A recent national survey of critical care nurses reveals that the leads many nurses select to monitor their patients are diagnostically inferior to other available leads, and that lead placement often is inaccurate. This article reviews the best leads for electrocardiographic (ECG) monitoring, illustrates their accurate placement, and explains reasons for the dilemma in current practice. Questions relevant to practicing nurses are addressed, including 1) Is lead MCL1 as good as V1? 2) When is it appropriate to substitute lead MCL1 for V1? and 3) How important is it for electrodes to be placed exactly in specific anatomic locations? Finally, a case study is provided to illustrate how accurate monitoring can prevent misdiagnosis and resultant inappropriate therapy
Physiologic Monitoring| February 01 1993
Bedside Electrocardiogram Monitoring
Barbara J. Drew, RN, PhD
From the Department of Physiological Nursing, University of California, San Francisco.
Reprint requests to Barbara J. Drew, RN, PhD, Department of Physiological Nursing, N611Y, University of California San Francisco, San Francisco, CA 94143-0610.
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AACN Adv Crit Care (1993) 4 (1): 25–33.
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Barbara J. Drew; Bedside Electrocardiogram Monitoring. AACN Adv Crit Care 1 February 1993; 4 (1): 25–33. doi: https://doi.org/10.4037/15597768-1993-1003
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