Health Care
3M Center, Building 275-4W-02
St. Paul, MN 55144-1000
USA
1 800 228-3957
healthcare@3M.com
www.3M.com/healthcare
3M Canada Company
Post Office Box 5757
London, Ontario N6A 4T1
Canada
1 800 563-2921
Recycled Paper
40% Pre-consumer waste paper
10% Post-consumer waste paper
3M and Red Dot are registered
trademarks of 3M.
Printed in U.S.A.
© 3M 2005 All Rights Reserved
70-2009-3356-5
Proper Skin Prep Helps Ensure ECG Trace Quality
Clinician survey finds that most are unaware of variations in skin impedance
and how easily it can be reduced for artifact-free traces and increased efficiency.
Craig D. Oster
Technical Service Specialist, 3M Health Care
Most clinicians have experienced unacceptable ECG trace
quality when using disposable electrodes. When the monitor
alarm goes off, they try everything to fix the problem from
adjusting the ECG monitor to replacing all the electrodes,
leadwires or cables to calling biomedical engineering for
help. All this takes time, increases costs, adds to staff and
patient frustration, and may place the patient at risk.
A new survey shows that something as easy and simple as
proper skin preparation prior to electrode placement can
significantly reduce ECG artifact in most electrode situations
by lowering patient skin impedance. Nursing professionals
and biomedical engineers attending the 1998 AACN National
Teaching Institute
™
& Critical Care Exposition (AACN 1998
NTI™) and the 1998 Annual Meeting of the Association for
the Advancement of Medical Instrumentation (AAMI)
experienced first hand the dramatic difference in traces
after a skin preparation agent was performed to their own
arms prior to electrode placement.
The skin contributes to the noise or artifact associated with
disposable skin electrodes. But clinical studies have shown
that the electrode-skin interface is frequently overlooked as
a major source of artifact affecting many electrophysiologic
recordings.
1
The ideal skin preparation technique for the
application of disposable ECG electrodes includes removing
part of the stratum corneum to allow electrical signals to
travel back to the electrode.
2
Patient Skin Impedance
Electrocardio
g
raph
y (heart monitoring) measures and records
the time sequence of the electronic voltage generated by the
heart muscle. The electrocardiogram (ECG, EKG) is the
g
raphical recording of the electrical activity of the heart.
A patient’s heart and skin, along with the monitor, cable,
leadwire, connector, and ECG electrode all play a distinct
role in obtaining an electrocardiogram. This paper describes
how high patient skin impedance at the electrode placement
site is a common reason ECG artifact is seen and how it can
be greatly reduced.
There are short-term and long-term monitoring applications
for ECG electrodes. Short-term monitoring is also referred to
as resting or diagnostic monitoring. Usually the electrocar-
diogram is produced in a few minutes. Long-term monitoring
is generally of the “critical care” type, with patients being
monitored for extended periods of time. This may consist of
Holter or cardiac event recorders, telemetry transmitters and
intensive care or bedside monitoring units.
An electrode basically consists of a sensing element
(snap) in contact with an electrolyte (gel). When the
electrode is placed on the skin surface, the skin becomes
an integral part of the circuitry. Should this circuitry be
compromised due to high patient skin impedance, the signal
integrity can be adversely affected, causing base line wander,
substantial noise (artifact) and even loss of the ECG trace.
Other influences beyond high patient skin impedance that
can contribute to high patient skin impedance artifact include
the environment i.e. electrical field (60 Hz), humidity,
temperature, static electricity or the patient’s skin condition
such as diaphoresis.
The skin is the body’s outer covering, which is called the
integumentary system. Its function is to protect the body
against a multitude of environmental insults. The skin is the
most flexible organ of the body. The skin has two distinct
layers; the epidermis (the outer most layer), and the dermis,
(the inner layer).
Most of the epidermis is stratified squamous epithelium and
lacks blood vessels. The cells deeper and closer to the
dermis, however, are nourished by dermal blood vessels and
can reproduce. As this happens, they push old cells toward
the skin’s surface. By the time they reach the surface, those
cells are dead and flattened. The remaining dead cells
contain keratin fibers packed with plasma membranes.
This outer
most layer is named the stratum corneum. It is
tough, shedding millions of skin cells daily. This layer is
the source of most problems with ECG trace quality.
