Published
We have always used white on the right chest, black on the left chest and red on the belly. When we use limb leads we do the same except the red goes on the leg. It doesn't pick up the most accurate resps, but they save their skin. You can also place them on the back in the same fashion. Where else are they putting them? If the leads aren't on right, we just change the lead pattern (Lead I, Lead II, Lead III, etc) to get what we need.
Depolarization wave moving toward a positive lead will be upright.
Depolarization wave moving toward a negative lead will inverted.
Depolarization wave moving between negative and positive leads will have both upright and inverted components
I hope this helps
This doesnt have anything to do with babies, but lead placement has become more important as they try to find different areas for law suits.
I read where a patient died of sudden cardiac arrest. His chart was sequestered 4 months later and they said he had multiple cardiac changes shown on his ekg tracings. The changes were due to various placements after his baths and lead electrode changes. The hospital settled, but when you place leads in different areas, it can show a slight change on the ekg.
I think the reason there has been so much discussion on our unit (and why I posted the original question) was because of the possibility of lawsuits....and we have one really picky Neonatologist! All in all, I just want to make sure that we are getting the most accurate tracing possible!!
I agree that coming in and finding that some sweet nurse has tied the lines in a big ol' knot (so they stay nice 'n neat) is quite a pain in the rear...we've actually had a couple of instances where the knots were tied so tightly that the wires snapped and poked into the baby!! Yikes!!!
NICUnewbie
14 Posts
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 positions...I was thinking about doing an in-service since this subject seems to be poorly understood by our nurses (myself included), but am having trouble finding info pertaining to preemies....
Thanks!