ST Segment Monitoring for Myocardial Ischemia

Many patients in the critical care unit (CCU) are at risk for myocardial ischemia and acute coronary artery reocclusion. The use of continuous ST segment monitoring detects transient and sustained ischemia, despite the absence of symptoms, more completely than rate and rhythm monitoring alone. The accuracy and sensitivity of the ST segment for detection of ischemia is dependent on the number and location of the electrocardiographic leads used in conjunction with the site of obstruction. Thus, when using ST segment monitoring for detection of ischemia, one of the most important decisions for the nurse to make is lead selection. In addition, both ischemic and nonischemic ST segment changes must be considered