Abstract: A method of using a medical device to take multiple electrocardiograms (ECG) and, if needed, to be converted into an automated external defibrillator (AED). The medical device is configured to take the ECG without deploying any AED electrode pad and, if convenient, to be held by a person so that the person can simply put fingers from both hands on two contacts to take the ECG. Alternatively, the two contacts may be placed on the person's bare skin. The medical device is configured to separate into two components: An AED body and a cartridge. A computer for viewing the ECG may be built into the medical device or may be connected to the medical device. Conversion of the medical device to an AED occurs by removing a first AED electrode pad and a second AED electrode pad from a flattened and stacked arrangement within the cartridge.

Abstract: A wearable medical device for detecting and treating life-threatening arrhythmias includes a wearable vest portion, sensing electrodes, therapy pads, at least one motion sensor, and a cardiac monitor. The cardiac monitor is configured to detect whether the patient is experiencing a treatable arrhythmia using an ECG signal and in response, determine a confidence level for the detected treatable arrhythmia using outputs from the at least one motion sensor. Determining the confidence level includes detecting patient motion prior to the detection of the treatable arrhythmia. Determining the confidence level further includes increasing the confidence level in response to determining that the patient is motionless coinciding with the detection of the treatable arrhythmia, or decreasing the confidence level in response to determining the patient motion after the detection of the treatable arrhythmia. The cardiac monitor is configured to determine whether to deliver a treatment shock based on the confidence level.

Abstract: Devices, systems, and methods for providing patient wear compliance information are provided. For example, a medical device includes a plurality of electrodes configured to be continuously coupled externally to a patient and to monitor electrical activity on the skin of the patient. The system also includes at least one motion sensor configured to generate a motion signal based upon movement of the patient. The system further includes a processor configured to receive an electrical signal based on the monitored electrical activity, record a wear onset event based on the electrical signal and the motion signal, record a wear offset event based on one or more of the electrical signal and the motion signal indicating that the patient is not wearing the medical device, and output a graphical representation including information regarding the patient's wear compliance based on the recorded wear onset event and the recorded wear offset event.

Abstract: A compact AED with integrated CPR coaching has capability to provide coaching on cardiopulmonary resuscitation for a person in cardiac distress. The compact AED is also capable of delivering an electrical charge to the person. The AED is provided in a device body, which comes in two parts: a front-body housing and a user-separable cartridge, the latter holding disposable AED components. The front-body housing is placed on the chest of a person undergoing CPR. Use of the front-body housing enables the compact AED to coach the rescuer on CPR. One or more CPR sensors are part of the front-body housing. A circuit board within the front-body housing receives data from AED and CPR sensors and enables coaching of the rescuer.

Abstract: This document describes systems, methods, and devices for sensing electrical activity in a brain of a mammal Some aspects include a cortical electrode assembly configured, in use, to sense electrical activity at a surface of a brain, the assembly comprising: a ring-shaped substrate; and a plurality of electrical sensors affixed to the ring-shaped substrate, wherein the plurality of electrical sensors are spaced along the ring-shaped substrate so as to form a ring of electrical sensors that substantially encircle an aperture formed by the ring-shaped substrate.

Abstract: In at least one example, a medical device is provided. The medical device includes at least one therapy electrode, at least one acoustic sensor, and at least one processor coupled with the at least one therapy electrode and the at least one acoustic sensor. The at least one processor is configured to deliver at least one pacing pulse via the at least one therapy electrode and to analyze processed acoustic data to determine whether the at least one pacing pulse resulted in capture.

Abstract: Systems for detecting contact between an electrode and a patient's skin using one or more contact detection schemes are provided. An example system can include an electrode assembly comprising at least one electrode configured to be disposed substantially proximate to the patient's skin and configured to at least one of sense an ECG signal of the patient and provide one or more therapeutic pulses to the patient, one or more sensors disposed on the electrode assembly and isolated from the electrode, the sensors configured to measure one or more properties to determine contact between the electrode and the patient's skin, and a controller configured to receive data representing the measured one or more properties and determine, based at least in part on the received data, whether the electrode is in contact with the patient's skin. The sensors can include temperature, impedance, capacitance, optical, and other similar sensors.