How Skin Impedance Affects Trace Quality
Skin impedance can be defined as the opposition or resistance
to the passage of alternating current (AC) electrical signals
and is measured as a voltage/current. There is no quick
assessment of a patient, other than actual measurement, to
determine if he or she has high skin impedance. Factors such
as age, sun exposure, skin lotions, relative humidity and
ambient temperature can influence skin impedance. Skin
impedance plays a critical role in ECG trace quality.
Conclusion
In the clinical setting, artifact can generate false interpretation
of recordings and data, induce false alarm conditions, mask
tr
ue alarm conditions, necessitate frequent electrode
replacements and create a time-consuming and frustrating
experience for both the patient and caregiver.
3
The routine use of the appropriate trace preparation has been
demonstrated to be an effective tool for lowering patient skin
impedance for adults. Trace preparation tends to be thought
of – wrongly – as a tool to be used only with certain elec-
trodes or only as a means of trouble-shooting ECG artifact.
The findings of this paper support use of the appropriate skin
preparation for all electrode applications. This best practice
will eliminate most skin impedance related ECG artifact and
produce clearer traces for better diagnosis, lo
wer costs, reduce
time and frustration for nursing and biomedical engineering
and improve overall comfort for patients.
ABSTRACT
Proper Skin Prep Helps Ensure
ECG Trace Quality
Although most clinicians do not realize it, the skin is a major
source of ECG artifact. Artifact can lead to unnecessary
electrode changes, higher costs, false alarms and frustration
for staff and patients. By lowering skin impedance, clearer
traces result.
A survey of biomedical engineers, technicians and nursing
professionals attending a national conference looked at
actual practice for ECG electrode skin preparation and time-
consuming troubleshooting activities. Only 17 percent of the
respondents said the
y have a protocol in place that requires
skin preparation prior to placing an electrode on a patient.
The survey showed that proper skin preparation prior to
electrode placement lowers skin impedance and can
significantly reduce artifact in all electrode applications.
BIOGRAPHY
Craig Oster is a Mechanical Engineer who has spent his most recent 10 years of his 20 year engineering
career with 3M Health Care in product development, manufacturing and currently in technical service.
REFERNCES
1. Medina V, Clochesy JM, and Omery A, Comparison of electrode site preparation techniques, Heart and Lung: The Journal of Critical Care, 1989, pp. 456-460.
2. Clochesy JM, Cifani L, and Howe K, Electrode site preparation techniques: A follow-up study, Heart & Lung: The Journal of Critical Care, 1991, pp. 27-30.
3. Medina, Comparison of electrode site preparation techniques, Hear
t and Lung:
The Jour
nal of Critical Care, 1989, p 456.
The challenge facing electrode designers is to develop an
electrode with reliable electrical characteristics that are gentle
to patient’s skin, even during long-term monitoring situations.
The challenge facing clinicians is to understand the factors
that can affect ECG trace quality, beyond the electrode.
Clinician Survey
To better understand actual practice for ECG electrode skin
preparation, 3M conducted a survey at the 1998 AAMI
Annual Meeting and the 1998 AACN National Teaching
Institute
™
& Critical Care Exposition (AACN 1998 NTI
™
).
Survey participants were primarily biomedical engineers and
technicians from AAMI and nursing professionals from
AACN 1998 NTI
™
. The results of the survey were
surprising. Most of the nursing professionals were not aware
of skin impedance, or how it can affect ECG trace quality.
In fact, only 17 percent of the participants said they have a
protocol in place that requires skin preparation prior to
placing an electrode on a patient. Also, most of the biomed-
ical engineers and technicians were aware of the affect skin
impedance has on trace quality, but were not aware of the
extreme variability of skin impedance, how it affects ECG
trace quality and how easily it can be reduced.
Survey participants had their skin impedance measured by
having two 3M
™
Red Dot
™
Electrodes 2261 and 2259 placed
on their forearm with a Prep-Check # 105 electrode imped-
ance meter, made by General Devices, connected to the
electrodes. The following histogram describes the measure-
ments taken before any means of electrode site preparation:
The average skin impedance measured
in this study was 354 K-ohms.
The skin of each participant was then prepared with mild skin
abrasion to the electrode site using 3M
™
Red Dot
™
Trace Prep
2236 (fine sandpaper material). This mild abrasion
technique consisted of holding the participants skin with
one hand and gently wiping the skin three times with the
trace preparation in the other hand. This technique took a
few seconds for each electrode site and was in general, not
uncomfortable for the participant. The following histogram
describes the measurements taken:
Survey Findings
The average skin impedance measured in this study, after
using the trace preparation was 20 K-ohms. This was a 325
K-ohms reduction in the average impedance.
