical Records |
| – An introductory article to the basic analysis of ECG and EEG |
|
| Introduction |
| Bio signals are referred to as "The summation of electrical potential differences across the tissues, organs or cells leading to electrical signals." |
| |
| Some of the important Biosignal analyses performed across the medical specialties are: |
 |
Electro Cardiogram |
|
Electro Encephalogram |
|
Electro Myogram |
|
Electro Occulogram |
|
Electro Retinogram |
|
| |
| ECG |
| ECG is a procedure performed to measure and record the electrical activity of the heart. The Wave segment includes P, QRS and T waves. The ECG recordings are considered to be one of the vital signs and find its significance across all the medical specialties: |
|
Cardiology |
|
Outpatient |
|
Ophthalmology |
|
Neurology and others |
|
Electro Retinogram |
|
| |
| Analysis of ECG signals: |
| 1. |
Normal ECG Wave |
| 2. |
First degree AV block – Prolonged conduction time of the PQ segment > 0.22 seconds |
| 3. |
Bundle Block – Widened QRS complex, interval > 0.1 second |
| 4. |
Myocardial infarction – Elevated ST segment |
| 5. |
Coronary insufficiency – Depressed ST segment and presence of negative T Wave |
| 6. |
Ventricular fibrillation – Train of pulses instead of PQRST waves |
|
| |
| Heart block – The state referred when the beat rate is slower than the normal rate. |
| |
| Below are the different types of Heart blocks - |
| 1. |
1st degree AV block – Prolonged Conduction time |
| 2. |
2nd degree AV block – Conduction of few pulses rather than all from atrium |
| 3. |
3rd degree AV block – Asynchronous action of Atrium and Ventricle. |
| 4. |
Adams – Stokes attack – Sudden attack of total block |
| 5. |
Bundle Block –Improper conduction of the stimulus to the Ventricle. |
| 6. |
Atrial Fibrillation –Fast beating rate (300 – 500 beats/min) of the atrium. Ventricles beat very slowly |
| 7. |
Ventricular fibrillation – Fast beating rate of the Ventricles. No pumping of the blood to different parts of the body. |
|
| |
| EEG |
| Electrical recordings from the surface of the brain or from the outer surface of the head are mainly due to the electrical activity in the brain. The intensity and patterns of this electrical activity are determined to great extent by the overall level of the brain resulting, from functions in the retricular activating system (awakening and sleep) results in Electroencephalograph. |
| |
| The intensities of the brain waves on the surface of the scalp range from 0-300 micro Volts and the frequencies range from once in every few seconds to 50 or more per second. |
| |
| Characteristics of EEG: |
| 1. |
Irregular and no general pattern |
| 2. |
Sometimes, appearance of distinct patterns. |
|
| |
| Classification of EEG waves: |
| 1. |
Alpha Waves: |
| |
| • |
Frequency – 8-13 Hz |
| • |
Occurrence – Found in normal persons with awake status in resting state. |
| • |
Occurs normally in Occupital region. D. |
| •. |
Disappears during sleep |
| • |
Amplitude range – 20 – 200 micro Volts with mean of 50 micro Volts |
|
| 2. |
Beta Waves: |
| |
| • |
Frequency – 13-30 Hz |
| • |
Occurrence – Recorded from the Parietal and frontal region scalp. Classified as Beta 1 – Inhibited by the cerebral activity and, Beta 2 – Excited by the mental activity. Ex: Tension. |
|
| 3. |
Theta Waves: |
| |
| • |
Frequency – 4-8 Hz |
| • |
Occurrence – Parietal and temporal regions of the scalp in children. |
| • |
Occurs during emotional stress in adults particularly during disappointment and frustration. |
|
| 4. |
Delta Waves: |
| |
| • |
Frequency – 0.5 – 4 Hz |
| • |
Time duration – 2 – 3 seconds |
| • |
Occurrence - Mainly in the Cortex independently by the activities in the lower regions of brain. During deep sleep in premature babies and in very serious organic brain disease. |
|
|
| |
| In order to view the patient's ECG and EEG, CareEMR provides a 2-way approach to gather and retrieve these results intact with the patient's e-chart. |
| |
| Treatment Plan – CareEMR's Lab module provides an approach to attach and easy retrieval of the ECG, EEG charts etc, to / from the patient's e-chart. This provides a structured way of recording the values with user – defined level indicators (H, L, LL, HH etc). The values displays within the Assessment section of the SOAP note and with the XML format for interoperability purposes. These are achieved through an integrated approach of the Document Manager and Lab modules of CareEMR. |
| |
| PACS – Most of the devices used to capture the ECG, EEG etc usually generates a Non-DICOM compliant images. CareEMR's CarePACS system includes a unique feature of converting the JPEG and BIT map images onto DICOM images. As part of the client's customization requirements the team works towards the conversion of proprietary file system to DICOM images adhering to the CarePACS modalities. |
| |
| If you believe that a comprehensive Vital sings readings are important as part of the Electronic Medical Record - Products / Features and are essential for your Practice / Organization for better patient care and increase in ROI. |
| |
| Kindly contact us at CareEMR. |
| |
| By Vinay |
 |
