Practical clinical skills provides free training and reference guides our simulation based lessons cover heart sounds murmurs lung sounds carotid bruit blood pressure measurement and ekg training the quick reference guides are a timely information source at the point of care. Cardiac monitoring part 1 electrocardiography ecg 2 january 2007 comment if the ecg trace is showing a flatline the most likely cause is mechanical though check the patient has not had a cardiac arrest jevon p 2003 ecgs for nurses essential clinical skills for nurses oxford blackwell publishing paul s hebra j . Note citations are based on reference standards however formatting rules can vary widely between applications and fields of interest or study the specific requirements or preferences of your reviewing publisher classroom teacher institution or organization should be applied. If the trace is showing small qrs complexes check that the ecg gain is correctly set and the desired monitoring lead has been selected repositioning the electrodes or selecting another monitoring lead sometimes helps jevon 2003 clinical causes include pericardial effusion obesity and hypothyroidism
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