Can Medical Assistants Do EKGs?

Electrocardiograms are diagnostic tests used to examine heart function. Once done only in hospitals, most EKGs can now be performed in doctor’s offices by a trained medical assistant. It’s a time saver for patients and an important source of revenue for physicians.

What is an EKG?

Developed in 1903 by Dutch physician William Einthoven, an electrocardiogram, or EKG, painlessly records electrical activity in the heart, according to The Nobel Prize. It maps voltage from different angles, converting electrical signals into a wave-like tracing. Doctors can tell how the heart is functioning by measuring the peaks and valleys in the waveform.

How Is an EKG Performed?

Electrocardiograms are performed with electrocardiographs, machines that measure voltage through electrodes attached to the skin. There are several types of EKGs a medical assistant can perform or assist with.

The most common is the 12-lead EKG using ten electrodes and 12 leads to produce twelve unique reference points and six waves, P, Q, R, S and T, for doctors to examine. The test is done with the patient in a recumbent position and takes just minutes to complete.

Doctors can also order portable EKGs for patients with occasional or activity-related cardiac symptoms. Known as event monitoring, devices measure a few inches and can be worn for weeks to catch the rare abnormalities a conventional EKG might miss. Wireless, monitoring centers receive readings in real-time. Patients press a button whenever symptoms occur, and the physician can cross-reference them to determine if they coincide with irregularities in heart rhythm.

A medical assistant working with a cardiologist may assist with so-called stress tests, an EKG taken while a patient walks on a treadmill or rides a stationary bicycle. Directly supervised by a physician, it shows how the heart performs under physical stress. Because there’s some risk to patients who are already experiencing potential cardiac symptoms, a medical assistant never performs this test alone.

What Do Doctors Learn from EKGs?

Electrocardiograms are one of many tests used to evaluate the heart. Results are part of a larger clinical picture that only a skilled cardiologist can interpret. EKGs help a doctor diagnose:


Ischemia is a reduction in blood supply to the heart muscle causing chest pain. It can indicate an impending heart attack, or a chronic oxygen deficiency called angina.


Dysrhythmias are abnormal rhythms caused by disruptions in the heart’s electrical system. Examples include bradycardia, tachycardia, and atrial fibrillation.

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is an enlarged heart. It can occur due to an abnormal gene mutation or untreated high blood pressure. Over time, it leads to heart failure.

Heart Attacks

A myocardial infarction, or heart attack, is the death of heart muscle caused by an obstruction in a coronary artery, such as a blood clot or atherosclerotic plaque. An EKG can diagnose a heart attack in progress, so it’s the fastest route to a life-saving intervention.

Doctors also order EKGs to rule out heart disease as the cause of worrisome symptoms, such as:

  • Recurrent chest pressure or pain
  • Neck, shoulder and jaw pain
  • Shortness of breath
  • Lightheadedness
  • Nausea
  • Chronic fatigue

Among the many tests that can diagnose heart disease, the EKG is the quickest, least invasive and most cost-effective. It’s often included in annual exams for people over 50.

Performing EKGs: The Medical Assistant’s Role

Medical assistants can perform 12-lead EKGs from start to finish without direct supervision and may assist with the placement of event monitors and preparation for stress tests. In a general practitioner’s office, they may do a few EKGs weekly. In a cardiology practice, they may do dozens per day, so efficiency matters. Steps for a typical EKG include:

Pretest Preparation

Medical assistants prevent delays by stocking necessary supplies in advance and performing quality control checks on equipment to ensure they are functioning properly.

Spaces should be sanitized and comfortable for patients. Electronic devices, including air conditioners, fans and cell phones, may interfere with readings and should be turned off temporarily.

Patient Education

Medical assistants prepare patients for testing by explaining how EKGs are performed. Obtaining the best results requires patients to stay still and follow simple instructions, so answering questions and clarifying expectations in advance alleviates stress and improves cooperation.


Some patients have physical limitations that impact the EKG process. People with heart failure, for example, can’t breathe well laying down. Making accommodations enhances patient’s comfort, improves efficiency and ensures optimal results.

Patient Preparation

Preparation for an EKG is minimal. Medical assistants remind clients to remove metal jewelry, watches and body piercings that can interfere with electrical signals and cause artifact. They provide loose-fitting garments for electrode placement. They can assist patients with limited mobility into position. Medical assistants can also shave hair and cleanse the skin where electrode pads will be applied so they’ll stick firmly, while avoiding areas directly over bony prominences or where the skin is red or irritated.


The steps to perform an EKG are:

  • Place the electrodes on the patient’s body and attach the color-coded leads.
  • Turn on the electrocardiograph and follow the manufacturer’s instructions for running a pretest control strip.
  • Cue the patient to take a deep breath and stay still until they’re signaled the test is complete.
  • Examine the strip for quality. If excessive artifact is present, take a second reading.

Medical assistants can’t interpret an EKG, but they can tell with experience when there’s a significant abnormality. Unusual results should be discussed with the physician right away.

Once complete, results are added to the patient’s chart, and the medical assistant can help with aftercare.


After testing, the medical assistant:

  • Removes the leads and electrode pads.
  • Assists patients with mobility issues to redress and collect their belongings.
  • Explains when results can be expected, where to direct questions and who to contact if they have concerning symptoms.
  • Discards used linens and supplies to prevent the spread of infections.
  • Sanitizes the room for the next patient.

Final Thoughts

Medical assistants learn everything they need to know about heart health and electrocardiograms in a vocational school program. It’s among their most valuable skills and one of the most important ways they help deliver top-quality healthcare.

Ready to start helping patients with EKGs? The Medical Assistant Technician Diploma Program is designed to prepare you to obtain entry-level employment as a medical assistant technician. This program offers you the opportunity to learn the necessary knowledge and skills both in the classroom and in a supervised clinical practice. You will learn how to prepare patients for various technical examinations such as EKGs and phlebotomy, as well as how to perform several such procedures.

Ready to move from the classroom to a career? Florida Technical College is here to help. Contact us to learn more about completing the medical assistant technician diploma program at Florida Technical College.

* These examples are intended to serve only as a general guide of possible employment opportunities. There are many factors that determine the job an individual may obtain and Florida Technical College cannot guarantee its graduate any particular job. Some positions may require license or other certifications. We encourage you to research the requirements for the particular position you desire.