Abstract: A neuromodulation adaptor configured to provide an electrical coupling between an otherwise incompatible stimulation lead and neurostimulator device, the neuromodulation adaptor including a proximal portion having a plurality of electrical conductors spaced apart at a first pitch spacing and configured to electrically engage with a corresponding plurality of electrical terminals of a neurostimulator device, and a distal portion including a stimulation lead port assembly, the stimulation lead port assembly including an upper portion and a lower portion configured to house the plurality of conductor elements and a set screw assembly, the plurality of conductor elements and set screw assembly spaced apart at a second pitch spacing and configured to electrically engage with a corresponding plurality of electrical connectors of a stimulation lead.

Abstract: In embodiments, a wearable medical system (WMS) for an ambulatory patient, which can be a wearable cardioverter defibrillator (WCD) system, analyzes the patient's ECG signal to generate a detection outcome. The WMS also has an ambulatory user interface that outputs a human-visible indication. A programming device, such as a PC, a tablet, etc., establishes a communication link with the WMS during an in-person session with the patient. The programming device may include a programming screen that reproduces the human-visible indication in real time. An advantage can be that the person programming the WMS need not strain to look also at the ambulatory user interface at the time they are looking at the programming device. Another advantage can be that the patient will recognize that he or she is better protected, and have their confidence in the WMS increased, and therefore better comply with wearing the WMS as required.

Abstract: A therapeutic electrode component includes a base plate having a first side and a second side having a conductive surface. A repository having an internal volume to releasably retain a conductive fluid is disposed on the first side of the base plate. A rupturable membrane is disposed between the internal volume of the repository and the conductive surface of the base plate. A coupling is disposed on the base plate that is configured to detachably engage a gas charge, whereby the gas charge is detachable from the coupling without causing destruction of the gas charge, to provide a hermetic seal with an outlet of the gas charge, and to provide fluid communication between the internal volume of the repository and the outlet of gas charge when the gas charge is engaged by the coupling. A retainer is configured to detachably secure the gas charge to the base plate.

Abstract: In embodiments, a wearable cardiac defibrillation (WCD) system includes one or more flexible ECG electrodes. The WCD system may have a support structure that is dimensioned to be worn so as to press the electrodes towards the body of the patient. The electrodes may be made from appropriate material so as to flex in order to match a contour of the body of the patient. An advantage over the prior art is that the flexible electrode may make better electrical contact with the patient's skin, and therefore provide a better ECG signal for the WCD system to perform its diagnosis.

Abstract: A method of stimulation of a body of a user for therapeutic effects having the steps of providing a stimulator connected to a garment. The garment is connected to a first predetermined location on a user's body. Positioning a user's body at a predetermined orientation. The next step includes applying stimulation from the stimulator to the first predetermined location on the user's body so that therapeutic effects are experienced at both the first predetermined location and at a second predetermined location of a user's body.

Abstract: A medical device can include a housing, an energy storage module within the housing to store an electrical charge, and a defibrillation port to guide via electrodes the stored electrical charge to a person in need of medical assistance. The medical device can also include a processor to perform a patient signal analysis on an electrocardiogram (ECG) signal corresponding to the person and further determine, based on a result of the patient signal analysis, whether post-shock transcutaneous pacing should be performed on the person.

Abstract: There is provided herein a small form factor portable automatic external defibrillator (AED) having a controller, a charging circuit and a discharge circuit to discharge capacitors using a respective pair of electrode pads. The defibrillator may be separable into two portions at a bisection. Each portion may have a respective electrode pad on corresponding upper surfaces thereof for electrical contact with the chest. A circuit completion wire may complete the electric circuit between the two portions. The defibrillator may comprise a peel-off layer covering both adjacent electrodes. The peel-off layer is adhered to the board at peripheral edges thereof. As such, when pressure is applied to the bisection, the board snaps into the two portions and the peel-off layer simultaneously peels from the portions. In this way, the defibrillator may be deployed quickly with a single break apart manoeuver.

Abstract: A driver assist design analysis system includes a processing system and a database that stores vehicle data, vehicle operational data, vehicle accident data, and environmental data related to the configuration and operation of a plurality of vehicles with driver assist systems or features. The driver assist design analysis system also includes one or more analysis engines that execute on the processing system to determine one or more driving anomalies (e.g., accidents or poor driving operation) based on the vehicle operational data, and that correlate or determine a statistical relationship between the driving anomalies and the operation of the driver assist systems or features.