Following the assessment of skin impedance, survey
participants were asked if they ever have unacceptable
ECG trace quality. Only 14 percent answered that they
almost never have unacceptable trace quality. The clear
majority of participants stated that they experience occasions
of unacceptable trace quality, (52 percent replied “often”
and 34 percent replied “occasionally”).
Troubleshooting Unacceptable Trace Quality
Troubleshooting trace quality can be time-consuming, costly
and risky to the patient. The survey found that 34% of the
clinicians most often attempt to resolv
e the trace quality
problem by adjusting the ECG monitor, 30 percent immedi-
ately change all of the electrodes and 11 percent immediately
change the cable and/or leadwires. When this method of trou-
ble shooting does not work, biomedical engineering is called
to assist. Forty-one percent of the survey participants stated
that it usually takes biomedical engineering and nursing a
total of 15-30 minutes to obtain an acceptable ECG trace.
Another 27 percent stated that it takes 60 minutes or more.
Many survey participants said, “I eventually pay no attention
to monitor alarms!”
Frustrating Delays and Higher Costs
Trouble-shooting ECG trace quality is clearly frustrating for
the clinician, may delay treatment for the patient and is costly
for a facility. The cost for changing all of the electrodes is
approximately $.20 for each electrode. The cost of changing
a leadwire is approximately $5 for each leadwire. An average
cable costs $60. In a five lead-monitoring scenario, the cost
of trouble-shooting may range from $1.00 - $85 for each
trouble-shooting event. For a hospital with 100 fully utilized
five-lead ECG monitoring systems and an average patient
stay of five days, annual trouble-shooting costs could range
from a few thousand dollars if only electrodes are changed to
many thousand dollars if leadwires and cables are replaced.
This cost analysis does not include the cost to the facility for
nursing and biomedical time, wasted chart paper, delay in
treatment or the risk of missing a life threatening event. It
also does not include the discomfort that may be caused to
a patient for removal and re-application of electrodes.
Best Recommended Practice
for Applying Disposable Electrodes
The stratum corneum of the epidermis has high impedance.
Removal of the stratum corneum at the electrode site will
dramatically reduce the skin impedance. The following is
a technique that can be followed and will reduce skin
impedance.
1. Select electrode application sites without bony prominence,
avoiding fatty areas and major muscles. This placement
method will help reduce motion-related artifact and maximize
the ECG signal strength.
2. If the patient has a f
air amount of hair at the electrode
application site, the hair should be clipped. Sha
ving is not
necessary and may actually cause some skin irritation.
3.
The electrode application site should be clean and dr
y
.
The preferred method of cleaning is with soap and water plus
dr
ying the skin with a dr
y cloth or gauze. In emergency
situations, this ma
y be dif
f
icult. Ho
wever, clean and dry skin
does contribute to good electrode adhesion and good trace
quality.
4. Cleaning with isoprop
yl alcohol should be avoided or
limited to situations which electrode adhesion is an issue
(diaphoresis, e
xcessi
v
el
y oil
y or lotion-co
vered skin), since
it ma
y deh
ydrate the skin, thus causing skin impedance to
increase. If alcohol is used, allow it to dry prior to the
electrode application.
5. Attach the leadwires to the electrode prior to placing the
electrode on the patient. This will eliminate the potential for
patient discomfort if snap leadwires are pressed onto the
electrode, after the electrode has been placed on the patient.
Optimum patient comfort can be obtained if squeeze clip or
pinch clip leadwires are used.
6. Electrode application sites should be abraded to lower the
skin impedance. The Red Dot Trace Prep 2236 used in this
clinician survey has proven to be an effective tool for lower-
ing skin impedance.
Note: These photos are intended to show “typical” tracings
for the situations indicated. Actual results may vary depend-
ing on other factors.
Trace Prep Misunderstandings
Prior to a demonstration of proper skin preparation technique,
clinicians often comment that they do not have time to
prepare skin; it may be painful for the patient, should only
be done as a means of troub
le shooting or onl
y with a certain
brand of electrodes. After the skin preparation demonstration
using the Red Dot Trace Prep, the comments changed to,
“that didn’t take much time” and “that didn’t hurt” or “it feels
like a cat’s tongue!”
Measured Skin Impedance Prior to 3M
TM
Red Dot
TM
Trace Prep
Skin Impedance af
ter using 3M
TM
R
ed Dot
TM
T
race Prep
Dr
amatic effects of 3M
TM
R
ed Dot
TM
T
race Prep on ECG traces
The challenge facing electrode designers is to develop an
electrode with reliable electrical characteristics that are gentle
to patient’s skin, even during long-term monitoring situations.
