Re: 12 Lead ECG placement.....just wondering

[Guest guest]

Nope, you are correct, they go under the breast.

________________________________

From: texasems-l [texasems-l ] On Behalf Of

[txladymedic@...]

Sent: Friday, August 27, 2010 3:00 PM

To: texasems-l

Subject: 12 Lead ECG placement.....just wondering

I had an interesting conversation with a friend that works for an MD. She did a

12 lead ECG like most of us probably would have going under the breast to place

the leads and just undoing the bra not removing it as the " girls " would have

been unleashed with the removal. Her Doc insisted that she totally remove the

bra and that she place the leads ON the breast rather than UNDER it. His

rational is that the breast tissue would not affect the outcome of the ECG and

the placement would be more precise. This is the first I've heard of placing

them on the breast...I've always heard (and done) under the breast tissue. Same

basic principle for obese folks. Anyone else heard of placing them on the

breast?? Maybe I've become old and need to go take a Cardiology refresher.....

Leach, CCEMT-P

[Guest guest]

Nope, you are correct, they go under the breast.

________________________________

From: texasems-l [texasems-l ] On Behalf Of

[txladymedic@...]

Sent: Friday, August 27, 2010 3:00 PM

To: texasems-l

Subject: 12 Lead ECG placement.....just wondering

I had an interesting conversation with a friend that works for an MD. She did a

12 lead ECG like most of us probably would have going under the breast to place

the leads and just undoing the bra not removing it as the " girls " would have

been unleashed with the removal. Her Doc insisted that she totally remove the

bra and that she place the leads ON the breast rather than UNDER it. His

rational is that the breast tissue would not affect the outcome of the ECG and

the placement would be more precise. This is the first I've heard of placing

them on the breast...I've always heard (and done) under the breast tissue. Same

basic principle for obese folks. Anyone else heard of placing them on the

breast?? Maybe I've become old and need to go take a Cardiology refresher.....

Leach, CCEMT-P

[Guest guest]

Read the Standard Lead section of the following document:

Recommendations for the Standardization and Interpretation of the

Electrocardiogram: Part I: The Electrocardiogram and Its Technology A

Scientific Statement From the American Heart Association

Electrocardiography and Arrhythmias Committee, Council on Clinical

Cardiology; the American College of Cardiology Foundation; and the Heart

Rhythm Society Endorsed by the International Society for Computerized

Electrocardiology

http://content.onlinejacc.org/cgi/reprint/49/10/1109.pdf

It cites evidenced based doubt, but ultimately recommends under the breasts

until further evidence dictates otherwise. I was thinking there was a new

version of this document out but am not on my office computer.

Best Regards,

Mark Eliot, Capt

EMS Officer

New Braunfels Fire Dept

From: texasems-l [texasems-l ] on behalf of

[txladymedic@...]

Sent: Friday, August 27, 2010 3:00 PM

To: texasems-l

Subject: 12 Lead ECG placement.....just wondering

I had an interesting conversation with a friend that works for an MD. She did a

12 lead ECG like most of us probably would have going under the breast to place

the leads and just undoing the bra not removing it as the " girls " would have

been unleashed with the removal. Her Doc insisted that she totally remove the

bra and that she place the leads ON the breast rather than UNDER it. His

rational is that the breast tissue would not affect the outcome of the ECG and

the placement would be more precise. This is the first I've heard of placing

them on the breast...I've always heard (and done) under the breast tissue. Same

basic principle for obese folks. Anyone else heard of placing them on the

breast?? Maybe I've become old and need to go take a Cardiology refresher.....

Leach, CCEMT-P

[Guest guest]

Read the Standard Lead section of the following document:

Recommendations for the Standardization and Interpretation of the

Electrocardiogram: Part I: The Electrocardiogram and Its Technology A

Scientific Statement From the American Heart Association

Electrocardiography and Arrhythmias Committee, Council on Clinical

Cardiology; the American College of Cardiology Foundation; and the Heart

Rhythm Society Endorsed by the International Society for Computerized

Electrocardiology

http://content.onlinejacc.org/cgi/reprint/49/10/1109.pdf

It cites evidenced based doubt, but ultimately recommends under the breasts

until further evidence dictates otherwise. I was thinking there was a new

version of this document out but am not on my office computer.

