Monitoring electrocardiographic changes: results of a national survey

This article describes the electrocardiographic (ECG) monitoring practices of a national sample of nurses caring for patients who have suffered an acute myocardial infarction (AMI). Of specific interest were lead section practices, diagnosis of infarct evolution, and use of right precordial leads. Two populations were randomly sampled in an attempt to minimize sampling bias. Of the 2,549 mailed surveys, 882 were returned (34.8% response rate) from 48 states. Lead II was used most commonly (66.3%) with a single-channel system. Lead II plus V1 (or MCL1) was selected most often (62.4%) with dual-channel systems. Few (20%) respondents reported "always" modifying lead selection based on location of AMI; selected most often (62.4%) with only 43.3% correctly identified classic ischemia, injury, and infarction. Right precordial leads are used infrequently in practice.