The challenge facing clinicians is to understand the factors
that can affect ECG trace quality, beyond the electrode.
Clinician Survey
To better understand actual practice for ECG electrode skin
preparation, 3M conducted a survey at the 1998 AAMI
Annual Meeting and the 1998 AACN National Teaching
Institute
™
& Critical Care Exposition (AACN 1998 NTI
™
).
Survey participants were primarily biomedical engineers and
technicians from AAMI and nursing professionals from
AACN 1998 NTI
™
. The results of the survey were
surprising. Most of the nursing professionals were not aware
of skin impedance, or how it can affect ECG trace quality.
In fact, only 17 percent of the participants said they have a
protocol in place that requires skin preparation prior to
placing an electrode on a patient. Also, most of the biomed-
ical engineers and technicians were aware of the affect skin
impedance has on trace quality, but were not aware of the
extreme variability of skin impedance, how it affects ECG
trace quality and how easily it can be reduced.
Survey participants had their skin impedance measured by
having two 3M
™
Red Dot
™
Electrodes 2261 and 2259 placed
on their forearm with a Prep-Check # 105 electrode imped-
ance meter, made by General Devices, connected to the
electrodes. The following histogram describes the measure-
ments taken before any means of electrode site preparation:
The average skin impedance measured
in this study was 354 K-ohms.
The skin of each participant was then prepared with mild skin
abrasion to the electrode site using 3M
™
Red Dot
™
Trace Prep
2236 (fine sandpaper material). This mild abrasion
technique consisted of holding the participants skin with
one hand and gently wiping the skin three times with the
trace preparation in the other hand. This technique took a
few seconds for each electrode site and was in general, not
uncomfortable for the participant. The following histogram
describes the measurements taken:
Survey Findings
The average skin impedance measured in this study, after
using the trace preparation was 20 K-ohms. This was a 325
K-ohms reduction in the average impedance.
Following the assessment of skin impedance, survey
participants were asked if they ever have unacceptable
ECG trace quality. Only 14 percent answered that they
almost never have unacceptable trace quality. The clear
majority of participants stated that they experience occasions
of unacceptable trace quality, (52 percent replied “often”
and 34 percent replied “occasionally”).
Troubleshooting Unacceptable Trace Quality
Troubleshooting trace quality can be time-consuming, costly
and risky to the patient. The survey found that 34% of the
clinicians most often attempt to resolv
e the trace quality
problem by adjusting the ECG monitor, 30 percent immedi-
ately change all of the electrodes and 11 percent immediately
change the cable and/or leadwires. When this method of trou-
ble shooting does not work, biomedical engineering is called
to assist. Forty-one percent of the survey participants stated
that it usually takes biomedical engineering and nursing a
total of 15-30 minutes to obtain an acceptable ECG trace.
Another 27 percent stated that it takes 60 minutes or more.
Many survey participants said, “I eventually pay no attention
to monitor alarms!”
Frustrating Delays and Higher Costs
Trouble-shooting ECG trace quality is clearly frustrating for
the clinician, may delay treatment for the patient and is costly
for a facility. The cost for changing all of the electrodes is
approximately $.20 for each electrode. The cost of changing
a leadwire is approximately $5 for each leadwire. An average
cable costs $60. In a five lead-monitoring scenario, the cost
of trouble-shooting may range from $1.00 - $85 for each
trouble-shooting event. For a hospital with 100 fully utilized
five-lead ECG monitoring systems and an average patient
stay of five days, annual trouble-shooting costs could range
from a few thousand dollars if only electrodes are changed to
many thousand dollars if leadwires and cables are replaced.
This cost analysis does not include the cost to the facility for
nursing and biomedical time, wasted chart paper, delay in
treatment or the risk of missing a life threatening event. It
also does not include the discomfort that may be caused to
a patient for removal and re-application of electrodes.
Best Recommended Practice
for Applying Disposable Electrodes
The stratum corneum of the epidermis has high impedance.
Removal of the stratum corneum at the electrode site will
dramatically reduce the skin impedance. The following is
a technique that can be followed and will reduce skin
impedance.
1. Select electrode application sites without bony prominence,
avoiding fatty areas and major muscles. This placement
method will help reduce motion-related artifact and maximize
the ECG signal strength.
2. If the patient has a f
air amount of hair at the electrode
application site, the hair should be clipped. Sha
ving is not
necessary and may actually cause some skin irritation.
