Monthly Archives: January 2013

When Discussing Skin Irritation, There is A Lot to be Considered

Whether a patient has undergone a simple resting ECG or long term event monitoring which often lasts up to 30 days, patients share a similar complaint, skin irritation.  At one time or another  it seems every doctor’s office, scanning service, hospital and cardiologist has received the dreaded patient call claiming they are sporting a blister, raw red skin, or sores.  The question we need to ask ourselves is WHY patients being adversely affected, and WHAT can we do about it? 

In the past we have all found it easy to blame the electrode and assume that it is the electrode itself causing skin irritation, however we have learned that there are other factors to take into account and hopefully moving forward, these issues are given consideration.   Did you ever wonder why there are so many different types of electrodes?  There are literally hundreds on the market today and each possesses a diverse set of properties.  As we know every patient is different and some patients may have special needs.  Electrodes are designed for a specific purpose, to meet these special needs.  With that in mind what we could start asking ourselves is, was it our choice of electrode rather than the electrode itself that is responsible for our patients’ skin irritation.  

Below outlines some examples of patient/procedure types with skin characteristics that may prove challenging when it comes to ECG monitoring.

Also view a variety of Electrodes <Here>

Procedure Type

Suggested Requirements

Resting Procedures such as EKGs and echo tests
  • Milder prep
  • Less aggressive electrode


Ambulatory procedures such as Holter, stress, and event recording
  • More aggressive prep
  • More aggressive electrode



Patient Type

Suggested Requirements

Sensitive Skin

Elderly Patients

Pediatric Patients

Patients with Skin Allergies

  • Milder prep
  • Low chloride gel electrode
  • Breathable, less aggressive Electrode
  • Skin barrier between skin and electrode (optional)
  • Do not use adhesive tapes to secure lead wires, tapes can further aggravate the skin


Diaphoretic Patient

Active Patients prone to perspiration


Oily Skin

  • More aggressive prep
  • Higher chloride gel electrode
  • Additional electrode gel to help prevent slippage and fall off
  • Skin barrier between skin and electrode to prevent moisture passing between skin and electrode(optional)



A Few Strategies For Your New Year’s Resolutions


1. Don’t tie your goals to a definite time of day. It promotes clock watching and if you get off schedule for some reason, you lose the opportunity to practice your new habit. Here are a couple examples of nonscheduled habits. For example, if you don’t want to join the gym but want to promise yourself to be a little more physically fit, don’t take the elevator at work, walk the stairs. Don’t park as close as you can to the store; park 10 spots further away. During your lunch hour, most of us make a phone call, don’t sit and talk on the phone, get up! Walk around your house or around the building you work in.
2. When most people decide to address a bad habit such as smoking or binge eating, they usually try to quit cold turkey. You’re better off trying to replace the bad habit with a better one. For example, you normally go out at 3pm for a cigarette break, instead of walking outside, walk to the kitchen and get a glass of water and occupy your hands with a treat such as a handful of peanuts, carrots or hard candy, you get the idea anyway to replace the oral fixation. Your habit of getting up is still accommodated and your oral fixation is replaced with something healthier.
3. A positive outlook is a good start to a resolution but it will only get you so far. You also need to think about all of the obstacles that could get in the way. Be prepared for them and add it to your plan so you are not disappointed. Disappointment & frustration lead to quitting. This is a big reason why we fall off of that “Band Wagon”. If you want to go on that diet, be sure you are prepared for those hunger moments and irritable mood swings. Most feel it isn’t worth it and quit. Try #3 above and when you are hungry drink a glass of water instead of eating the candy bar. Water can decrease your appetite. It is hard to distinguish between being thirsty and being hungry, so try drinking water and waiting 20 to 30 minutes to see if you’re still hungry.”