Alternative electrocardiography electrode placement

Alternative electrocardiography electrode placement Continuous real‐time ECG monitoring is an essential part of basic intra‐operative monitoring guidelines . However, the three‐lead ECG electrodes routinely placed in the Mason–Likar (M‐L) configuration (i.e. both infraclavicular fossae, and the anterior axillary line midway between the iliac crest and the costal margin) can encroach on the surgical field during anterior chest wall, upper abdominal and shoulder surgery. Further electrode relocation reduces their access by the anaesthetist, and risks misinterpretation .Takuma et al. suggest relocation to the anterior acromial region and anterior superior iliac spines bilaterally, but this is associated with abnormalities in R‐wave amplitude (specifically an increase in lead 2) .Instead, we have found that placing electrodes on the left and right sides of the forehead and a third anywhere below neck on the left side improves accessibility without detriment to ECG output morphology (Fig. ). With minor re‐adjustment, this configuration can be used successfully alongside processed electroencephalography electrodes.Suggested position of ECG electrodes.ReferencesAmerican Society of Anesthesiologists. Standards for basic anaesthetic monitoring 2016. https://www.asahq.org/~/media/Sites/ASAHQ/Files/Public/Resources/standards-guidelines/standards-for-basic-anesthetic-monitoring.pdf. (accessed 02/02/2018).Association of Anaesthetists of Great Britain and Ireland. Recommendations for standards of monitoring during anaesthesia and recovery 2015. Anaesthesia 2016; 71: 85–93.Jowett NI, Turner AM, Cole A, Jones PA. Modified electrode placement must be recorded when performing 12‐lead electrocardiograms. Postgraduate Medical Journal 2005; 81: 122–5.Takuma K, Hori S, Sasaki J, et al. An alternative limb lead system for electrocardiographs in emergency patients. American Journal of Emergency Medicine 1995; 13: 514–17. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anaesthesia Wiley

Alternative electrocardiography electrode placement

Free
1 page

Loading next page...
1 Page
 
/lp/wiley/alternative-electrocardiography-electrode-placement-zTz6it95SM
Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
Copyright © 2018 The Association of Anaesthetists of Great Britain and Ireland
ISSN
0003-2409
eISSN
1365-2044
D.O.I.
10.1111/anae.14271
Publisher site
See Article on Publisher Site

Abstract

Continuous real‐time ECG monitoring is an essential part of basic intra‐operative monitoring guidelines . However, the three‐lead ECG electrodes routinely placed in the Mason–Likar (M‐L) configuration (i.e. both infraclavicular fossae, and the anterior axillary line midway between the iliac crest and the costal margin) can encroach on the surgical field during anterior chest wall, upper abdominal and shoulder surgery. Further electrode relocation reduces their access by the anaesthetist, and risks misinterpretation .Takuma et al. suggest relocation to the anterior acromial region and anterior superior iliac spines bilaterally, but this is associated with abnormalities in R‐wave amplitude (specifically an increase in lead 2) .Instead, we have found that placing electrodes on the left and right sides of the forehead and a third anywhere below neck on the left side improves accessibility without detriment to ECG output morphology (Fig. ). With minor re‐adjustment, this configuration can be used successfully alongside processed electroencephalography electrodes.Suggested position of ECG electrodes.ReferencesAmerican Society of Anesthesiologists. Standards for basic anaesthetic monitoring 2016. https://www.asahq.org/~/media/Sites/ASAHQ/Files/Public/Resources/standards-guidelines/standards-for-basic-anesthetic-monitoring.pdf. (accessed 02/02/2018).Association of Anaesthetists of Great Britain and Ireland. Recommendations for standards of monitoring during anaesthesia and recovery 2015. Anaesthesia 2016; 71: 85–93.Jowett NI, Turner AM, Cole A, Jones PA. Modified electrode placement must be recorded when performing 12‐lead electrocardiograms. Postgraduate Medical Journal 2005; 81: 122–5.Takuma K, Hori S, Sasaki J, et al. An alternative limb lead system for electrocardiographs in emergency patients. American Journal of Emergency Medicine 1995; 13: 514–17.

Journal

AnaesthesiaWiley

Published: Jan 1, 2018

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve Freelancer

DeepDyve Pro

Price
FREE
$49/month

$360/year
Save searches from
Google Scholar,
PubMed
Create lists to
organize your research
Export lists, citations
Read DeepDyve articles
Abstract access only
Unlimited access to over
18 million full-text articles
Print
20 pages/month
PDF Discount
20% off