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52
-
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V5
On the left anterior axillary line, horizontal with V4 electrode.
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V6
On the left middle axillary line, horizontal with V4 electrode.
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V3R-V7R
On the right side of the chest in positions corresponding to those on the left.
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VE
Over the xiphoid position.
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V7
On the 5th intercostal space at the left posterior axillary line of back.
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V7R
On the 5th intercostal space at the right posterior axillary line of back.
Figure 11-2 C-electrode Placement For 5-lead Set
Recommended ECG Lead Placement for Surgical Patients
The placing of the ECG leads will depend on the type of surgery that is being performed. For example, with open chest
surgery the electrodes may be placed laterally on the chest or on the back. In the operating room, artifacts can
sometimes affect the ECG waveform due to the use of ES (Electrosurgery) equipment. To help reduce this you can
place the electrodes on the right and left shoulders, the right and left sides near the stomach, and the chest lead on the
left side at mid-chest. Avoid placing the electrodes on the upper arms, otherwise the ECG waveform will be too
small.
Warning
When using Electrosurgery equipment, leads should be placed in a position in equal distance from
Electrosurgery electrotome and the grounding plate to avoid cautery. Electrosurgery equipment wire and
ECG cable must not be tangled up.
ECG cables can be damaged when connected to a patient during defibrillation. Check cables for
functionality before using them again.
Pacemaker failure: During complete heart block or pacemaker failure to pace/capture, tall P-waves
(greater than 1/5 of the average R-wave height) may be erroneously counted by the monitor, resulting in
missed detection of cardiac arrest.
External pacing electrodes: When a pacemaker with external pacing electrodes is being used on a patient,
arrhythmia monitoring is severely compromised due to the high energy level in the pacer pulse.This may
result in the arrhythmia algorithm’s failure to detect pacemaker non-capture or asystole.
During surgery: Use the special electrode ECG safety cable, for measuring ECG in the operating room.
These cables have extra circuitry to protect the patient from burn and decrease electrical interference. This
also reduces the hazard of burn in case of a defective neutral electrode at the HF device. These cables
cannot be used for measuring respiration.
When using Electrosurgery equipment, never place an electrode near the grounding plate of the
Electrosurgery device, otherwise there will be a great deal of interference with the ECG signal.
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Using 5-lead ECG set
The default setting is ECG CH1 corresponding to Channel II, and ECG CH2 to Channel I, you can modify the setting
to meet your needs. You can set them to correspond to any two from I, II, III, aVR, aVL, aVF., V. If you set both to the
same value, one of them will be adjusted to another option automatically. (Figure 11-3)