Best Regards,

Mark Eliot, Capt

EMS Officer

New Braunfels Fire Dept

From: texasems-l [texasems-l ] on behalf of

[txladymedic@...]

Sent: Friday, August 27, 2010 3:00 PM

To: texasems-l

Subject: 12 Lead ECG placement.....just wondering

I had an interesting conversation with a friend that works for an MD. She did a

12 lead ECG like most of us probably would have going under the breast to place

the leads and just undoing the bra not removing it as the " girls " would have

been unleashed with the removal. Her Doc insisted that she totally remove the

bra and that she place the leads ON the breast rather than UNDER it. His

rational is that the breast tissue would not affect the outcome of the ECG and

the placement would be more precise. This is the first I've heard of placing

them on the breast...I've always heard (and done) under the breast tissue. Same

basic principle for obese folks. Anyone else heard of placing them on the

breast?? Maybe I've become old and need to go take a Cardiology refresher.....

Leach, CCEMT-P

[Guest guest]

Sounds like there's a doc out there who really likes boobies!!!

April McGuffey-LP, CCEMT-P

________________________________

To: texasems-l

Sent: Fri, August 27, 2010 3:00:01 PM

Subject: 12 Lead ECG placement.....just wondering

I had an interesting conversation with a friend that works for an MD. She did

a 12 lead ECG like most of us probably would have going under the breast to

place the leads and just undoing the bra not removing it as the " girls " would

have been unleashed with the removal. Her Doc insisted that she totally remove

the bra and that she place the leads ON the breast rather than UNDER it. His

rational is that the breast tissue would not affect the outcome of the ECG and

the placement would be more precise. This is the first I've heard of placing

them on the breast...I've always heard (and done) under the breast tissue. Same

basic principle for obese folks. Anyone else heard of placing them on the

breast?? Maybe I've become old and need to go take a Cardiology refresher.....

Leach, CCEMT-P

[Guest guest]

I'm going to ask a silly question just to try and understand the

rational behind the doc, but could the wire in a bra impact the ECG

readings in some manner? I've never heard of it doing that, but it's

been a few years since I had to do ECGs. Barry

Barry Sharp, MSHP, CHES

Tobacco Prevention & Control Program Coordinator

Substance Abuse Services Unit

Mental Health and Substance Abuse Division

12 Lead ECG placement.....just wondering

I had an interesting conversation with a friend that works for an MD.

She did a 12 lead ECG like most of us probably would have going under

the breast to place the leads and just undoing the bra not removing it

as the " girls " would have been unleashed with the removal. Her Doc

insisted that she totally remove the bra and that she place the leads ON

the breast rather than UNDER it. His rational is that the breast tissue

would not affect the outcome of the ECG and the placement would be more

precise. This is the first I've heard of placing them on the

breast...I've always heard (and done) under the breast tissue. Same

basic principle for obese folks. Anyone else heard of placing them on

the breast?? Maybe I've become old and need to go take a Cardiology

refresher.....

Leach, CCEMT-P

------------------------------------

[Guest guest]

Or the Dr was bored?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

In a message dated 8/27/2010 3:56:30 P.M. Central Daylight Time,

barry.sharp@... writes:

I'm going to ask a silly question just to try and understand the

rational behind the doc, but could the wire in a bra impact the ECG

readings in some manner? I've never heard of it doing that, but it's

been a few years since I had to do ECGs. Barry

Barry Sharp, MSHP, CHES

Tobacco Prevention & Control Program Coordinator

Substance Abuse Services Unit

Mental Health and Substance Abuse Division

-----Original Message-----

From: texasems-l [mailto:texasems-l ] On

Behalf Of Lee

Sent: Friday, August 27, 2010 3:52 PM

To: texasems-l

Subject: RE: 12 Lead ECG placement.....just wondering

Nope, you are correct, they go under the breast.

________________________________

From: texasems-l [texasems-l ] On Behalf

Of [txladymedic@...]

Sent: Friday, August 27, 2010 3:00 PM

To: texasems-l

Subject: 12 Lead ECG placement.....just wondering

I had an interesting conversation with a friend that works for an MD.

