Conducting An Exercise Stress Test; Patient Preparation; Preparing Patient Skin; Patient Hookup - Welch Allyn ELI 280 Addendum User Manual

6. CONDUCTING AN EXERCISE STRESS TEST

Patient Preparation

Before attaching the electrodes, ensure the patient fully understands the procedure and what to expect.
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Privacy is very important to ensure the patient is relaxed.
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Explain the method to be taken for skin preparation and electrode application.
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Make sure the patient is comfortable and that the arms and hands are relaxed.
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Once all the electrodes are attached, ask the patient not to talk to assist in good baseline ECG acquisition.

Preparing Patient Skin

Thorough skin preparation is very important. There is natural resistance on the skin surface from various sources
such as hair, oil, and dry, dead skin. Skin preparation is intended to minimize these effects.
To prepare the skin:
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Shave chest hair at the electrode sites if necessary.
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Clean skin with alcohol or warm, soapy water to remove body oils, lotion and powder.
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Thoroughly dry the skin.
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Gently exfoliate the skin with an abrasive pad where the gel center of each electrode will be applied.

Patient Hookup

Attach the electrodes to the lead wires on the patient cable or acquisition module before attaching electrodes to the
patient.

To Attach the Electrodes

1. Firmly attach each lead wire to an electrode.
2. Place the gel area of the electrode over the center of the prepared area using the positioning illustrated in
figure 4; press the adhesive ring into place. Avoid pressing the center of the gel area.
3. Place right arm (RA) and left arm (LA) leads close to the shoulder on the clavicle bone.
4. Place right leg (RL) lead on the sternum. This lead can be placed in another stable location for patient
comfort.
5. Place left leg (LL) lead on the lower left side of body, as close to the hip as possible, on the iliac crest
(original Mason-Likar position), or on the lowest rib on the left side of the chest (modified Mason-Likar
position).
6. Ensure electrodes are securely attached to the skin. To test electrode contact, lightly tug the lead wire to
check adhesion. If the electrode moves freely, the site should be prepped again. If the electrode does not
move easily, a good connection has been obtained.
NOTE AND CAUTION: Proper skin preparation is very important. Poor ECG signal quality is the main
cause for incorrect beat and arrhythmia detection. RA and LA are susceptible to muscle interference. LL
lead is susceptible to interference from clothing, a belt, and movement.
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