Re: EKG electrode placement (Was: Digest Number 5653)

[Guest guest]

There are two common reasons in my experience for ED staff removing the

prehospital 12-lead electrodes: (1) quasi-incompatibility (most prehospital are

the 'button'-type while most EDs use the alligator clips) (2) lack of

consideration for the prehospital 12 lead.

The second can be solved by education and always giving a copy of the 12 lead to

the ED staff (I've found they are frequently not passed on if 'negative'.) The

first is just life. You can alligator clip on to the 'button'-style, but it's

more hassle then it's worth. The best result would be to remove EMS' leads and

immediately replace it with your systems (in the same spot.)

Considering the amount of attention that's been focused on coronary issues in

the last five years, they are still handled relatively poorly in many location

and very inconsistently across various localities/regions. One of the worst

elements of that is the amount of work that is done prehospitally then

completely ignored by ED staff.

Austin

> Even more interesting is the number of times that the electrodes are moved

> once the patient gets to the ED.

>

> I tried to make it policy for the tabs to be left in place when we were

> expecting to repeat the EKG, but it was almost impossible to keep folks from

> taking the stickies off the chest....most common was from the rad techs:

> " The radiologist insists on having them off because it makes it more

difficult

> to read the chest xray. "

>

> One cardiologist I worked with would use a skin marking pen to show where

> he wanted the leads placed....

>

> ck

>

>

> In a message dated 08/29/10 03:38:21 Central Daylight Time, Gene Gandy

> writes:

>

>

> 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.

>

>

>

>