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ViSi Mobile Smart Tip - Skin Preparation

When utilizing disposable electrodes, most practitioners have had unacceptable ECG trace quality. When the monitor alarm sounds, they do everything from resetting the ECG monitor to changing all electrodes, lead wires, and cables to contacting biomedical engineering for assistance. All of this consumes time, money, and frustration for both staff and patients, and potentially puts the patient at risk. However, clinical studies have revealed that electrode-skin contact is a primary cause of artifact in many electrophysiologic recordings.

Skin preparation and ECG electrode placement directly impact the quality of the ECG signal, HR value, and cNIBP value. ViSi Mobile Disposable Kit comes with 5 ECG Electrodes which are adhesive pads with conductive gel connected to the ECG lead wires of the chest Sensor to display the ECG waveforms and detect the HR.

The following steps are recommended for skin preparation:

  • Select ECG electrode sites on the patient’s chest
  • Choose sites that are flat, avoiding fatty areas and major muscles
  • Thoroughly clean the sites with soap and water to remove excess skin oils and skin cells
  • Gently rub the site dry with a dry gauze pad or cloth. Some individuals will require alcohol to properly clean the skin's surface, in which case make sure that the alcohol is thoroughly dried before the electrodes are placed.
  • Place the electrodes in the predetermined location, making sure that your lead wires move away from the joint angles, and that your electrodes are smooth on the skin with no wrinkles.
  • A drop of Ultrasound or Doppler gel can be added to the center of the electrode to increase conductivity if tracing isn’t showing

Take note:

  • If hair is present, shave or clip the hair in approximately a 1-2 inch diameter for each electrode. Also, remove hair from the areas where the chest sensor, chest & upper arm securements are placed.
  • To avoid skin irritation, avoid areas that appear damaged; remove ECG electrodes if the patient complains of pain/itching; replace ECG electrodes per the electrode manufacturer’s instructions and place them on different sites
  • Only use snap-on type electrodes.
  • Use all of the same types of high-quality ECG electrodes on the patient. Mixing ECG electrode types can adversely affect ECG monitoring
  • To ensure patient safety, use only components and accessories recommended or supplied by Sotera Wireless, Inc. Accessories must always be used in accordance with your facility’s policies and the manufacturer's recommendations
  • Only use the ViSi Mobile Chest Sensor Cable Chest Sensor provided by Sotera Wireless, Inc. for the ViSi Mobile Monitoring System. The Chest Sensor Cable Chest Sensor is designed to provide defibrillation protection as indicated in the Specifications section of the manual. ViSi Mobile is designed to be compatible with the use of an external defibrillator.
  • To ensure patient safety, the conductive parts of the ECG electrodes, including connectors and other patient-applied components, should not contact other conductive parts, or earth ground, at any time.

For more details regarding the application of the 3 and 5 lead-wire ECG Electrode Placement, refer to pages 70-71 in our ViSi Manual. If you have any more questions, you may contact our customer service.


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Filed Under: ViSi Mobile, ViSi Tip of the Month