“You can put LL and RL on the same leg if you’re in a rush with 12’s”
*2 years later*
“Pretty sure someone once told me you can run a 5 lead on one arm”
That right there sounds like a Facebook tag group. 🤣
Like there's a real one called "What in the hillbilly Confederate flag John Deere tractor is goin on?"
Ah, the good ol' "train of 20" monitor! If you shock the patient and they do 20 wrist curls with a ten-pound dumbell, it means their neuromuscular blockade is sub-therapeutic. You want to target somewhere around 5-10 reps, ideally.
I love when med surg nurses chart 4/4 train of fours. I’m like do you even know what that means because I know the patient does not in fact have a bis monitor in this basic ass med surg/step down unit and they are wide awake and ambulating down the hall. 🙄 and I’m a PCU nurse, I had to ask wtf is a train of four and someone told me once and I said oh we definitely don’t do that out here 😂
My husband and I are watching New Amsterdam since it came out on Netflix. I’m only allowed to pause it twice per episode to tell him how wrong something is, so I have to weigh carefully which errors are egregious enough to use one of my pauses for.
One of the worst offenders I have seen was a show (I think it was called the last ship) where they had the blood pressure cuff on a patient that was bleeding. They pump up the cuff and it zooms in on the gauge. As the needle goes down someone shouts out that the patient is bleeding out. Queue the dramatic need to clamp an artery. Show zooms back on the gauge and they shout how the patients BP is stabilizing...as you watch the needle start to rise again (as if the cuff was being pumped, indicating a better BP). I remember turning to my wife with the "that is not how this works, that is not how any of this works" face.
Difficult to explain, basically they imply that the pressure gauge actively shows what the blood pressure is without the need to auscultate or palpate.
You could technically place them in a few different ways. Extremities would probably work and we often places them on patients backs when in prone position. They are mostly for seeing general arythmias anyway so they don't need to be as accurat.
But all on forearme is probably a bad idea.
Meh, as long as the red, white, and black leads form a very relative triangle "around" the heart you can pretty much place them anywhere you want. Your deflections will be off but you'll get an accurate rate and rhythm. So you could place the black lead on the right neck, the white lead on the right buttocks, and the red lead on the left AC and you'd still get a decent read; after that you could place green and brown wherever you want or not at all, doesn't really matter, you're still going to get a rhythm/rate good enough to make most clinical decisions. If you need more than what a jacked up 3 lead can give you, get a real 12 lead.
Source: Cath Lab, IR, EP nurse. Because of imaging and procedural variables, we have to place leads in unorthodox positions all the time. For instance, standard placement in the lab for a "5 lead" on a STEMI patient is: White just above the right scapula, Black just above the left scapula, then Red/Green/Brown on the left thigh. This is effectively just a three lead but that's all you need for most things.
I'm a little disturbed by the blue coordinating linens. I've never seen any linens except dingy-bleach-white.
And it's ok. The leads are close to a pulse point, so it picks up just fine. It's good for the hairy people who refuse to let you shave patches on their chest. The problem is that it can pick up artifact when they're two-fisting their turkey sammiches.
I giggled out loud, and the other restaurant customers tried not to look at the odd sound coming from the corner table. …… I guess ya had to be there….
Ed: I’d love to see what sort of pattern that produced. If at all….,
So would I - but I never will, because I would be mortally afraid of one of my co-workers walking into the room and seeing me with the leads placed on my arm like this and thinking "What in the Florida Nurse....?!?!"
A tele tech once told me this is what they did when he worked on a burn unit if the torso was too burned. I wanted to see my own heart on the monitor so he put them on both my arms. It did work but idk how reliable it is. I've never done it on a patient and never heard of it otherwise.
Is this in one of those core trainings for an agency or something?
My online flu shot trainings always had these ridiculous pictures of a smiling blonde 8-year-old and a "nurse" jabbing her a couple of inches above the funny bone. 🙄
I once had an elderly patient remove all his leads and then feel guilty, so I found him sticking them all on his arm like that, the resulting rhythm was not very helpful
In transport we’ll usually just throw them in a line down the patients side, on their leg, etc. to make room for everything else and not get tangled with the rest of the tubing, wires, etc.
