10 - 2 Defibrillator/Monitor Operator’s Manual
• To optimize the respiration waveform, place the RA and LA electrodes horizontally when monitoring
respiration with ECG Lead I; place the RA and LL electrodes diagonally when monitoring respiration
with ECG Lead II.
10.4.1 Optimizing Lead Placement for Resp
If you want to measure Resp and you are already measuring ECG, you may need to optimize the placement of
the two electrodes between which Resp will be measured. Repositioning ECG electrodes from standard
positions results in changes in the ECG waveform and may influence ST and arrhythmia interpretation.
â– Cardiac activity that affects the Resp waveform is called cardiac overlay. It happens when the Resp
electrodes pick up impedance changes caused by the rhythmic blood flow. Correct electrodes placement
can help to reduce cardiac overlay. Avoid the liver area and the ventricles of the heart in the line between
the respiratory electrodes. This is particularly important for neonates.
â– Some patients with restricted movement breathe mainly abdominally. In these cases, you may need to
place the left leg electrode on the left abdomen at the point of maximum abdominal expansion to
optimize the respiratory wave.
â– In clinical applications, some patients (especially neonates) expand their chests laterally, causing a negative
intrathoracic pressure. In these cases, it is better to place the two respiration electrodes in the right
midaxillary and the left lateral chest areas at the patient’s maximum point of the breathing movement to
optimize the respiratory waveform.
• Respiration monitoring is not for use on the patients who are very active, as this will cause false
alarms.
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