Tele placenta

[Tristin Brownlee]

New cvicu nurse staring in two weeks. My old job consicisted of bedside icu and float charge tele. I’ve found to get really good readings on patients when I put the red dots on shoulders or biceps of hard to read pts. Why do we put tele stickers on the chest but real ekg on the limbs. Should I do limbs always? Is it a patient comfort factor? Thanks y’all and any nice pdfs for cvicu wouldn’t be really appreciated too ?

[Tristin Brownlee]

My phone seems to have minds of its own ? topics should be tele placement but I like where it went haha

[amoLucia]

I liked the topic too. I was thinking 'wow! Something new I haven't heard of!

[Cowboyardee]

I don't know the reason for certain, but I can give you a few speculatove answers from my own experience:

1) there may be more artifact and possibly lower amplitude using stickers on the limbs rather than on the chest. On a 12 lead, you can just have the patient hold still for a few seconds, but for continuous telemetry that may not be practical.

2) telemetry setups often use the limb leads to monitor respiration, and this is only really possible with chest placement rather than limb placement.

3) many Tele setups have short wires that are impractical for limb placement.

4) with (relatively high) chest placement of the (red) left leg lead, leads II and III actually function as a bit of a lateral view of the heart. Of course, theyre not the same thing as a real precordial lead v4, v5 or v6, but for the purposes of looking at st segments at a glance and noticing that the patient may have a problem, it can be useful to get a little better look at the lateral portion of the heart rather than just the inferior views you'd normally see in these leads. Telemetry is more geared for monitoring than diagnosis after all.

[amoLucia]

To PP - TY for some explanation. I retired some time ago, and my CCU experience was waaaay back in the Dark Ages before then. So you shook some cobwebs out for me. Nice to know.