1. Application of a Patient Telemetry Unit by June Graney
Internet in Education University of South Florida
2. Target AudienceUndergraduate nursing studentsPatient care
techniciansRegistered Nurses new to telemetry or returning towork
force
3. ObjectivesIdentify types of monitoring devices usedState
patient education related to telemetryList equipment neededDescribe
required skin preparationIllustrate 5 lead placement of
electrodes
4. Types of Monitoring12-Lead EKGHolter and event
monitorsHardwire monitorsOutpatient monitoringTelemetry
5. Patient EducationAssess level of understandingExplain
rationaleIdentify tape allergiesDescribe lead placementEnsure
privacy and dignity
6. Assemble EquipmentEKG PatchesSkin prep padsRazor as
neededUnit and batteryTelemetry gown or holder
7. Skin PreparationAssess the areas of applicationShave or clip
areas with excessive hairRub with alcohol and allow to dryAvoid
bony areas, irritated skin, and incisions
8. Apply Electrodes
9. Lead Placement
10. 5 Electrode LeadPlacementWhite-Right ArmBlack-Left
ArmBrown-ChestGreen-Right LegRed-Left Leg
11. Implications of Improper Lead PlacementArtifact and
wandering baselinesAlterations in waveformsFalse diagnosis of
infarctionSkin irritation or infection
12. Dont Forget a Pouch!
13. FinalizingNotify monitor technician or centralized
stationEnsure adequate transmission of waveformsPatient comfort,
safety, and questionsDocument application and corresponding
unitnumber
14. ReferencesAmerican Heart Association. (2004). Practice
Standards for Electrocardiographic Monitoring in Hospital Settings.
Circulation. 2004; 110: 2721-2746 doi:
10.1161/01.CIR.0000145144.56673.59Lewis, S.M., Heikemper, M.M.,
& Dirksen, S.R. (2007) Medical-Surgical Nursing: Assessment and
management of Clinical problems. (7th Edition). St. Louis MO:
Mosby.