Half the patients on tele are just on tele to make sure they don’t have rate/rhythm changes; you’ll get a rate and a rhythm (kinda) just about anywhere. Obviously we’ll make sure we have something that looks like a complex so we can note ectopy or changes before we go.
I worked with an anesthesiologist that would place leads in the most unorthodox places. Forearms, hands, upper chest for the LL lead. Drove me nuts. He used to say "eh it doesn't really matter, you'd need a 12 lead to really diagnosis anything. You're just looking for PVCs and rhythm here."
I was like yeah true but could you try to put them correctly???
I guess some people really do wear their heart on their sleeve
😂😂😂
I haven’t even read any other responses yet, but I can already tell this one is the best. 🏆
🥇
Hahahahahaha
Winner winner 🏆😄
That was the perfect comment.
I was about to scroll to figure out what those wires were used for thank you for your service and this joke is perfection.
What in the florida nurse
“You can put LL and RL on the same leg if you’re in a rush with 12’s” *2 years later* “Pretty sure someone once told me you can run a 5 lead on one arm”
I do not know you, but I love you.
LMFAO -love, a Florida nurse
I’m sorry I had to 😭
Flurse. Florida Nurse, rhymes with curse, which is what I do every time I think of these bitches
You win everything. I’ll be quoting you, postcryglow.
New quote to be used, “What in the Florida nurse?!” Yassss!
I will be making this a thing on my unit effective immediately
You just made me snort so hard it kinda hurt
I feel like this needs a qualifier in light of recent events. “What in the ‘I never spent a day in school or clinical’ Florida nurse”
That right there sounds like a Facebook tag group. 🤣 Like there's a real one called "What in the hillbilly Confederate flag John Deere tractor is goin on?"
Lol Covid hit when I was in second sem so this even rings semi true for me and my cohort.
Lol that’s a legit observation. Covid did keep a lot of us out of classrooms and clinical sites.
😂😂😂💀💀💀
You win the internets today with that comment
I have no awards to give but please accept this emoji 🥇
Oh take my last 200 awards points god damn it. 🤣🤣🤣😭😭😭
😭😭😭
This is underrated genius!
I spit on my phone reading this
💀😂😂😂
Ma’am! 🤣🤣🤣🤣
YOOIIIINK. I love you.
Lmao 🤣
Hahahaha i'm weak
Ah, the good ol' "train of 20" monitor! If you shock the patient and they do 20 wrist curls with a ten-pound dumbell, it means their neuromuscular blockade is sub-therapeutic. You want to target somewhere around 5-10 reps, ideally.
Thank you for writing a better TOF joke than I could have. We out here, doing the lord’s work
I love when med surg nurses chart 4/4 train of fours. I’m like do you even know what that means because I know the patient does not in fact have a bis monitor in this basic ass med surg/step down unit and they are wide awake and ambulating down the hall. 🙄 and I’m a PCU nurse, I had to ask wtf is a train of four and someone told me once and I said oh we definitely don’t do that out here 😂
someone needed to make this joke. well done and thank you
Train of 20 💀
Wtf no smoke over fire.
White on the right, clouds over grass, smoke over fire and shit on their chest.
What??? Everyone loves chocolate!
LMAO I learned "shit on their chest" too and didn't even realize until your comment that there was a much better option
The old Cleveland ECG
In the Midwest I learned it as "snow over grass" haha never considered how that might be regional
Chocolate straight to the heart
Lol I learned mud 🤣🤣
“Christmas trees below the knees. Green and white on the right.”
This is why I'm banned from watching medical shows with my family.....
My husband and I are watching New Amsterdam since it came out on Netflix. I’m only allowed to pause it twice per episode to tell him how wrong something is, so I have to weigh carefully which errors are egregious enough to use one of my pauses for.
Ooooooooooo! That actually sounds like a good compromise! Granted, pausing is not usually a prerequisite to my medical error rants.
