Mindray iMEC8 Vet - Placing Resp Electrodes; Optimizing Lead Placement for Resp; Cardiac Overlay; Abdominal Breathing

9-2
9.4 Placing Resp Electrodes
Since the same leads are used for ECG and respiration monitoring, the lead placement is very important. Some patients,
due to their clinical condition, expand their chest laterally, causing a negative intrathoracic pressure. In these cases it is
better to place the two crocodile clips used for respiration monitoring laterally in the right axillary and left lateral chest
areas, at the maximum point of the breathing movement, to optimize the respiratory waveform.
NOTE
 Please select the ECG cable with no resistance for RESP monitoring.
 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.
 Place the electrodes to try to avoid crossing the liver area and the ventricles of the heart with the electrodes
line.
Lead placement (5-lead)
9.4.1 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.
9.4.2 Cardiac Overlay
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.
9.4.3 Abdominal Breathing
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 optimise the respiratory wave.