Ramsey Medical petMAP+ II Operator's Manual page 8

Use of an Electrosurgical Unit (ESU) will often result in interference
on the ECG trace and potentially erroneous heart rates. Never use the ECG
for determining heart rate until the ECG waveform has been stable for 10
seconds or more after ESU use. The BP and SpO2 are typically not
adversely affected by ESU usage, but under certain circumstances the ESU
could adversely affect them. Always assure that the ESU ground plate is
well placed on the patient and placed distant from the ECG electrodes.
Inaccurate ECG heart rate readings may result when an
electrosurgical unit (ESU) is used while monitoring with the petMAP+II. If
this is suspected, discontinue use of the petMAP+II while the ESU is in use.
When ESU is used, patient leads and wires should be away from the
surgical operation site and other devices. This reduces the burning risk due
to a poor connection of the ESU neutral electrode.
The scientific literature describes interference from a number of
electrical devices that can produce artifacts that look like normal or
abnormal ECG waveforms but are not actual ECG waveforms, and these
potential ECG artifact generators include IV pumps, line isolation monitors,
electrosurgical units, pacemakers and other stimulators, fluid warmers,
bronchoscopes, etc. In such instances, these devices are usually
malfunctioning in some way when producing ECG artifacts, but not always.
In rare patient arrhythmias there may be 1 or more peaked
complexes with each actual beat that resemble the actual, true QRS
complex. In such circumstances the unit can mistake the additional peaked
complexes for a QRS and hence the heart rate displayed will be higher than
the true heart rate. On the display where each QRS is detected there is a
small indicator mark (yellow or red) below the detected QRS waveform to
indicate it has been detected as a QRS. If in doubt about the ECG heart
rate, confirm that only true QRS complexes are being identified as such by
looking at the small marks. Even in the presence of such rare arrhythmias,
the BP and the SpO2 heart rates should read properly.
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