GE Healthcare 12RL ECG Quick Guide - Manual (Page 2)

LA
RA
RL
LL
V
1
V
5
L
R
N
F
C
1
C
5
Precordial electrodes V2, V3, V4, and V6 are not
needed. Instead, these waveforms are reconstructed
using data derived from the other, directly recorded,
ECG leads. The calculated waveforms are displayed as
dV2, dV3, dV4, and dV6.
All 12 waveforms on the monitor screen. Leads dV2,
dV3, dV4 and dV6 are not directly measured but
reconstructed from the information recorded from the
other ECG leads.
Accuracy in clinical practice
It has been shown that observations were identical
between 12RL and standard 12-lead ECGs for the
following: tachycardia, bundle branch and fascicular
blocks, left atrial enlargement and the distinction
of ventricular tachycardia from supraventricular
tachycardia with aberrant conduction
2 . The same
study also found 99% agreement for prior anterior MI
and 95-99% agreement for diagnosis of acute MI.
These results compare favorably with expected
accuracy of standard 12-lead ECG, which means 12RL
is appropriate for detecting cardiac abnormalities in
hospitalized patients.
When to use 12RL
Using 12RL technology is a lot like using a standard
12-lead ECG. 12RL enables 12-lead ECG monitoring
on patients when a conventional 12-lead ECG is not
practical since some precordial leads may block the
echocardiographic transducer location or be in the
way for defi brillator pads. 12RL provides 12-lead ECG
monitoring for a larger patient population.
Since 12RL technology uses the standard electrode
positions, switching from 12RL ECG to conventional
12-lead ECG just requires adding four electrodes.
Where the current standard of care monitoring may
be utilizing fi ve electrodes, adding one more chest
electrode would mean that clinicians could obtain the
benefi ts of 12RL technolology.
What you need
12RL technology requires a six leadwire set and a
corresponding trunk cable in order to obtain the
ECG signal.
Va and Vb must be identifi ed as V1 and V5 in the
monitor and properly placed in V1 and V5 electrode
locations to enable the 12RL functionality. If this is not
the case, the monitor will just show eight leads and
not calculate or show V2, V3, V4 and V6 waveforms.
Why 12RL uses V1 and V5
Lead V1 is one of the best leads for identifi cation of
P-waves, is important for accurate rhythm analysis
and provides critical information in distinguishing:
• ventricular tachycardia (VT) from supraventricular
tachycardia (SVT) 1, 2
• SVT with aberrancy 1, 2
Lead V5 is valuable in detecting MI 2 and helps to
provide coverage of the anterior and lateral walls of
the heart.
On the other hand, there are reasons for not using
other precordial leads for 12RL:
• The location for lead V2 conflicts with the preferred
location for an echocardiography transducer 2
• Leads V3 and V4 may obstruct the placement of
defibrillator pads 2
Calculating the other four precordial leads from V1
and V5 can be done with very little error.
2
ECG reports
The clinician can generate a standard 12-Lead ECG
report with measurements calculated by the
GE 12SL
™ ECG analysis program, including:
• Ventricular rate
• PR interval
• QRS duration
• QT/QTc intervals
• Axis
6 Lead Confi guration AHA 6 Lead Confi guration IEC