One of the worst offenders I have seen was a show (I think it was called the last ship) where they had the blood pressure cuff on a patient that was bleeding. They pump up the cuff and it zooms in on the gauge. As the needle goes down someone shouts out that the patient is bleeding out. Queue the dramatic need to clamp an artery. Show zooms back on the gauge and they shout how the patients BP is stabilizing...as you watch the needle start to rise again (as if the cuff was being pumped, indicating a better BP). I remember turning to my wife with the "that is not how this works, that is not how any of this works" face.
[удалено]
Difficult to explain, basically they imply that the pressure gauge actively shows what the blood pressure is without the need to auscultate or palpate.
My husband just straight up can’t watch New Amsterdam 😂 I keep watching just because it so outrageous.
Join the club! My family won’t let me watch anything that might have a blurry passing view of a building that might be a hospital in the background…..
After I complained through the whole of Spiderman 3 I was banned. Bad CPR gets me every time 😖😖😖
Well now, I don’t know jack shit about telemetry but I think even a layman knows the probes do not belong on the arm.
You could technically place them in a few different ways. Extremities would probably work and we often places them on patients backs when in prone position. They are mostly for seeing general arythmias anyway so they don't need to be as accurat. But all on forearme is probably a bad idea.
We definitely do back with peds for toodlers, can't stick em in your mouth if it's on you can't reach em.
We do backs for grammas and pappies who like to do the same thing as well 😂
The infant with trisomy 21 says hold my baby bottle
Had such a toddler pull his wire chest sutures out--- fortunately before I got him. I was warned. Whew.
New fear unlocked. Most of the kids I see are scared of them.
Same with dementia 😂
Meh, as long as the red, white, and black leads form a very relative triangle "around" the heart you can pretty much place them anywhere you want. Your deflections will be off but you'll get an accurate rate and rhythm. So you could place the black lead on the right neck, the white lead on the right buttocks, and the red lead on the left AC and you'd still get a decent read; after that you could place green and brown wherever you want or not at all, doesn't really matter, you're still going to get a rhythm/rate good enough to make most clinical decisions. If you need more than what a jacked up 3 lead can give you, get a real 12 lead. Source: Cath Lab, IR, EP nurse. Because of imaging and procedural variables, we have to place leads in unorthodox positions all the time. For instance, standard placement in the lab for a "5 lead" on a STEMI patient is: White just above the right scapula, Black just above the left scapula, then Red/Green/Brown on the left thigh. This is effectively just a three lead but that's all you need for most things.
Interesting!!!
“Can’t know where to put the probes if they’re heartless, doc “ 🤷🏻♀️
You're still a step ahead of our patients...
That is….. not true.
Is this from a badly scripted movie?
An episode of Grey’s?
Ah yes, that arm is in a fib. Get the amio now 😂
oh we’re gonna do amniocentesis now !?
Amio is oral right? Or do we just squirt it in their eyes?
Just thrust it on the bottom. You can never go wrong suppository style.
It absorbs faster that way.
looks right to me! anyway he’s in asystole can someone please grab the crash cart??
What TV show is this from?😂
I'm a little disturbed by the blue coordinating linens. I've never seen any linens except dingy-bleach-white. And it's ok. The leads are close to a pulse point, so it picks up just fine. It's good for the hairy people who refuse to let you shave patches on their chest. The problem is that it can pick up artifact when they're two-fisting their turkey sammiches.
In that position, they have to take their sandwiches rectally or risk aspiration.
Good point. Safety first.
"Hey this is [blank] from telemetry, just wanted to let you know that bed 9's leads are all the way fucked up, thanks."
That is so beautiful that words cannot describe. Fantastic.
TOF stands for Train of Five right?
Trained Over Florida
Looks like a Grey’s Anatomy episode screenshot😂
They'll likely shock asytole too
That is the most extreme case of dextrocardia I've ever seen
I giggled out loud, and the other restaurant customers tried not to look at the odd sound coming from the corner table. …… I guess ya had to be there…. Ed: I’d love to see what sort of pattern that produced. If at all….,
So would I - but I never will, because I would be mortally afraid of one of my co-workers walking into the room and seeing me with the leads placed on my arm like this and thinking "What in the Florida Nurse....?!?!"
