EKG or Rhythm Strips

[Cardiomegaly]

Hello,

I am a third year nursing student and I am curious, do CVICU nurses use rhythm strips or EKG's (12/15 leads) to check for arrhythmias, heart blocks, etc. MY father works in the Cardiac ICU and says that usually he uses rhythm strips most of the time but he can read an EKG if necessary. Is this true for most cardiac ICUs?

Thank you for your time!

[eCCU]

Most cardiac ICUs use rhythm strips, however in some Cardiac ICU use Phillips monitor which also do continuous 12lead ECG. But generally most use 5 lead rhythm strips.

[RNerd81]

Continuous monitoring done via bedside monitoring...Usually 5-lead, but can do continuous 12. If something's fishy I usually request a formal 12-lead (different machine). Our institution has a order set that authorizes nurses to order a formal 12-lead for a rhythm or rate change, chest pain, or a variety of other things. The docs usually fill this out on admission. But for moment-to-moment monitoring, we use the 5-lead set-up.

[nursie_nursie_415]

... to clarify the differences...

Pulse oximeters monitor the patient, ABGs help diagnose.

Rhythm strips monitor the patient, EKGs help diagnose.

Hope this was helpful :)

[turnforthenurse, MSN, NP]

Typically rhythm strips are used along with the 5 lead monitoring. If a 12 lead is warranted (sudden chest pain, crazy rhythms, etc) then we get one. As the PP said 12 leads are used as a diagnostic :)

[nursingpower]

We have the option to print a rhythm strip but I don't like them. I prefer to print a the page so that I can see all 12 leads and I can measure my intervals on the monitor and have them printed on the same Page.

[steinaly7]

I work in a cardiac icu and each patient's rhythm is being constantly monitored on a telemetry remote that records their rhythm. It does alarm for certain arrhythmias but cannot detect what a 12 or 15 lead engineers could as far as all lethal arrhythmias, different heart blocks, and ST segment elevations. The 12 or 15 lead ekg is done when patients come into the er with chest pain, palpitations, etc. Ekgs can also be done in drs offices and if bad those patients are then admitted. We also do 12 leads as needed if a patient has worsening chest pain and is waiting for a heart cathetertization or similar emergent situations. A 12 lead ekg is very thorough and looks at multiple leads giving much more precise info. However they are costly and only done as needed not continuously or even everyday like rhythm monitors. Hope this helps!

[brainkandy87]

Well, you never want to diagnose from telemetry alone. It's great to monitor for rhythm changes, but if you suspect a change (significant change, anyway), get a 12 lead. I wish our monitors could do continuous 12 leads. That sounds like the bee's knees. Our Likepaks do it, but those aren't available in every room.

[Pheebz777, BSN, RN]

5 lead cardiac monitoring can display most of the lethal cardiac arrythmias if it is a truly lethal arrythmia. You only need a 12-lead EKG if you suspect a new change in a patient cardiac status to correlate that with the patient's current presentation.

A 12-lead can interpret accurately what arrythmia the patient is experiencing but you would also need to use your knowledge in determining if it is a true arrythmia or not. A 12 lead can help assist you the location of a possible MI whether anterior, inferior, lateral, septal etc.

So to answer your question, all ICU patients have constant telemetry monitoring. The EKG is only used as a diagnostic tool.

[sharifi9879]

in most CCUs and ICUs, the nursing staff use one long Lead (stripe) to get information about patients status at two point: in the start and at the end of shift.

use of ECG is more helpfull to diagnosis complicated arrythmia.

[Cardiomegaly]

Thank you all! I truly appreciate your answers!