If, in moving through your life, you find yourself lost...go back to the last place where you knew who you were, and what you were doing, and start from there. Bernice Johnson Reagon.

16 August 2010

Electrode positioning...

Which position is the proper position for electrode placement? Some people say that placement of the limb leads on the chest and abdomen is perfectly alright. Then there is another group (including me) that believes that limb leads go on the limbs.

So who's right?

I got to wondering this after the 'tale of two 12-leads'. What happened is one of our supplemental response paramedics completed a 12-lead (with chest/abdominal limb lead placement) and I repeated it (with limb placement of the limb leads). There were marked differences between the two.

So it got me to wondering- is this potential difference capable of producing a missed diagnosis?. 

Well, we're going to figure that out. I am going to enlist a couple of smart people and we are going to figure it out. We'll post the results over at MEDIC 914 and I'll also put it up at Paramedicine 101.


Rogue Medic said...

For anything diagnostic, the limb leads, should be on the limbs.

For routine monitoring of whatever lead you like to look at during transport (Lead II, MCL1, . . . ), the modified placement is acceptable. The limb leads tend to pick up much more artifact, because the limbs move more.

Epijunky said...

I'm a firm believer in limb leads belong on the limbs.

That belief did get me some pretty interesting looks from my preceptors, however.

Anonymous said...

It's amazing how easy it is to resolve your patient's inferior MI's by simply moving your leads up to the torso. Check out this workshop about various EKG nuances.