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6 ECG, Arrhythmia, and ST Monitoring Selecting the Primary and Secondary ECG Leads
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CAUTION To protect the monitor from damage during defibrillation, for accurate ECG information and to
protect against noise and other interference, use only ECG electrodes and cables specified by Philips.
Selecting the Primary and Secondary ECG Leads
The monitor uses the primary and secondary lead to compute HR and to analyze and detect cardiac
arrhythmias. They are also available for recordings and for display on the Information Center.
The secondary lead setting is used only if your monitor is configured for multi-lead (instead of single-
lead) arrhythmia analysis. It determines which additional lead will be used for arrhythmia analysis.
To select a lead as primary or secondary lead:
♦ In the Setup ECG menu, select Primary Lead or Secondary Lead, then select the
appropriate lead. You can assign any available lead whether it is currently displayed or not.
Checking Paced Status
It is important to set the paced status correctly when you start monitoring ECG.
♦ To change the paced status in the Setup ECG menu, select Paced, then select Yes or No.
WARNING Pace pulse rejection must be switched on for paced patients by setting “Paced” to Yes. Switching pace
pulse rejection off for paced patients may result in pace pulses being counted as regular QRS
complexes, which could prevent an asystole alarm from being detected. When changing profiles, and at
admission/discharge, always check that paced status is correct for the patient.
Some pace pulses can be difficult to reject. When this happens, the pulses are counted as a QRS
complex, and could result in an incorrect HR and failure to detect cardiac arrest or some arrhythmias.
Keep pacemaker patients under close observation.
You should choose a lead as primary or secondary lead
that has the following characteristics:
• the QRS should be either completely above or below
the baseline and it should not be biphasic
• the QRS should be tall and narrow
• the P-waves and T-waves should be less than 0.2 mV