Thursday, February 19, 2009

Mnemonic for EKG Lead Placement

Today in anesthesiology, I helped out with the setup for a patient undergoing a whipple procedure for pancreatic cancer. the surgery lasted all day (roughly 8-5pm) and was pretty complex, plus there was a really amazing resected specimen (part of the pancreas, duodenum, with a huge yellow globular tumor). slices of the tumor were sent to a tissue bank and the rest was sent to pathology. but i digress.

after the whipple man was well underway, i tagged along and observed four IVF procedures in which eggs were being harvested from hormonally primed women. then i bounced back to the OR to help set up 2 more patients for a D&C and TVH.

slowly, i am starting to learn how to think like an anesthesiologist. also, i am starting to figure out the myriad of procedures that have to be done in a hurry. during the IVF procedures, it was amazing to think about how marvelous noninvasive inventions like the EKG, pulse oximeter, and even an O2 nasal cannula with CO2 monitors can improve patient safety without harming the patient at all. anesthesia itself has always amazed can a person go to sleep, have their abdomen exposed, have a tumor resected with their plumbing all reconnected...and wake up with minimal pain (thanks to an epidural), alive and kicking? the miracle of anesthesia. amen.

oh wait, i forgot about the title of this post.

so the EKG leads in the OR have 5 leads. on the left side, the resident taught me the mnemonic "smoke over fire," meaning that the red lead is below the black lead (and the brown lead is in between, pretend it's wood if it makes you feel better). on the right side, the green lead is below the white lead, so I have decided to make my own mnemonic: "snow falling on cedars." okay, okay, I know that the biggest criticism of my MSP lessons (based on comments in Evalue) was that I was heavy on the mnemonics, but there are oodles of things in medicine that don't have any intrinsic why the white lead has to be white...and why i am spending time typing this ramble when I should be sleeping....zzzz...


Christian Brown said...

hey i couldn't find a contact address, but i was wondering if you have a larger version of your brainstem handout .. it's really useful
(i'm a second year medical student at Oxford in the UK)

many thanks!!
Christian (

LK said...

so is the brown one under the white one or the green one? btw thanks for the post. i think it's pretty interesting