1. Application of a Patient
Telemetry Unit
by
June Graney
Internet in Education
University of South Florida

2. Target Audience
Undergraduate nursing students
Patient care technicians
Registered Nurses new to telemetry or returning to
work force

3. Objectives
Identify types of monitoring devices used
State patient education related to telemetry
List equipment needed
Describe required skin preparation
Illustrate 5 lead placement of electrodes

4. Types of Monitoring
12-Lead EKG
Holter and event monitors
Hardwire monitors
Outpatient monitoring
Telemetry

5. Patient Education
Assess level of understanding
Explain rationale
Identify tape allergies
Describe lead placement
Ensure privacy and dignity

6. Assemble Equipment
EKG Patches
Skin prep pads
Razor as needed
Unit and battery
Telemetry gown or holder

7. Skin Preparation
Assess the areas of application
Shave or clip areas with excessive hair
Rub with alcohol and allow to dry
Avoid bony areas, irritated skin, and incisions

8. Apply Electrodes

9. Lead Placement

10. 5 Electrode
Lead
Placement
White-Right Arm
Black-Left Arm
Brown-Chest
Green-Right Leg
Red-Left Leg

11. Implications of Improper Lead
Placement
Artifact and wandering baselines
Alterations in waveforms
False diagnosis of infarction
Skin irritation or infection

12. Don’t Forget a Pouch!

13. Finalizing
Notify monitor technician or centralized station
Ensure adequate transmission of waveforms
Patient comfort, safety, and questions
Document application and corresponding unit
number

14. References
American Heart Association. (2004). Practice Standards
for Electrocardiographic Monitoring in Hospital
Settings. Circulation. 2004; 110: 2721-2746 doi:
10.1161/​01.CIR.0000145144.56673.59
Lewis, S.M., Heikemper, M.M., & Dirksen, S.R. (2007)
Medical-Surgical Nursing: Assessment and
management of Clinical problems. (7th Edition). St.
Louis MO: Mosby.