✓ If 12-lead ECG is available, continuous ST-segment monitoring should be performed using all 12 leads.
✓ If 12-lead ECG is unavailable, use the most appropriate leads for ST-segment monitoring based on the patient’s needs and risk for ischemia and/or arrhythmias.
For patients with ACS and a known “ST fingerprint,” obtained during STEMI or PCI, use the lead(s) that best displays the patient’s “ST fingerprint” when monitoring.
If the “ST fingerprint” is not known in ACS use leads III and V3.
For patients without definitive ACS, but are suspected of having or being ruled out for ACS, leads III and V5 should be monitored.
In noncardiac patients undergoing surgical procedures or admitted to the ICU, lead V5 is valuable for identifying demand-related ischemia, which appears to be more common in this group of patients.
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AACN Practice Alert| August 01 2008
Crit Care Nurse (2008) 28 (4): 70–72.
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ST-Segment Monitoring. Crit Care Nurse 1 August 2008; 28 (4): 70–72. doi: https://doi.org/10.4037/ccn2008.28.4.70
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