Feasibility of a Novel ECG Electrode Placement Method in Newborn Infants

Abstract

Background: International newborn resuscitation guidelines recommend electrocardiogram (ECG) heart rate (HR) monitoring at birth. We evaluated the application time of pre-set ECG electrodes fixed to a polyethene patch allowing adhesive-free attachment to the wet skin of the newborn chest. Objectives: Using a three-electrode pre-set ECG patch configuration, application success was calculated using video analysis and measured at three time points, the time to (1) apply electrodes; (2) detect recognizable QRS complexes after application; and (3) display a HR after application. Method: A prospective observational study in two UK tertiary maternity units was undertaken with 71 newborns including 23 who required resuscitation. Results: The median (IQR) time for ECG patch application was 8 (6-10) seconds, detection of recognizable QRS complexes 8 (2-12) seconds, and time to output HR was 23 (15-37) seconds. Conclusion: Pre-set ECG chest electrodes allow rapid HR information at birth without electrode detachment or compromising skin integrity.