User's Manual
Connecting and Positioning ECG Electrodes
6-6 ECG and Arrhythmia Monitoring
Connecting and Positioning ECG Electrodes
Correct lead placement is always important for accurate diagnosis.
Especially in the precordial leads, which are close the heart, QRS
morphology can be greatly altered if an electrode is moved away from its
correct location. Each electrode is color-coded. Use the placement diagrams
available on the display of the MX40 and in this section for guidance.
Additional lead placement information is available in the Online Help at the
IntelliVue Information Center.
When placing electrodes on the patient, choose a flat, non-muscular site
where the signal will not be impacted by either movement or bones.
Philips recommends that electrodes be changed every 24 hours.
Clinicians will tend to see more motion related artifact on the ECG of
ambulatory patients than on patients that are restricted to a bed. Proper
skin preparation and electrode application are very important in reducing
this problem.
Problems with the ECG signal stem from two main sources:
1 Patient-related sources with noise on the waveform caused by clinical
considerations such as poor skin prep, dry electrodes, and poor
electrode adhesion, as well as by patient motion and muscle artifact
2 Frequency-related sources resulting in dropouts from signal
disturbances and loss of signal. See Risk Management Considerations p.
15-5.
Even in complex situations where problems overlap, most of the time you’ll
be able to greatly enhance performance by taking corrective action.
In addition to correct positioning of the electrodes, optimal skin preparation
prior to electrode placement will help ensure a clear signal for diagnosis.
1 Prepare the patient’s skin. Good electrode-to-skin contact is important
for a good ECG signal, as the skin is a poor conductor of electricity.
Select sites with intact skin, without impairment of any kind.
Clip or shave hair from the site as necessary.
Wash site with soap and water, leaving no soap residue.
Note— Philips does not recommend using ether or pure alcohol,
because they dry the skin and increase the resistance.
Dry thoroughly.
Use ECG skin preparation paper (abrasive) to remove dead skin
cells and to improve the conductivity of the electrode site.