Telemetry patches

[ttlarson]

Hello,

I am wondering how often do you change your telemetry patches on your units?

I am new to this page and I am looking forward to your help and information and getting to know you.

Any information would be helpful.

Thank you

[dianah, ASN]

I have done a cursory web search and have found nothing definitive or absolute to answer your question.

Some nurses recommend changing only if the pad loses contact with the skin which would interfere with transmission of signal.

Some recommend changing every 24-48 hours.

Any time the leads/pads are changed, position should be changed to allow the skin under the previous pad a break from having adhesive on it.

Yet the pads should not be moved greatly from their previous position, so the ECG tracing remains as close to the original as possible, to provide continuity in monitoring rhythm changes.

I work in a cath lab and when patients arrive in our lab we routinely remove all the pads and apply new ones so they are not in the field of view when we take the cath images.

I see a LOT of red and irritated skin from either patient sensitivity to adhesive or from electrodes remaining on the skin for a long time.

Therefore I endorse the "change every 24-48 hours" rule.

Look up proper skin prep too, before electrodes are placed. This will impact the quality of the ECG tracings.

Hope you get more responses, sorry I couldn't find a hard-and-fast rule.

Maybe someone will do a project???

[87RN]

I change them daily with baths.

[kool-aide, RN]

Q day and prn

[cmillerva, BSN, RN]

Our hospital protocol states that the patches/electrodes be changed everyday with baths and as needed.

The gel in the pads begin to dry out and loose conductivity, thus not giving an accurate reading on the telemetry monitor

[FlyPunky]

So 3M now makes a telemetry electrode that is composed of the cloth type tape, with the metal button part being composed of a non-radio opaque material, meaning that it is not visualized on x-ray, and can be used in the cath lab and MRI. Because of the breathable nature of the tape, it only has to be changed every 5 days. The foam type electrodes have to be changed more often, mainly because they will sequester body fluids underneath them, leading to loss of adhesion and occasionally a minimal contact dermatitis. For my own self, I write the date on the electrode whenever I put them on, just so my team knows how long they've been on.

[Burks21]

If I'm working back to back shifts, I'll change them my first night. If I'm only working 1 day in a row, they get changed. It's just included in my assessment really. I'm there, might as well do it.

You'd be amazed at the number of false alarms you get with frequent patch changes. It's not uncommon to come across a patch drier than my humor.

[YumCookies, BSN, RN]

At my hospital, q24h is considered best practice. I usually change them when they come off or if there's a lot of artifact.