EKG Lead Placement - page 3

I've been trying to find some information on the proper EKG lead placement for Neonates (using three leads)...there is an argument in our nursery about this and everyone places the lead in different... Read More

  1. by   dawngloves
    Quote from Gompers
    Oh no! I checked their website, and unless I'm blind, they no longer list Puppy Dog leads! Only the Kitty Cats, limb leads, and these new ones called "Noah" which are radiolucent limb/back leads. I hope they haven't stopped making those Dogs!!!

    http://www.kendall-ltp.com/neon01.htm
    We hated the puppies! We'd change them once a shift because they'g fall off. Forget having them stay on a 24 weeker! We tried putting a little water on them and that did nothing.Kitties are somewhat better, but also a PITA.
  2. by   prmenrs
    I think we gave up trying to put them on VLBWs for the 1st wk of life--took either the oxymeter pulse or a HR from the UAC. The respiratory therapists would put that capsule on their abds so the CPAP/SIMV apparatus could count the respirations. Plus, if they are on body humidity, those leads are never going to stick!
  3. by   KRVRN
    I've found that when a baby is on humidity the leads (and temp probe stickers) become horribly SATURATED with water. Yeah, they stick "okay" but they just look so dang nasty you end up changing the anyway!
  4. by   KRVRN
    Another thing, now many of you guys actually INTERPRET the EKG? Like read the strip and interpret something other than brady or tachycardia? I suppose you have to be more specific about lead placement then...
  5. by   prmenrs
    Babies don't seem to have arrhythmias like grown-ups do. Most of the problems are from to much K+, too little Ca++, Digoxin issues, VSD repairs that took a stitch or 2 thru the conduction pathways, and an occassional, irritating SVT. If you think you see an arrhythmia, the docs will just say "get a 12 lead". So, lead placement for that purpose is a waste of time for babies. lol.
  6. by   Gompers
    Quote from dawngloves
    We hated the puppies! We'd change them once a shift because they'g fall off. Forget having them stay on a 24 weeker! We tried putting a little water on them and that did nothing.Kitties are somewhat better, but also a PITA.
    We usually don't use them on 24 weekers. Generally we'll use the limb leads by the same brand on kids under 1000 grams, either on the limbs or we'll cut the tails off and use them like regular chest leads. They seem to stick better to those skinny little ribs - the PuppyDogs always seemed too stiff and wouldn't conform to those tiny angular chests.

    To get hydrogel leads to stick on babies in high humidity environments, I've had luck cutting the tails off the limb leads and putting them on the baby's back in the same pattern as if they were on the chest. If the baby is laying on them, they seem to absorb less humidity than if they are more exposed to the air, plus the babies' backs are flatter than their fronts, so the leads seem to adhere more evenly. But if the baby is being positioned on the stomach, then I'll usually stick to chest placement, again to avoid that humid air.
  7. by   Gompers
    Quote from prmenrs
    Babies don't seem to have arrhythmias like grown-ups do. Most of the problems are from to much K+, too little Ca++, Digoxin issues, VSD repairs that took a stitch or 2 thru the conduction pathways, and an occassional, irritating SVT. If you think you see an arrhythmia, the docs will just say "get a 12 lead". So, lead placement for that purpose is a waste of time for babies. lol.
    Exactly. We don't keep cardiac kids anymore, so if our kids look like they're having arrhythmias, it's usually an electrolyte problem. We'll also get a STAT EKG and in the 10-15 minutes it takes them to come do the test, we've already gotten a set of lytes on the kid and usually have found our problem.
  8. by   BittyBabyGrower
    Same here, we don't use the 3 lead for diagnosis, unless it is SVT. We get the occas. PAC or PVC or block, but we hook up a 12 lead for that.

    I love when they get the hiccups and at first glance it's like...dang, what was THAT! LOL!
  9. by   CarVsTree
    Wasn't a baby, but came into PCU one day and we must have had a float putting tele on (who didn't ask how). Anyone, I found all leads on the belly. On one patient, I found a lead in the groin (and no it wasn't moved by the pt). It was just weird.

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