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This is the case with ECG machines, where the 12 lead ECG is sometimes not available. In these instances, a MCL1 and MCL6 can be used instead. These leads can also function in much the same way as the 12 lead ECG. A discussion on the use and application of the MCL1 and MCL6 for the purposes of cardiac monitoring is indicated below. The MCL1 and the MCL6 is useful for cardiac monitoring within the prehospital setting in cases when the 12 lead ECG is not available. The placement of the limb leads can be changed to carry out similar functions of the precordial leads (V1 to V6) (Sanders, 2011).
Such leads are considered modified chest leads. These modified chest leads can be used in monitoring cardiac responses within the prehospital setting in instances where the 12 lead ECG is not available. Such leads may be able to differentiate between supraventricular tachycardia and ventricular tachycardia and they also help indicate conduction blocks within the bundle branches . When MCL 1 is evaluated, the positive electrode is indicated in the V1 position, found in the fourth intercostal space, right of the sternum The negative electrode is placed anteriorly under the lateral end of the left clavicle.
Electrical activity emanating from the MCL 6 is seen through the placement of the positive electrode on the left midaxillary line within the 5th intercostal space. . The P waves are detected easily during the monitoring of the right-sided lead (Grayson, 2010). Ischemic incidents can also be detected easily. The MCL1 also stands for Marriott’s Chest Lead as well as Modified Central Lead. For MCL1, as was mentioned previously, the positive electrode is found in the 4th intercostal space, and the negative electrode is placed on the left arm (Narang Medical Limited, n.d). In locating the 4th intercostal space, one can palpate the manubrium seeking the bump which connects to the sternum; this runs even with the 2nd rib, and is followed by the 2nd intercostal space.
In using a three lead EKG machine, four electrodes must be placed on the patient, and these go to the right arm, the left arm, the left leg, and the 4th intercostal space (Beebe and Myers, 2009). A 6 second strip of leads I, II, III, can be run with the left leg wire applied to the chest lead, with the monitor placed on lead III. This will provide MCL1. In using the three lead EKG machine, with the monitor switch set on the typical lead II monitoring lead, the arm leads can be reversed with the white lead on the left and the black on the right; the red is placed on the 4th intercostal space at the right sternal area (Narang Medical Limited, n.d). In monitoring patients, it is important to monitor them using a lead which provides the most data about gaps in the rhythm (Beebe and Myers, 2010).
This would mean that either the V1 or the MCL1, not lead II can be used. Advantages in using the MCLI, not the Lead II include the fact that it is easy to distinguish between the left ventricular ectopy and the right ventricular ectopy in most instances (Narang Medical Limited, n.d). The modified
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