Comparison of the Use of Conventional and Prewired Electrodes for Electrocardiography in an Emergency Setting- The Spaghetti Study Ann Emerg Med. 2011;57:357-361

13 Jun

This isn’t particularly important but i like the idea (and the awesome study name).

This is what pre-wired electrodes look like. Though if you're patient has just undergone a traumatic "armectomy" then ECG not likely to be helpful

We’ve all seen wrong lead placements, shit I’ve contributed to a few myself, especially when you’re at the top doing the airway but trying to be hepful and getting your lefts and rights mixed up. Perhaps that’s just me

The other thing that really bugs me is the fuzzy baseline. It seems that every other ECG I see is almost unreadable. Well I suppose that’s a vast overstatement but it does happen.

As an interesting anecdote I once transferred a patient to our ICU after he’d been shocked for apparent VF. When he was shaking from his second rigor from cholecystitis and looked a bit blue and had the dodgy looking ECG trace then I understood why someone had thought it was VF.

As for the study. Very briefly, because the details aren’t especially important here

Half were pre-hsopital, half were in the ED. On a blinded reading there was less baseline noise in the pre-wired group and it was a whopping 25 seconds faster (about 20%).

I don’t really care about the speed thing but I like the idea of less noise and less ability to screw up the lead placement.

Problem comes in at cost. 50 cent for conventional and 2 euro for the pre-wired,

Given the number of ECGs we do I doubt that a four times increase in cost is worth it.

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