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)



Leave a Reply