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ECG and Heart Rate Monitoring
long-term (cloth-backed) electrodes. Do not use electrodes after their
expiration date, or if the gel has dried out.
2. Prepare the patient's skin for applying the electrodes.
Getting a good quality ECG signal depends largely on how good the contact is
between the electrodes and the patient's skin. To help assure this, you should
first clip or shave any excess hair and remove any skin residue or oils using an
alcohol pad. To reduce skin impedance, mildly abrade only the electrode
contact site using ultrafine sandpaper (220-400 grit). For diaphoretic patients,
use a benzoin prep to assure tighter adherence of the electrode.
3. Apply the electrodes to the patient.
Apply the pad by using a circular motion on the adhesive area first, then
pressing on the gel area gently, to avoid squeezing out the gel. Please refer to
the diagrams on the following pages for guidance on proper electrode
placement. You should change the electrodes every 24-48 hours to maintain a
good quality ECG signal.
4. Connect the ECG cable lead set to the electrodes and to the PPM3.
3.3. Checking the ECG Signal
When you have connected the patient following the steps listed above, you should
be able to see a clean ECG signal similar to the figure below on the PPM3
display. If the ECG contains artifact or noise, review the steps for proper
electrode site preparation and placement. The PPM3 should also display a
number for the patient's heart rate (HR) and the alarm limit settings.
Figure 14. ECG Waveform and HR Value
To manually test ECG and HR alarm functionality on a daily basis, you may
choose from two approaches. First, if a patient is currently being monitored with
3-2
N i g h t i n g a l e P P M 3 U s e r ' s G u i d e
April 2019
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