3.
The electrode application site should be clean and dr
y
.
The preferred method of cleaning is with soap and water plus
dr
ying the skin with a dr
y cloth or gauze. In emergency
situations, this ma
y be dif
f
icult. Ho
wever, clean and dry skin
does contribute to good electrode adhesion and good trace
quality.
4. Cleaning with isoprop
yl alcohol should be avoided or
limited to situations which electrode adhesion is an issue
(diaphoresis, e
xcessi
v
el
y oil
y or lotion-co
vered skin), since
it ma
y deh
ydrate the skin, thus causing skin impedance to
increase. If alcohol is used, allow it to dry prior to the
electrode application.
5. Attach the leadwires to the electrode prior to placing the
electrode on the patient. This will eliminate the potential for
patient discomfort if snap leadwires are pressed onto the
electrode, after the electrode has been placed on the patient.
Optimum patient comfort can be obtained if squeeze clip or
pinch clip leadwires are used.
6. Electrode application sites should be abraded to lower the
skin impedance. The Red Dot Trace Prep 2236 used in this
clinician survey has proven to be an effective tool for lower-
ing skin impedance.
Note: These photos are intended to show “typical” tracings
for the situations indicated. Actual results may vary depend-
ing on other factors.
Trace Prep Misunderstandings
Prior to a demonstration of proper skin preparation technique,
clinicians often comment that they do not have time to
prepare skin; it may be painful for the patient, should only
be done as a means of troub
le shooting or onl
y with a certain
brand of electrodes. After the skin preparation demonstration
using the Red Dot Trace Prep, the comments changed to,
“that didn’t take much time” and “that didn’t hurt” or “it feels
like a cat’s tongue!”
Measured Skin Impedance Prior to 3M
TM
Red Dot
TM
Trace Prep
Skin Impedance af
ter using 3M
TM
R
ed Dot
TM
T
race Prep
Dr
amatic effects of 3M
TM
R
ed Dot
TM
T
race Prep on ECG traces
Health Care
3M Center, Building 275-4W-02
St. Paul, MN 55144-1000
USA
1 800 228-3957
healthcare@3M.com
www.3M.com/healthcare
3M Canada Company
Post Office Box 5757
London, Ontario N6A 4T1
Canada
1 800 563-2921
Recycled Paper
40% Pre-consumer waste paper
10% Post-consumer waste paper
3M and Red Dot are registered
trademarks of 3M.
Printed in U.S.A.
© 3M 2005 All Rights Reserved
70-2009-3356-5
Proper Skin Prep Helps Ensure ECG Trace Quality
Clinician survey finds that most are unaware of variations in skin impedance
and how easily it can be reduced for artifact-free traces and increased efficiency.
Craig D. Oster
Technical Service Specialist, 3M Health Care
Most clinicians have experienced unacceptable ECG trace
quality when using disposable electrodes. When the monitor
alarm goes off, they try everything to fix the problem from
adjusting the ECG monitor to replacing all the electrodes,
leadwires or cables to calling biomedical engineering for
help. All this takes time, increases costs, adds to staff and
patient frustration, and may place the patient at risk.
A new survey shows that something as easy and simple as
proper skin preparation prior to electrode placement can
significantly reduce ECG artifact in most electrode situations
by lowering patient skin impedance. Nursing professionals
and biomedical engineers attending the 1998 AACN National
Teaching Institute
™
& Critical Care Exposition (AACN 1998
NTI™) and the 1998 Annual Meeting of the Association for
the Advancement of Medical Instrumentation (AAMI)
experienced first hand the dramatic difference in traces
after a skin preparation agent was performed to their own
arms prior to electrode placement.
The skin contributes to the noise or artifact associated with
disposable skin electrodes. But clinical studies have shown
that the electrode-skin interface is frequently overlooked as
a major source of artifact affecting many electrophysiologic
recordings.
1
The ideal skin preparation technique for the
application of disposable ECG electrodes includes removing
part of the stratum corneum to allow electrical signals to
travel back to the electrode.
2
Patient Skin Impedance
Electrocardio
g
raph
y (heart monitoring) measures and records
the time sequence of the electronic voltage generated by the
heart muscle. The electrocardiogram (ECG, EKG) is the
g
raphical recording of the electrical activity of the heart.
A patient’s heart and skin, along with the monitor, cable,
leadwire, connector, and ECG electrode all play a distinct
role in obtaining an electrocardiogram. This paper describes
how high patient skin impedance at the electrode placement
site is a common reason ECG artifact is seen and how it can
be greatly reduced.
