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Interpretation Made Easy. LEAD PLACEMENT LIMB LEADS MUST BE PLACED ON THE LIMBS Uses both positive and negative electrodes Current towards positive,

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Presentation on theme: "Interpretation Made Easy. LEAD PLACEMENT LIMB LEADS MUST BE PLACED ON THE LIMBS Uses both positive and negative electrodes Current towards positive,"— Presentation transcript:

1 Interpretation Made Easy

2

3 LEAD PLACEMENT LIMB LEADS MUST BE PLACED ON THE LIMBS Uses both positive and negative electrodes Current towards positive, view from negative

4 Precordial Leads

5 Acquisition & Transmission

6 Skin Preparation Helps obtain a strong signal Skin oils reduce adhesion of electrode and hinder penetration of electrode gel Dead, dried skin cells do not conduct well

7 Acquisition & Transmission Rubbing skin with a gauze pad can reduce skin oil and remove some of dead skin cells

8 Acquisition & Transmission Other causes of artifact Patient movement Cable movement Vehicle movement Electromagnetic Interference (EMI)

9 Acquisition & Transmission Patient Movement Make patient as comfortable as possible Supine preferred Look for subtle movement toe tapping, shivering Look for muscle tension hand grasping rail, head raised to “watch”

10 Acquisition & Transmission Cable Movement Enough “slack” in cables to avoid tugging on the electrodes Many cables have clip that can attach to patient’s clothes or bed sheet

11 Acquisition & Transmission Electromagnetic Interference (EMI) Can interfere with electronic equipment 60 cycle interference is a type of EMI Look for nearby cell phones, radios or electrical devices No contact between cables & power cords Turn off or move away from AC devices Use shielded cables; inspect for cracks

12 Limb Lead Placement Traditional Placement Acceptable Placement Avoid placing on the trunk!!!

13 Chest Lead Placement V1: fourth intercostal space to right of sternum V2: fourth intercostal space to left of sternum V3: directly between leads V2 and V4 V4: fifth intercostal space at left midclavicular line V5: level with V4 at left anterior axillary line V6: level with V5 at left midaxillary line

14 Chest Lead Placement

15 Acquisition & Transmission Things to look for Little or no artifact Steady baseline

16 Acquisition & Transmission

17 12-Lead Validation Lead I – Global Negativity? P, QRS and T Wave inverted? R Wave Progression? R Wave size increases in V leads Transition Zone? R Wave should be predominately positive in V3 and V4

18 12-Lead Validation Limb leads P wave, QRS, and T wave upside down in Lead I Global negativity Upper limb leads switched

19 12-Lead Validation R wave progression R waves progress in size from V1 to V4 If poor progression, check lead placement on electrodes normal poor

20 QUESTIONS?


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