Standardized placement of leads is important so the information obtained is assessed in a common frame of reference and appropriate judgments may be made on the patient's cardiac status. Six-lead systems are also now available, and these systems allow monitoring of two precordial leads. This system provides views from the six limb leads (I, II, III, aVR, aVL, aVF) plus one precordial (C or V) lead. The five-lead system is commonly used in most organizations. This system is used in many portable monitors and defibrillators. Only one lead is displayed, lead I, II, III, MCL 1, or MCL 6. The three-lead system is the oldest and simplest of all cardiac-monitoring lead systems. ECG monitors use a three-lead or five-lead wire system to provide different views of the heart’s electrical activity. Specific areas of the chest are used for placement of electrodes to obtain a view of the electrical activity in a particular area of the heart. A disadvantage of telemetry is that ambulation and activity may increase distortion of the ECG pattern, causing artifact. Telemetry is useful for progressive ambulation and when evaluating a patient's activity tolerance. Telemetry systems have electrodes and lead wires that are attached from the patient to a battery pack transmitting impulses to the monitor via radio-wave transmission. Impulses are transmitted directly from the patient to the monitor. Hardwire ECG monitors have electrodes and lead wires that are attached directly to the patient. Cardiac electrophysiologic monitoring by hardwire and telemetry is indicated for patients in critical care units, progressive care units, telemetry units, postanesthesia care areas, operating rooms, and emergency departments. These images may be used for diagnostic, documentation, and treatment purposes. A key component of such monitoring is the ECG, which provides a continuous graphic picture of electrical activity generated by the depolarization and repolarization of cardiac tissue. OVERVIEWĬontinuous cardiac electrophysiologic monitoring is performed routinely for most acute and critically ill patients. Cardiac Monitor Setup and Lead Placement - CE ALERTĪlterations in electrode position may distort the appearance of the waveform significantly, leading to misdiagnosis or mistreatment.ĭo not use an EASI-derived 12-lead electrocardiogram (ECG) and its measurements for diagnostic interpretations they are approximations to a conventional 12-lead ECG.
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