Failure Analysis Of ECG Electrode In Neonatal Multi-parameter Monitor

In 2021,China’s birth rate and natural population growth rate reached a new low,so the children and newborns draw great attention gradually on the national level.In clinical practice,the incidence of MARSI caused by Electrocardiograph(ECG)electrode of neonatal multi-parameter monitor is 11.4 %,which is the most common type of skin injury for hospitalized newborns.The falling of ECG electrode occurs more frequently.Both the falling of ECG electrode and MARSI will increase the workload of clinical care,affect the clinical diagnosis and treatment work,and then affect the rehabilitation of children,prolong the hospitalization time of children,increase the medical expenses and times,reduce satisfaction of patients and affect doctor-patient relationship.In view of the above problems,this paper analyzes the failure reasons of ECG electrode of neonatal multi-parameter monitor in clinical use by means of material engineering.The main research contents and conclusions are as follows:(1)The neonatal professional department of a Third-class hospital was selected to investigate the clinical use of ECG electrode of neonatal multi-parameter monitor by questionnaire survey,clinical application survey and small sample cost use failure survey experiment.It is found that in daily work,clinical medical staff will actively pay attention to the ECG electrode of multi-parameter monitor and understand MARSI,but the utilization rate of skin protective barrier is only 13.5%,and the time of actively replacing ECG electrode is1-2 days;clinical medical staff are troubled by the frequent falling off of ECG electrode.They are also distressed by MARSI caused by ECG electrode.The utilization rate of ECG electrode for hospitalized newborns is about 98%,and more than 80% of hospitalized newborns will live in the infant incubator.Although the use of skin isolation and protecting barriers is relatively small at this stage,with the publicity of skin management guidelines going deep into the clinic,the use rate of skin isolation and protection barriers will rise sharply in the foreseeable future.Through the failure experiment of small sample size,it is found that the manufacturer of disposable ECG electrode used by newborns takes into account the particularity and comfort of neonatal skin in the design,which weakens the stickiness of ECG electrode.Although it is more convenient to remove,it is relatively easier to fall off.In the clinical use of multi-parameter monitor,the failure of central electrical monitoring occurs frequently.The falling off of ECG electrode is the main reason,which needs urgent attention.(2)Domestic ECG electrodes in clinical use were selected and collected in their use departments,and then the performance of ECG electrodes was tested according to relevant standards.Through the experiments on the falling off quantity,ECG acquisition ability and electrical performance of domestic ECG electrode after different continuous use time,and compared with the initial value and standard limit.It was found that the electrode patch attached to the left lower abdomen lasted the longest period of stability,and the ECG electrode patch on the left and right sides of the chest had the greatest falling off probability;Within 12 h,81 % of domestic ECG electrodes fell off.The performance of degrading domestic ECG electrodes used for 12-24 h began to rise sharply,and the degrading performance was serious after 48 h,so they were not suitable for continued use.Through the study on the varying performance of exposed and pollution-free domestic ECG electrodes with the increase of placement time in the infant incubator environment(temperature 32 ℃,humidity 55 %),it is found that the warm environment has little effect on the domestic ECG electrode.It is suggested that the falling of domestic ECG electrode within 12 h can be fixed back by other adhesive methods to continue ECG monitoring with the no polluting condition of.After using the skin isolation and protection barrier,the electrical performance of domestic ECG electrode has been significantly attenuated,which is still within the standard limit,and the ECG signal acquisition ability is basically not affected.It is recommended to be popularized in clinic.(3)The imported ECG electrodes in clinical use were selected for clinical use in neonatal internal medicine with relatively mild neonatal condition,and then the experimental test was carried out according to the experimental method of domestic ECG electrode.It was found that the imported ECG electrode was also the ECG electrode attached to the left lower abdomen,and the continuous use time was the longest,which was longer than that of domestic ECG electrode.There is also a high probability that the ECG electrodes on the left and right sides of the chest fall off.77 % of the experimental electrodes fell off within 8 h,and all the ECG electrodes on the left and right sides of the chest fell off within 24 h.The overall performance of the imported ECG electrode is relatively stable.Only after 48 h,the 10 Hz AC impedance parameter increased significantly,but it is also lower than the standard limit.The main failure reason within 72 h was the disappearance of viscosity.It is also found that the imported ECG electrode within 72 h can be fixed back by other adhesive methods to continue ECG monitoring without pollution after falling off.It is suggested that clinical nurses should observe the adhesion of imported ECG electrodes at least twice within 8h and replaced new ECG electrodes within 72 h.Through the experiment,it is found that the imported ECG electrode can also be recommended to popularize the use of skin isolation and protection barrier in clinic.