8-8 DELTA/DELTA XL/KAPPA VF8
8 ECG
AND HEART RATE
Transcutaneous Electrical Nerve Stimulators
Signals from transcutaneous electrical nerve stimulators (TENS) often resemble
pacemaker signals and may be labeled as such by the monitor. The monitor may reject
valid QRS complexes which follow misinterpreted TENS signals. To avoid the
resulting false asystole or “low rate” alarms that may occur due to this, follow the
steps outlined for assuring signal clarity (see “Pacer Detection” on page 8-4). If TENS
signals continue to register as pacer spikes, you may wish to disable pacemaker
detection.
Patient Preparation
Careful skin preparation and proper electrode placement support strong signals with
minimal artifact. In case of a technical alarm (for example, a detached lead), re-prep
the patient according to the following recommendations.
Follow the clinical techniques approved at your hospital for preparing the patient’s
skin. For a good quality signal, change electrodes every 24 to 48 hours. Electrodes
may have to be changed more frequently under the following conditions:
ECG signal degradation
Excessive patient perspiration
Patient skin irritation
A wide selection of reusable and disposable electrodes is available. Select the best
electrode for the monitoring situation. Dräger recommends Ag/AgCl disposable
electrodes. If you are using pre-gelled electrodes, verify that there is enough gel in the
electrode gel-filled area. Never use disposable electrodes after their expiration date or
when the gel has dried out.
Choose electrode sites in the configuration that will provide the best ECG (P- and T-
wave amplitudes should be no more than one third of the QRS amplitude). Select flat,
non-muscular sites to maximize electrode contact and minimize muscle artifact.
Avoid joints or bony protrusions. Consider the following special conditions when
selecting sites for electrode placement:
Surgery — Keep the electrodes as far from the surgical site as possible.
Burn Patients — Use sterile electrodes. Clean the equipment thoroughly. Follow
hospital infection control procedures.
Use a piece of waterproof tape (approximately 2 inches wide) or steri-drape to secure
electrodes and protect them from fluids. Form a small loop with the lead wire directly
beneath connection and secure with tape.
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