intercostal emg

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intercostal emg

Postby sleep123 » Wed May 12, 2010 2:54 pm

having some trouble finding a resource on where to place. thoughts?
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Postby RedSoxSleepGuy » Wed May 12, 2010 4:09 pm

Always a "guess" and everytime an adventure.....I have had luck with trying to find space between to ribs anterior to a cross section midline of the pt while he/she is sitting....I have better luck with the electrodes being between different ribs as opposed to 2 side by side along the same rib space.....but pt body position in bed will make or break your signals on some pt's.....As far as an actual reference for placement I remember reading an article that mentioned placement a while back but I have no idea where it was from...There are only a handful of labs that I know which utilize this somewhat outdated yet useful signal.
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Postby linuxgeek » Wed May 12, 2010 5:13 pm

We try to use the 6th intercostal space.

http://en.wikipedia.org/wiki/File:Gray411.png

I'm not sure if between ribs or within the same rib is the best place.
Maybe put 3 electrodes and try it out.
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Postby thesleepwhisperer » Thu May 13, 2010 2:03 am

We use 2 intercostal site on each side of the pt. Will normally put one side lateral and the other side medial. And for those pts who have we have a rough time seeing their ribs we have them raise the arm on the side up to help stretch things out some.
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intercostal emg

Postby Rachella » Mon Aug 15, 2011 5:38 am

Hi all,

we are looking at using intercostal emg's in our lab to better assess true central apneas.

What is the best patient test to use for biocals to determine if you have a good setup?

Paradoxical breathing?

Thanks,
Rachel :)
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Postby RPSGT88athome » Mon Aug 15, 2011 5:52 am

Dear Rachel,

That is a most beautiful name!

Anyway, intercostal EMG is not used by most labs as it is problematic at best.

Sincerely

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intercostal emg

Postby Rachella » Mon Aug 15, 2011 6:01 am

Hi RPSGT88,

Thank you for the compliment. Nonetheless, as per our doc's orders we are going to try it out for awhile.

Why is it problematic?

Thanks much,
Rachel :)
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Postby stars » Mon Aug 15, 2011 10:05 am

Filter setting
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Postby linuxgeek » Mon Aug 15, 2011 7:41 pm

It works most of the time for diagnostic studies. If you are thinking centrals while on CPAP, not so much.

You can play around with filters to help see the signals tru the EKG. Raise your LFF up to 35 or even higher if you can't see it. Make sure to sample as fast as possible (ie 512Hz or 1024Hz).

You have breathing so you don't need so much of a specific biocal.

If you wanted to get picky, do a biocal where you have them take in a deep breath & hold for 10 seconds. You'll see activity on the inhale, and maintained activity as they are working at keeping their chest extended.

Do it again, but have them hold their breath after the exhale. You'll see activity at inhale, but nothing after the exhale. At least that's what I would expect.
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Postby Mairi2 » Wed Aug 17, 2011 7:23 pm

Intercostals are an EMG signal, hence you set your filters as you would for any other EMG channel - HF 70 Hz or higher, LF 5-10 Hz, gain as needed to get a good signal. I've used them for years and not found them to be problematic at all.
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Postby LadyCandy » Wed Aug 17, 2011 9:49 pm

Mairi2 wrote:Intercostals are an EMG signal, hence you set your filters as you would for any other EMG channel - HF 70 Hz or higher, LF 5-10 Hz, gain as needed to get a good signal. I've used them for years and not found them to be problematic at all.


I nominate this answer for Binary Contribution of the Year Award, we have one of those, right?
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Postby stars » Wed Aug 17, 2011 10:31 pm

LF at list 30 with my very old Grass machine
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Postby Sleepy in the South » Wed Aug 31, 2011 6:36 pm

intercostal EMG sucks. I'd would rather zoom in to the patients chest/abd to view the movements than use the intercostal EMG.
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Postby linuxgeek » Thu Sep 01, 2011 6:52 am

Then you're not doing it right or your system can't amplify the signal properly.

We get a very good signal almost each & every night for a diagnostic. About 80%.
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Postby poopdeckpappy » Tue Sep 20, 2011 1:24 pm

linuxgeek wrote:Then you're not doing it right or your system can't amplify the signal properly.

We get a very good signal almost each & every night for a diagnostic. About 80%.


I agree. We use it on every pt and typically get a reliable signal. That said we only have one doctor who reallly likes and relies on it. They are also the only doctor who I know for sure reviews the raw data in detail.
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