She did a 12 lead ECG like most of us probably would have going under

the breast to place the leads and just undoing the bra not removing it

as the " girls " would have been unleashed with the removal. Her Doc

insisted that she totally remove the bra and that she place the leads ON

the breast rather than UNDER it. His rational is that the breast tissue

would not affect the outcome of the ECG and the placement would be more

precise. This is the first I've heard of placing them on the

breast...I've always heard (and done) under the breast tissue. Same

basic principle for obese folks. Anyone else heard of placing them on

the breast?? Maybe I've become old and need to go take a Cardiology

refresher.....

Leach, CCEMT-P

------------------------------------

Yahoo! Groups Links

------------------------------------

Yahoo! Groups Links

[Guest guest]

You know I've heard both ways on the underwire in the bra...if it is true

wire...most of the time they are plastic instead of wire. I tried to find a

study confirming or denying whether a underwire would effect the outcome of an

ECG but found nothing concrete either way.

I've seen cell phones effect the clarity of one but that is about it.

I don't know if he was bored or maybe he just needs to update his 12 lead ECG

placement skills.

>

> I'm going to ask a silly question just to try and understand the

> rational behind the doc, but could the wire in a bra impact the ECG

> readings in some manner? I've never heard of it doing that, but it's

> been a few years since I had to do ECGs. Barry

>

> Barry Sharp, MSHP, CHES

> Tobacco Prevention & Control Program Coordinator

> Substance Abuse Services Unit

> Mental Health and Substance Abuse Division

>

>

> 12 Lead ECG placement.....just wondering

>

>

>

> I had an interesting conversation with a friend that works for an MD.

> She did a 12 lead ECG like most of us probably would have going under

> the breast to place the leads and just undoing the bra not removing it

> as the " girls " would have been unleashed with the removal. Her Doc

> insisted that she totally remove the bra and that she place the leads ON

> the breast rather than UNDER it. His rational is that the breast tissue

> would not affect the outcome of the ECG and the placement would be more

> precise. This is the first I've heard of placing them on the

> breast...I've always heard (and done) under the breast tissue. Same

> basic principle for obese folks. Anyone else heard of placing them on

> the breast?? Maybe I've become old and need to go take a Cardiology

> refresher.....

>

> Leach, CCEMT-P

>

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

You know I've heard both ways on the underwire in the bra...if it is true

wire...most of the time they are plastic instead of wire. I tried to find a

study confirming or denying whether a underwire would effect the outcome of an

ECG but found nothing concrete either way.

I've seen cell phones effect the clarity of one but that is about it.

I don't know if he was bored or maybe he just needs to update his 12 lead ECG

placement skills.

>

> I'm going to ask a silly question just to try and understand the

> rational behind the doc, but could the wire in a bra impact the ECG

> readings in some manner? I've never heard of it doing that, but it's

> been a few years since I had to do ECGs. Barry

>

> Barry Sharp, MSHP, CHES

> Tobacco Prevention & Control Program Coordinator

> Substance Abuse Services Unit

> Mental Health and Substance Abuse Division

>

>

> 12 Lead ECG placement.....just wondering

>

>

>

> I had an interesting conversation with a friend that works for an MD.

> She did a 12 lead ECG like most of us probably would have going under

> the breast to place the leads and just undoing the bra not removing it

> as the " girls " would have been unleashed with the removal. Her Doc

> insisted that she totally remove the bra and that she place the leads ON

> the breast rather than UNDER it. His rational is that the breast tissue

> would not affect the outcome of the ECG and the placement would be more

> precise. This is the first I've heard of placing them on the

> breast...I've always heard (and done) under the breast tissue. Same

> basic principle for obese folks. Anyone else heard of placing them on

> the breast?? Maybe I've become old and need to go take a Cardiology

> refresher.....

>

> Leach, CCEMT-P

>

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

I have seen several EKG techs put it on the breast. They said it ensured proper

placement as placing under large breast often moved the lead to far down.

Renny Spencer

Paramedic

> >

> > I'm going to ask a silly question just to try and understand the

> > rational behind the doc, but could the wire in a bra impact the ECG

> > readings in some manner? I've never heard of it doing that, but it's

> > been a few years since I had to do ECGs. Barry

> >

> > Barry Sharp, MSHP, CHES

> > Tobacco Prevention & Control Program Coordinator

> > Substance Abuse Services Unit

> > Mental Health and Substance Abuse Division

> >

> >

> > 12 Lead ECG placement.....just wondering

> >

> >

> >

> > I had an interesting conversation with a friend that works for an MD.

