Drew B J
AACN Clin Issues Crit Care Nurs. 1993 Feb;4(1):25-33.
A recent national survey of critical care nurses reveals that the leads many nurses select to monitor their patients are diagnostically inferior to other available leads, and that lead placement often is inaccurate. This article reviews the best leads for electrocardiographic (ECG) monitoring, illustrates their accurate placement, and explains reasons for the dilemma in current practice. Questions relevant to practicing nurses are addressed, including 1) Is lead MCL1 as good as V1? 2) When is it appropriate to substitute lead MCL1 for V1? and 3) How important is it for electrodes to be placed exactly in specific anatomic locations? Finally, a case study is provided to illustrate how accurate monitoring can prevent misdiagnosis and resultant inappropriate therapy.
最近一项针对重症监护护士的全国性调查显示，许多护士选择用于监测患者的导联在诊断上不如其他可用导联，而且导联放置常常不准确。本文回顾了心电图（ECG）监测的最佳导联，说明了其准确放置方法，并解释了当前实践中存在这种困境的原因。文中讨论了与执业护士相关的问题，包括：1）MCL1导联与V1导联一样好吗？2）何时适合用MCL1导联替代V1导联？3）电极精确放置在特定解剖位置有多重要？最后提供了一个案例研究，以说明准确监测如何能够防止误诊及由此导致的不恰当治疗。