There are short-term and long-term monitoring applications
for ECG electrodes. Short-term monitoring is also referred to
as resting or diagnostic monitoring. Usually the electrocar-
diogram is produced in a few minutes. Long-term monitoring
is generally of the “critical care” type, with patients being
monitored for extended periods of time. This may consist of
Holter or cardiac event recorders, telemetry transmitters and
intensive care or bedside monitoring units.
An electrode basically consists of a sensing element
(snap) in contact with an electrolyte (gel). When the
electrode is placed on the skin surface, the skin becomes
an integral part of the circuitry. Should this circuitry be
compromised due to high patient skin impedance, the signal
integrity can be adversely affected, causing base line wander,
substantial noise (artifact) and even loss of the ECG trace.
Other influences beyond high patient skin impedance that
can contribute to high patient skin impedance artifact include
the environment i.e. electrical field (60 Hz), humidity,
temperature, static electricity or the patient’s skin condition
such as diaphoresis.
The skin is the body’s outer covering, which is called the
integumentary system. Its function is to protect the body
against a multitude of environmental insults. The skin is the
most flexible organ of the body. The skin has two distinct
layers; the epidermis (the outer most layer), and the dermis,
(the inner layer).
Most of the epidermis is stratified squamous epithelium and
lacks blood vessels. The cells deeper and closer to the
dermis, however, are nourished by dermal blood vessels and
can reproduce. As this happens, they push old cells toward
the skin’s surface. By the time they reach the surface, those
cells are dead and flattened. The remaining dead cells
contain keratin fibers packed with plasma membranes.
This outer
most layer is named the stratum corneum. It is
tough, shedding millions of skin cells daily. This layer is
the source of most problems with ECG trace quality.
How Skin Impedance Affects Trace Quality
Skin impedance can be defined as the opposition or resistance
to the passage of alternating current (AC) electrical signals
and is measured as a voltage/current. There is no quick
assessment of a patient, other than actual measurement, to
determine if he or she has high skin impedance. Factors such
as age, sun exposure, skin lotions, relative humidity and
ambient temperature can influence skin impedance. Skin
impedance plays a critical role in ECG trace quality.
Conclusion
In the clinical setting, artifact can generate false interpretation
of recordings and data, induce false alarm conditions, mask
tr
ue alarm conditions, necessitate frequent electrode
replacements and create a time-consuming and frustrating
experience for both the patient and caregiver.
3
The routine use of the appropriate trace preparation has been
demonstrated to be an effective tool for lowering patient skin
impedance for adults. Trace preparation tends to be thought
of – wrongly – as a tool to be used only with certain elec-
trodes or only as a means of trouble-shooting ECG artifact.
The findings of this paper support use of the appropriate skin
preparation for all electrode applications. This best practice
will eliminate most skin impedance related ECG artifact and
produce clearer traces for better diagnosis, lo
wer costs, reduce
time and frustration for nursing and biomedical engineering
and improve overall comfort for patients.
ABSTRACT
Proper Skin Prep Helps Ensure
ECG Trace Quality
Although most clinicians do not realize it, the skin is a major
source of ECG artifact. Artifact can lead to unnecessary
electrode changes, higher costs, false alarms and frustration
for staff and patients. By lowering skin impedance, clearer
traces result.
A survey of biomedical engineers, technicians and nursing
professionals attending a national conference looked at
actual practice for ECG electrode skin preparation and time-
consuming troubleshooting activities. Only 17 percent of the
respondents said the
y have a protocol in place that requires
skin preparation prior to placing an electrode on a patient.
The survey showed that proper skin preparation prior to
electrode placement lowers skin impedance and can
significantly reduce artifact in all electrode applications.
BIOGRAPHY
Craig Oster is a Mechanical Engineer who has spent his most recent 10 years of his 20 year engineering
career with 3M Health Care in product development, manufacturing and currently in technical service.
REFERNCES
1. Medina V, Clochesy JM, and Omery A, Comparison of electrode site preparation techniques, Heart and Lung: The Journal of Critical Care, 1989, pp. 456-460.
2. Clochesy JM, Cifani L, and Howe K, Electrode site preparation techniques: A follow-up study, Heart & Lung: The Journal of Critical Care, 1991, pp. 27-30.
3. Medina, Comparison of electrode site preparation techniques, Hear
t and Lung:
The Jour
nal of Critical Care, 1989, p 456.