> > She did a 12 lead ECG like most of us probably would have going under

> > the breast to place the leads and just undoing the bra not removing it

> > as the " girls " would have been unleashed with the removal. Her Doc

> > insisted that she totally remove the bra and that she place the leads ON

> > the breast rather than UNDER it. His rational is that the breast tissue

> > would not affect the outcome of the ECG and the placement would be more

> > precise. This is the first I've heard of placing them on the

> > breast...I've always heard (and done) under the breast tissue. Same

> > basic principle for obese folks. Anyone else heard of placing them on

> > the breast?? Maybe I've become old and need to go take a Cardiology

> > refresher.....

> >

> > Leach, CCEMT-P

> >

> >

> >

> >

> >

> > ------------------------------------

> >

> >

[Guest guest]

I have seen several EKG techs put it on the breast. They said it ensured proper

placement as placing under large breast often moved the lead to far down.

Renny Spencer

Paramedic

> >

> > I'm going to ask a silly question just to try and understand the

> > rational behind the doc, but could the wire in a bra impact the ECG

> > readings in some manner? I've never heard of it doing that, but it's

> > been a few years since I had to do ECGs. Barry

> >

> > Barry Sharp, MSHP, CHES

> > Tobacco Prevention & Control Program Coordinator

> > Substance Abuse Services Unit

> > Mental Health and Substance Abuse Division

> >

> >

> > 12 Lead ECG placement.....just wondering

> >

> >

> >

> > I had an interesting conversation with a friend that works for an MD.

> > She did a 12 lead ECG like most of us probably would have going under

> > the breast to place the leads and just undoing the bra not removing it

> > as the " girls " would have been unleashed with the removal. Her Doc

> > insisted that she totally remove the bra and that she place the leads ON

> > the breast rather than UNDER it. His rational is that the breast tissue

> > would not affect the outcome of the ECG and the placement would be more

> > precise. This is the first I've heard of placing them on the

> > breast...I've always heard (and done) under the breast tissue. Same

> > basic principle for obese folks. Anyone else heard of placing them on

> > the breast?? Maybe I've become old and need to go take a Cardiology

> > refresher.....

> >

> > Leach, CCEMT-P

> >

> >

> >

> >

> >

> > ------------------------------------

> >

> >

[Guest guest]

One thing that nobody has mentioned is that no matter where it's put, if

somebody else does an ECG later and places them in different places, even

slightly, the reading will be skewed and there will be differences even if there

have been no changes in the patient's coronary status.

One thing I do with my students to illustrate all this is let them play with the

electrodes and put them in all sorts of places and see how placement changes

things. It's one of the best ways to illustrate vector to them.

GG

12 Lead ECG placement.....just wondering

> >

> >

> >

> > I had an interesting conversation with a friend that works for an MD.

> > She did a 12 lead ECG like most of us probably would have going under

> > the breast to place the leads and just undoing the bra not removing it

> > as the " girls " would have been unleashed with the removal. Her Doc

> > insisted that she totally remove the bra and that she place the leads ON

> > the breast rather than UNDER it. His rational is that the breast tissue

> > would not affect the outcome of the ECG and the placement would be more

> > precise. This is the first I've heard of placing them on the

> > breast...I've always heard (and done) under the breast tissue. Same

> > basic principle for obese folks. Anyone else heard of placing them on

> > the breast?? Maybe I've become old and need to go take a Cardiology

> > refresher.....

> >

> > Leach, CCEMT-P

> >

> >

> >

> >

> >

> > ------------------------------------

> >

> >

[Guest guest]

Don't know about evidence based. But approx. 2 months ago now, I was in

the hosp. overnite for SVT and had the nurse place the leads over my breast

in the ED. the nurse stated that was the proper way and that the breast

tissue did not interfere with the readout.

