How to train for a stress test
Bruce Protocol Stress Test
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okay today we'll be doing an EKG on
Brent we've already added in his age
gender race height and weight into the
computer and now we'll begin the test
the first thing a lisanna done is wash
your hands and remove the ten elector
from the package now she'll be using the
abrasion pad to clean off the area it's
very important to definitely get in and
get all of the first layer of skin off
because it can cause a lot of audio
which is extra noise that shows up on
the EKG that can make the test come out
wrong
if you cannot talk to your patients
before the test is going to tell them
not to use any lotions or any of like
thick soaps because we need the tests to
be very clear of any excess stuff on
there to cause any more artifact if the
patient has a hairy chest you also need
to use a razor blade to shave off the
excess hair
if the signs are not clean then those
the pads won't stick and that the
electrodes don't stick that you can't
get a good reading and if a patient is
on a treadmill sweating you wouldn't
want them to come off so it's really
good to make sure that whole layer is
off you can see Alison's scrubbing and
getting that completely off it's not
always comfortable for the patient but
it's necessary for the tests
she has two more sites to do and finish
the standard method for the Mason like
our EKGs would be to place the left
Rhodes down by the ankles and up by the
arms as well as on the chest but today
we'll be using the modified exercise
Mason like our method so we'll be using
two electrodes down on the abdomen into
up on the shoulders rather than on on
and ankles you can see that she's using
the alcohol pad to completely clean off
the area so that the electrodes will
stick better and it's very important
that she doesn't touch the areas after
she's wiped them off with the alcohol
because she has we have oils on our
fingers that could keep the electrodes
from sticking during the test
now these are the electrodes that we'll
use there's gel on the bottom of them
and that's what produces the positive
charge and the further out the reading
for the test now you want to be very
careful as to not touch any of the
sticky part of the pad you just want the
very outside part of it so the first one
she's placing on there goes on the
distal intrical dick euler fossa at the
top on the right side and then she'll
place the left side distal into
radicular fossa the next patch we'll
stick is v1 which is placed in the
fourth right intercostal space at the
sternal border
then she'll place v2 which is also
placed at the four left intercostal
space at the sternal border
for now so skip v3 and go to v4 which is
placed in the fifth left intercostal
space at the midclavicular line and then
halfway between so place v3 which is
between v2 and v4 at a diagonal next
show place
v5 which is placed in the anterior
axillary line at the same horizontal
plane as before
next will be v6 which is placed in the
mid axillary line at the same horizontal
plane as
the next one will be actually our ground
I'm sorry we'll go to our left one first
which is placed in line with the
abdominal above the iliac crest and the
final Winchell place is our ground one
which is in line on the right side the
abdomen at the iliac crest
okay this test is the Bruce protocol
test it's to do a vo2 max test for the
for this purpose the computer will be
running the test but if you run it
yourself
every three minutes you'll increase the
grade starting at ten and moving up to
12 then the 14 16 18 and 20 the speed
will start out at 1.7 and then it will
gradually move up to 2.5 3.4 4.2 5.0 and
then 5.5 at any point in time the person
who is doing the test can ask to stop if
they're not feeling comfortable you can
see Brentt has this shirt on it's
actually to hold the electrodes in place
so we can get a reading throughout the
whole time Allison has already done is a
blood pressure reading so now we'll
begin the test
now we grade is up to 10 and the speed
is at 1.7 during each stage wanting to
get an RBE from the client and I also
will be taking a blood pressure as you
can see Bren will be resting his arm on
her shoulder so that there isn't any
chance of getting the wrong breathing
one blood pressure is done during each
three-minute interval but during each
minute we'll get an R PE and we'll also
get a heart rate
jarppi
the treadmill moves do great 40 has via
3.4 treadmill move to a 16 percent grade
at a 4.2 speed the Bruce protocol is a
mass vo2 test therefore we can take the
Brisbin all the way up to the top but
however if this had been a submaximal
test we would usually stop the
participant 85 percent of their max
which is where he is right now
Irby
14
now that right now is at an eighteen
percent grade at a 5.0 speed like we
said at the beginning the participant
may stop the test at any time
these chose to drop now so now we'll do
a pulldown
and now during the cooldown we'll make
sure we get the heart rates and the
blood pressures and make sure the
patient is recovering
during this test the heart rate
increased as a workload increased the
EKG had a normal sinus rhythm and there
were no signs of ST segment changes
tachycardia was present but that's
what's to be expected this clinical
exercise test was without incident and
Brent would be cleared for exercise
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