User Manual
SKIN PREPARATION AND LEAD PLACEMENT
PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft 45
All information contained herein is subject to the rights and restrictions on the title page.
Note: Make sure that the expiration date on the electrodes has not passed. A dry
electrode will not conduct.
The transceiver must be carried securely on the patient.
If the transceiver is allowed to dangle or jostle as the patient moves, then the weight of
the device will tug on the electrodes, causing degradation of the signal. Even if the
electrodes are in good contact, excessive tugging on the electrodes will change the
physical structure of the gel, thereby generating motion artifact signals. Transceivers
can be carried securely if you insert them into pouches or, place them into a patient’s
gown pocket. In addition, ensure that the lead wires are not twisted around one
another as they each serve as an antenna.
Patient characteristics which require special attention in order to obtain a good contact.
The following types of patients may require special attention:
1. Patients with dark or leathery skin
In these patients, resistance is high and generally, the ECG signal has a low amplitude.
Skin motion will add large deviations to the baseline, and tugging effects are exagger-
ated. Buff the skin to elevate the temperature and bring the vascular flow to the sur-
face.
2. Patients with high perspiration levels
The main problems with these patients are lack of adhesion of the electrode and the
dilution of the gel. However, when the skin is moist and pores are open, there is a
greater ability for the gel to penetrate the epidermis. Again, buff the skin to remove
excess moisture and elevate the temperature.
3. Patients who have lost large amounts of fat or muscle mass
Even if a good contact is made, skin movement is excessive. Minimum artifact may be
achieved by careful placement close to bone. Electrodes need to be positioned away
from areas with large amounts of fat or muscle mass, as the vascular layer is farther
from the epidermis. Therefore, the signal quality will be reduced. To stabilize, the
electrodes may need to be moved higher or more laterally on the patient.
4. Patients who have midline surgical dressings and wounds
The brown chest lead can be moved to the V3-V6 area. (page 48)