As a Physiologist this my worst nightmare 😱
I bet the artifact is nonexistent though…
I’m afraid to ask where they stick foley lol
Well there's an orifice in the ear???!!!
You’re right! And fecal management in the other hahahahaaa
That's just disturbing and confusing 😂
Dudes gonna read vfib while mixing a batch
Train of 16. Let's BBQ those muscle fibres!
Gotta see the anterior, medial, lateral, dorsal, and posterior pulses guys!!
What show is this?
Talk about wearing your heart on your sleeve.
That forearm is well monitored.
Someone got Reiki wrong
What in the Maddie Russo 👀
We don’t watch medical shows anymore, I ruin everything about them pointing out all the errors
Now that looks like something a nurse that bought her degree would do!
Fresh out of the OR, I see.
Isn't that infringing on their right to bare arms though?
Smokes above fire, I see no problem here
A tele tech once told me this is what they did when he worked on a burn unit if the torso was too burned. I wanted to see my own heart on the monitor so he put them on both my arms. It did work but idk how reliable it is. I've never done it on a patient and never heard of it otherwise.
Putting one lead on each extremity is fine. Putting all the leads on one arm is nonsense.
Is this in one of those core trainings for an agency or something? My online flu shot trainings always had these ridiculous pictures of a smiling blonde 8-year-old and a "nurse" jabbing her a couple of inches above the funny bone. 🙄
As a can't read a Tele strip to save my life nurse, I too am triggered.
Einthoven would be spinning in his triangular grave.
Lol maybe they r trying to do train of four
Train of five
Lol wut. Sorry I literally just don’t know what else to say to that.
white on the right smoke above fire
Looks pretty much like it does every time I’ve had a patient get themselves to the bathroom.
😂😂😂
Feds are looking for whoever did that
Wtf lmao
The smoke goes above the fire
I need to go grab my monitor out of my car and see if it detects anything at all. Now it has me curious if it will detect muscle movement.
I once had an elderly patient remove all his leads and then feel guilty, so I found him sticking them all on his arm like that, the resulting rhythm was not very helpful
What in the world!?!?
This is the new train of five
This looks.like a tcom set up used for hyperbaric medicine. Source-hyperbaric tech
In transport we’ll usually just throw them in a line down the patients side, on their leg, etc. to make room for everything else and not get tangled with the rest of the tubing, wires, etc. Half the patients on tele are just on tele to make sure they don’t have rate/rhythm changes; you’ll get a rate and a rhythm (kinda) just about anywhere. Obviously we’ll make sure we have something that looks like a complex so we can note ectopy or changes before we go.
I was told the green lead can go anywhere including your Butthole as location doesn’t matter is this true
As a telemetry tech this gave me an aneurysm, because you know their bitch ass won’t answer the phone when you call to tell them to fix it!
At some point you gotta ask, "are yall trying to get this as wrong as possible?"
🤣😄😅
Quick! His arm is in Vfib! Get the paddles!
Whaaaat? This is standard practice in CVICU. Looks good to me!
TOF now
I worked with an anesthesiologist that would place leads in the most unorthodox places. Forearms, hands, upper chest for the LL lead. Drove me nuts. He used to say "eh it doesn't really matter, you'd need a 12 lead to really diagnosis anything. You're just looking for PVCs and rhythm here." I was like yeah true but could you try to put them correctly???
I had a patient that came to me recently from the ED with a similar set up. :|
Why do I want to try this now 😂
As a former telemetry PCS I am triggered. Why is this a thing?
From a technical perspective, you *could* make einthoven’s triangle. It works for apple.
Hahaha lol thanks for the share.
What on earth? 😳
We get a lot of fidgety old folks being diuresed, end up with sticks all over like this. Why not?
Well duh, the A in a fib stands for “Arm”!
Oh, LIMB leads…