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Asset Type
Electrocardiograph (EKG) Machine
Manufacturer
Model
What This Guide Helps With
This guide assists Clinical Engineering in troubleshooting situations where the PageWriter TC70 fails to acquire an ECG signal. Symptoms may include a flatline display, “No Signal” or “Lead Off” messages, inability to capture patient ECG, or repeated acquisition errors. Most issues are caused by external factors such as lead placement, electrode quality, cable integrity, or patient interface rather than internal hardware failure.
Step-by-Step Troubleshooting
Verify Power and Battery
- Ensure the unit is powered on and the battery (if applicable) is charged.
- Check for low-battery indicators or power error messages.
Why: ECG acquisition may fail if the unit lacks sufficient power to operate fully.
Check Patient Electrodes
- Inspect all electrodes for proper adhesion, expiration date, and skin preparation.
- Replace electrodes if dried out, loose, or expired.
Why: Poor electrode contact prevents proper ECG signal detection.
Verify Lead Wires and Connections
- Inspect all ECG lead wires for breaks, frays, or damaged connectors.
- Confirm leads are securely connected to both the machine and patient electrodes.
- Swap leads with a known working set to rule out wire failure.
Why: Damaged or loose leads are a common cause of “No ECG” acquisition.
Check Lead Placement on Patient
- Confirm correct anatomical placement of all leads according to device instructions.
- Ensure the patient is not moving excessively, as motion artifacts can prevent signal detection.
Why: Misplacement or motion prevents proper ECG acquisition.
Verify Device Settings
- Ensure the correct patient type and lead configuration are selected in the menu.
- Check filters and gain settings to make sure they are within normal acquisition parameters.
Why: Improper settings can result in failure to detect the ECG signal.
Test with a Simulator
- Connect the device to a known ECG simulator.
- If the simulator shows a signal, the problem is likely patient- or electrode-related.
Why: Confirms device acquisition circuitry is functional.
If the Problem Persists
If the above steps fail:
- External causes have likely been ruled out.
- The device should be:
- Removed from service
- Labeled Out of Service
- Sent for bench evaluation or vendor repair
Reason: At this point, the fault is likely internal (e.g., acquisition board, A/D converter, or software fault).
Clinical Use Tip
Never attempt acquisition troubleshooting on an active patient without verifying electrodes and patient stability first. Move the patient to another verified ECG machine to ensure continuous monitoring. Only perform troubleshooting when patient safety can be assured.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Device displays ‘No Signal’ and fails to acquire ECG during patient test.”
Cause
What was observed during troubleshooting.
Example:
“Lead wires inspected and swapped; electrodes replaced; patient lead placement corrected. Device still fails to detect signal.”
Resolution
What action was taken.
Example:
“Device removed from service, labeled Out of Service, sent for bench evaluation.”
Helpful Details to Include
- Outlet and battery status
- Lead wire integrity
- Electrode type and placement
- Device settings at time of failure
- Any alarms or messages displayed
- Patient motion during acquisition
Final Thought
Patient safety and proper monitoring are paramount. Start with logical, external checks before assuming internal device failure. Escalation to repair should be timely, and documenting each step via CCR ensures accurate records and reduces repeat troubleshooting.
That is successful troubleshooting.