In a message dated 8/27/2010 4:00:11 P.M. Eastern Daylight Time,

txladymedic@... writes:

I had an interesting conversation with a friend that works for an MD. She

did a 12 lead ECG like most of us probably would have going under the breast

to place the leads and just undoing the bra not removing it as the " girls "

would have been unleashed with the removal. Her Doc insisted that she

totally remove the bra and that she place the leads ON the breast rather than

UNDER it. His rational is that the breast tissue would not affect the

outcome of the ECG and the placement would be more precise. This is the first

I've heard of placing them on the breast...I've always heard (and done) under

the breast tissue. Same basic principle for obese folks. Anyone else heard

of placing them on the breast?? Maybe I've become old and need to go take a

Cardiology refresher.....

Leach, CCEMT-P

[Guest guest]

Don't know about evidence based. But approx. 2 months ago now, I was in

the hosp. overnite for SVT and had the nurse place the leads over my breast

in the ED. the nurse stated that was the proper way and that the breast

tissue did not interfere with the readout.

In a message dated 8/27/2010 4:00:11 P.M. Eastern Daylight Time,

txladymedic@... writes:

I had an interesting conversation with a friend that works for an MD. She

did a 12 lead ECG like most of us probably would have going under the breast

to place the leads and just undoing the bra not removing it as the " girls "

would have been unleashed with the removal. Her Doc insisted that she

totally remove the bra and that she place the leads ON the breast rather than

UNDER it. His rational is that the breast tissue would not affect the

outcome of the ECG and the placement would be more precise. This is the first

I've heard of placing them on the breast...I've always heard (and done) under

the breast tissue. Same basic principle for obese folks. Anyone else heard

of placing them on the breast?? Maybe I've become old and need to go take a

Cardiology refresher.....

Leach, CCEMT-P

[Guest guest]

Came across this, thought it might help.

" Breast tissue appears to have a practically negligible effect on ECG

amplitudes, and in women, the placement of chest electrodes on the breast rather

than under the breast is recommended in order to facilitate the precision of

electrode placement at the correct horizontal level and at the correct lateral

positions. "

Rautaharju PM, Park L, Rautaharju FS, Crow R. A standardized procedure for

locating and documenting ECG chest electrode positions: consideration of the

effect of breast tissue on ECG amplitudes in women. J Electrocardiol. 1998

Jan;31(1):17-29.

Sent from my iPhone,

McGee, EMT-P, EMT-T

Don't know about evidence based. But approx. 2 months ago now, I was in

the hosp. overnite for SVT and had the nurse place the leads over my breast

in the ED. the nurse stated that was the proper way and that the breast

tissue did not interfere with the readout.

In a message dated 8/27/2010 4:00:11 P.M. Eastern Daylight Time,

txladymedic@... writes:

I had an interesting conversation with a friend that works for an MD. She

did a 12 lead ECG like most of us probably would have going under the breast

to place the leads and just undoing the bra not removing it as the " girls "

would have been unleashed with the removal. Her Doc insisted that she

totally remove the bra and that she place the leads ON the breast rather than

UNDER it. His rational is that the breast tissue would not affect the

outcome of the ECG and the placement would be more precise. This is the first

I've heard of placing them on the breast...I've always heard (and done) under

the breast tissue. Same basic principle for obese folks. Anyone else heard

of placing them on the breast?? Maybe I've become old and need to go take a

Cardiology refresher.....

Leach, CCEMT-P

[Guest guest]

Thanks for the information....It's been an interesting and informative topic for

me.

>

> Don't know about evidence based. But approx. 2 months ago now, I was in

> the hosp. overnite for SVT and had the nurse place the leads over my breast

> in the ED. the nurse stated that was the proper way and that the breast

> tissue did not interfere with the readout.

>

>

> In a message dated 8/27/2010 4:00:11 P.M. Eastern Daylight Time,

> txladymedic@... writes:

>

> I had an interesting conversation with a friend that works for an MD. She

> did a 12 lead ECG like most of us probably would have going under the breast

> to place the leads and just undoing the bra not removing it as the " girls "

> would have been unleashed with the removal. Her Doc insisted that she

> totally remove the bra and that she place the leads ON the breast rather than

> UNDER it. His rational is that the breast tissue would not affect the

> outcome of the ECG and the placement would be more precise. This is the first

> I've heard of placing them on the breast...I've always heard (and done) under

> the breast tissue. Same basic principle for obese folks. Anyone else heard

> of placing them on the breast?? Maybe I've become old and need to go take a

> Cardiology refresher.....

>

> Leach, CCEMT-P

>

>