Pre-attached Electrodes

[mikie]

In recent threads about lead wires, etc, got me to thinking. As a paramedic student & EMT, i have seen many different agency setups...My question is, do you pre-attach your electrodes to your leads? I have seen both.

I have heard anecdotes about reduced efficacy/stickyness if you pre-attach them, at the same time, it seems like it saves time.

What is your practice?

 

[Shishkabob]

Sometimes I do, sometimes I don't.


Nothing is so time sensitive that I need an EKG 5 seconds sooner.

 

[NomadicMedic]

I preload my electrodes. Both my regular ekg and my 12 lead cables. I use the monitor so often that they won't dry out.


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[jjesusfreak01]

I preload my electrodes. Both my regular ekg and my 12 lead cables. I use the monitor so often that they won't dry out.

Ditto...they're used multiple times each shift.

 

[fortsmithman]

I preload my electrodes. Both my regular ekg and my 12 lead cables. I use the monitor so often that they won't dry out.


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My service only does 3 lead.

 

[Aidey]

I preload my electrodes. Both my regular ekg and my 12 lead cables. I use the monitor so often that they won't dry out.

We do to. Our ambulance is in service 24/7 so chances are they are going to get used within a couple of hours.

 

[MedicBender]

Every service I've seen has done this, IMHO its just less of a hassle

 

[usalsfyre]

Old partner always did it (to her saves time) new partner never does (says they tangle easier). Really makes no difference to me.

 

[NomadicMedic]

We restock at the hospital, so setting up the monitor leads with fresh electrodes, rebuilding the IV roll and getting replacement meds out of the Pyxis is the standard that we do after every call. I like knowing that I'm good to go after every call.


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[Melclin]

I always want them pre-attached.

Its not a clinical thing. I'm just a clutz and anything that reduces the likelihood of me fumbling or dropping things in front of pt/family and making myself looking completely incompetent, the better.

Also, it does save time. In concert with a bunch of other time saving measures, it adds up. Again, its not a clinical thing. Its about making things run smoother and more efficiently with sick patients. It boosts my own confidence, it makes a potentially stressful situation, less so, it makes me look better in front of CIs who have to report on my progress and has a subtle positive affect on the dynamics of a job.

I like it when I lay a pt on the stretcher, my partner closes the back doors and by the time they open the side door and hop in to help me, I've already done seven different things. Its adds to the feeling that they're working with someone who knows what they're doing.

 

[JJR512]

I've only been attaching monitor leads to patients for a short while, but having the electrodes pre-attached makes me slower. I find it to be both more difficult and more time consuming to detangle the leads when the electrodes are attached.

Almost all of the Paramedics I work with prefer to have them pre-attached.

The Maryland Medical Protocols actually addresses this, but only in a pilot protocol aimed specifically at EMT-Bs that allows them, with special permission, to acquire and transmit 12-lead ECGs in the abscence of ALS providers so the receiving hospital can be prepared for an AMI patient.

Remove electrodes from a sealed package immediately before use.

Using previously unpacked electrodes or electrodes with expired date​

codes may impair ECG signal quality.

No other mention of removing electrodes from the package, or attaching them to the monitor leads, is mentioned anywhere in the protocols.

 

[Sasha]

Nope. Unless we are picking up from a nursing home, if the patient needs a monitor chances are they are already on it. You just unsnap the tele and snap your leads on to the ones they're already wearing.

 

[medicdan]

Nope. Unless we are picking up from a nursing home, if the patient needs a monitor chances are they are already on it. You just unsnap the tele and snap your leads on to the ones they're already wearing.

Ditto. We do mostly ALS IFT (SCT), so we end up connecting to patients more often than applying electrodes to patients. We do keep the 12-lead cables pre-connected, though.

 

[mikie]

I find it to be both more difficult and more time consuming to detangle the leads when the electrodes are attached.

That's the problem I typically have with it; i find it easier to untangle wires w/o electrodes.

The Maryland Medical Protocols actually addresses this...

LOL of course, they address everything!


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My next question for those that don't preattach their leads...

Do you place the electrode on the patient's skin first or on the lead?

 

[usalsfyre]

Lead first, it often takes an uncomfortable amount of pressure to snap the lead on (or is darn hard due to adipose tissue).

 

[medicdan]

That's the problem I typically have with it; i find it easier to untangle wires w/o electrodes.



LOL of course, they address everything!


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My next question for those that don't preattach their leads...

Do you place the electrode on the patient's skin first or on the lead?

I find if we reallocate the hospital's 5x2 electrode pad and pre-connect the leads they stay well organized...

In general, I connect the lead to the electrode, then the electrode to the patient, when possible, to avoid pressing on their skin unnecessarily.

 

[sir.shocksalot]

When I worked for a slow service we didn't because we would only do a 12-lead about once every 2 days, same with IFT. But on 911 we do a 12-lead several times a day so I try to pre-load the 12 lead so I don't have to spend 3 seconds snapping them together.

 

[HotelCo]

When I worked for a slow service we didn't because we would only do a 12-lead about once every 2 days, same with IFT. But on 911 we do a 12-lead several times a day so I try to pre-load the 12 lead so I don't have to spend 3 seconds snapping them together.

If that three seconds actually means something for the patient, more than likely they're screwed either way.


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[HotelCo]

I don't pre attach them. Sometimes my partners do, and that's fine, as long as it doesn't become a tangled mess.


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[MrBrown]

We have a big plastic bag of stickies in the back of the Lifepak 12 so always attach new ones at the end of a job