ECG Monitoring Overview : 

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Electrocardiogram (ECG) is produced by the continuous electrical activity of the patient’s heart, and displayed with wave and numeric on the monitor in order to accurately assess the physiological state of the patient at the time. The ECG cable should be connected properly, so as to obtain a correct measurement value and normal display.

A ICU Patient monitor simultaneously display 7 ECG waves. Patient cable consists of two parts.

  • Wires connected to the monitor
  • ECG electrodes connected to the patient Connect to the device with five lead ECG cable, and ECG can display two different waves by adjusting the two leads.

The parameters displayed in the parameter area  include heart rate (HR), ST segment measurements and arrhythmia counts per minute. All these parameters can be used as alarm parameters. Most of the Latest ECG monitors are  designed for defibrillation proof, so the monitor operates normally after defibrillation.

1. What is ECG Monitoring :

Monitoring the ECG produces a continuous waveform of the patient’s cardiac electric activity to enable an accurate assessment of his current physiological state. Only proper connection of the ECG cables can ensure satisfactory measurement.

On the Normal Display, usually the monitor provides display of 1 channel or 2-channel ECG waveforms.

  • The patient cable consists of 2 parts; The cable that connects to the monitor; The lead set that connects to the patient.
  • Using a 3-lead or 5-lead set, the ECG can derive up to two waveforms from two different leads. 
  • The monitor displays the Waveform , Heart Rate (HR), ST segment and Arrhythmia analysis.
  • All of the parameters above can be set as alarm parameters.

2. How to Place and Install  ECG lead and  Electrodes for ECG Monitoring :

  • Electrode placement for 5-lead set is shown in below Figure
    • Red (R) electrode – Be placed near the right shoulder, directly below the clavicle.
    • Yellow (L) electrode – Be placed near the left shoulder, directly below the clavicle.
    • Black (N) electrode – Be placed on the right hypogastrium.
    • Green (F) electrode – Be placed on the left hypogastrium.
    • White (C) electrode – Be placed on the chest as illustrated in the below
ECG lead

3. What  is 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.

4. What is ST Segment Monitoring in ECG and what is ST segment measurement range  ? 

 The ST algorithm has been tested for accuracy of the ST segment data. The significance of the ST segment changes needs to be determined by a clinician. It is available to measure the variance of ST segment with ST analysis at the waveform tracks for selected lead. The ST measurement result displays numerically at ST1 and ST2 in the Parameter Area.

The trend of ST Segment can be viewed with table or graphic form in patient 
Measurement unit of ST segment is done in  mV. Measurement symbol of ST segment: “+” = elevating, “-” = depressing. Measurement range of ST segment is  -2.0 mV, ~ + 2.0 mV.

5. What is ECG Arrhythmia ? 

An arrhythmia is a problem with the rate and  rhythm of heartbeat. It means that  heart beats too quickly, too slowly, or with an irregular pattern.  The arrhythmia algorithm is used to monitor ECG of neonate and adult patient in clinical, detect the changing of heart rate and ventricular rhythm, and also save arrhythmia events and generate alarming information.

Arrhythmia algorithm can monitor paced and non-paced patients. Qualified personnel can use arrhythmia analysis to evaluate patient’s condition (such as heart rate, PVCs frequency, rhythm and ectopic beat) and decide the treatment. Besides detecting  changing of ECG, arrhythmia algorithm can also monitor patients and give proper alarm for arrhythmia.

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