To the Editor:-In patients with extensive burns, it is sometimes a challenge to monitor the ECG, because the lack of natural skin and application of protective ointments prevent the adherence of the ECG discs. We have used the following modification to monitor ECG successfully in these patients.
The ends of a standard 3-lead ECG wires are cut and small alligator clips are attached to them (Figure 1). After the patient is well sedated or asleep, using a sterile stapler (Davis + Heck), three stainless steel staples (35 wide; 6.9 mm x 3.8 mm) (Figure 2) are clipped to the skin near the right and left shoulders and left chest.
Because these staples are painful to place on an awake patient, one has to make sure that the patient is asleep or heavily sedated before the staples are placed. Some of these patients may already have staples in place to hold the homograft skin patches in place. The alligator clips are then attached to these staples. This provides a secure and steady ECG tracing. We hope this information will be useful to some of the readers.
Ram S. Ravindran, M.D.
Department of Anesthesia; Wishard Memorial Hospital; Indianapolis, Indiana 46254
(Accepted for publication June 17, 1997.)