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Trick of the trade: Quieting the shaky EKG tracing


EKGtremorA patient with Parkinson’s disease presents with chest pain to your ED. Her tremors prevent you from getting a good quality EKG because of the movement artifact.

How can you eliminate this artifact? (No cheating with rocuronium.)

Trick of the Trade
Have the patient sit on his/her hands.


Although I haven’t tried this myself, this trick apparently works for people with upper extremity tremors and movement disorders. Has anyone used this trick? It’s been referenced in: Burdick E350 Operating Manual. Milton, Wis: Siemens Burdick, Inc; 1990.

Thanks to Brooke, RN for this tip, and Alex for being a hand-sitting model!

Michelle Lin, MD
ALiEM Editor-in-Chief
Academy Endowed Chair of EM Education
Professor of Clinical Emergency Medicine
University of California, San Francisco
Michelle Lin, MD
Michelle Lin, MD

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