User's Manual

Introduction Lead Placement
4 - 2 0070-00-0575-50 Panorama™ Operating Instructions
4.1 Introduction
Various monitoring issues are directly linked to poor site preparation and improper ECG
electrode placement. If artifact is present on the ECG waveform, then the arrhythmia
processing, alarm processing, and quality of the monitoring function may be affected. The
presence of artifact can prevent the monitor from establishing an accurate reference ECG
waveform thereby increasing the degree of difficulty the monitor has assessing the ECG
rhythm.
The quality of an ECG signal is directly affected by electrode site skin preparation, electrode
patch quality and ECG lead placement. Optimizing the ECG signal is imperative for
accurate monitoring.
4.2 Skin Preparation
Electrode sites should be clean and dry and should provide a smooth flat surface. Proper skin
preparation is essential in obtaining an accurate ECG reading. Incidental electrical activity
and inaccurate readings may arise from incorrect skin preparation.
The following skin preparation procedure is recommended for secure electrode patch
application:
1. Shave the hair from the electrode sites in a circular area with a diameter of 2-4 inches.
2. Use a dry gauze pad to remove excess skin oils, skin cells and residue from the
electrode sites. Never rub the skin until it is raw or bleeding.
NOTE: Prepare the electrode site with alcohol only if the skin is
extremely greasy. If alcohol is used as a drying agent,
always allow the skin to dry before placing the electrode
patch on the skin.
4.3 Electrode Patch Location
NOTE: Store electrode patches at room temperature and open just
prior to use.
NOTE: Avoid more than one type of electrode on a patient because
of variations in electrical resistance.
NOTE: Avoid placing electrode patches directly over bone
prominences or over any high activity movement areas such
as shoulders or arms because muscle motion produces
electrical activity. If an electrode patch is placed over a large
muscle such as the pectorals, the monitor may detect this
additional muscle activity and could lead to false
arrhythmia calls.
1. Peel the backing off of the electrode patch only when it is ready for use to prevent
evaporation of the contact gel medium. Visually inspect the contact gel medium for
moistness. If the gel medium is not moist, do not use the electrode patch. Dry electrode
patches are not conductive.
NOTE: If using the snap type electrode wires, attach the electrode
patch to the lead wire before placing patch on the patient.