Abstract: An efficient spontaneous electrochemical current interacting press needle that relates to an acupuncture press needle of traditional Chinese medicine is provided. The efficient spontaneous electrochemical current interacting press needle includes a press needle and a conductive medical tape that fixes the press needle and attaches other press needles. The conductive medical tape includes a conductive adhesive and a gummed cloth. The press needle is adapted to be fixed on the conductive medical tape that fixes the press needle and attaches other press needles. In addition, a connecting conductive medical tape and/or an external conductor connecting point that is capable of attaching two or more press needles is also provided.

Abstract: In embodiments, a wearable cardiac defibrillation (WCD) system includes one or more electrode assemblies. The WCD system may have a support structure that is dimensioned to be worn so as to press the electrode assembly towards the body of the patient. The electrode assembly may have an electrode, and a compressible pillow structure that is compressed when the electrode assembly is pressed towards the body of the patient.

Abstract: The present invention relates to a method and to an apparatus for treating, diagnosing and/or monitoring a patient having a heart, a heart rhythm comprising periodically repeating Q, R, S and T waves of an electrocardiogram and a peripheral vascular system, said electrocardiogram exhibiting a repeating QRSTQ heart rhythm having a Q-T systole duration, a T-Q diastole duration and an R-R path length, said patient having a pulse rate corresponding to said R-R path length, the apparatus comprising a plurality of electrodes attachable externally or internally to the patient for electrically stimulating the patient non-invasively or invasively, in synchronization with the heart rhythm, by trains of pulses applied to the patient, determining, for cycles of the heart rhythm, a time corresponding to the end of an associated T-wave and applying trains of electrical stimulation pulses within a range of ?15% to ?1% corresponding to said R-R path length before the end of the T-wave and having a train duration selected in

Abstract: A heart activity sensor structure includes a flexible substrate being substantially non-conductive, at least two electrodes printed on one side of the flexible substrate and configured to be placed against a skin of a user in order to measure biometric signals related to heart activity, and an electrostatic discharge shield printed on opposite side the flexible textile substrate, compared to the printing of the at least two electrodes, for protecting the at least two electrodes from static electricity.

Abstract: A defibrillation pad for a defibrillator, includes: a pair of electrode pads (10) each including a gel portion (12); lead wires (21, 22); a pair of nonconductive release liners (30A, 30B) each detachably stuck to the corresponding gel portion (12) and each having a through hole (32A, 32B) opposed to the corresponding gel portion; and a connecting member (40) comprising an electric connecting pattern (41) having a predetermined electrical resistance, wherein the pair of gel portions (12), each of which is exposed from the corresponding through hole (32A, 32B), are electrically connected to each other through the electric connecting pattern (41) in a state where each of the pair of release liners (30A, 30B) are stuck to the corresponding gel portion. The connecting member (40) has a cut region (45) by which the pair of gel portions are electrically disconnected to each other when the pair of electrode pads are stuck to a living body.

Abstract: An electrode set is disclosed for a defibrillator, the set including at least two electrodes each having a carrier layer, a conductive contact layer, a conductive gel layer, and a non-conductive electrode cover. In the storage state of the electrode set, the electrode covers lie against each other in a planar relationship at least portion-wise, on the side that is remote from the gel layer of the at least two electrodes. The gel layers of the electrodes are directly in contact with each other in a portion-wise manner by way of two openings in the electrode covers.

Abstract: A defibrillator can include a first electrode and a second electrode where at least one of the electrodes includes more than one independently positionable pad. Such independently positionable pads, in various instances, may allow for alternative positioning of the components of an electrode when defibrillation is carried out during electrophysiological procedures in which placement of conventional electrodes is inadvisable, difficult, or impractical.

Abstract: A system and method for use during the administration of CPR chest compressions and defibrillating shock on a cardiac arrest victim. The system analyzes compression waveforms from a compression depth monitor to determine the source of chest compressions, and enables the delivery of defibrillating shock during a compression cycle if the compression waveforms are characteristic of an automated CPR chest compression device.

Abstract: A device for nerve stimulation therapy that includes at least one current generator, a housing having an outer surface and defining an interior cavity. The current generator includes a power supply and at least one current regulator, the and is configured to supply therapeutic current for a therapy interval. The device includes at least two leads electrically connected to the current generator and coupled to an associated electrode at least one electrode. The electrode has an insertion tip defined at the end of the electrode opposed to the lead such that the wherein the connection between the insertion tip and a central section of the electrode defines an angle that is not equal to 180 degrees.

Abstract: A method and system for improving the effectiveness of cardioversion and defibrillation through the ability to reduce transthoracic impedance. A method and system of decreasing transthoracic impedance that allows standardized pressure to be applied directly over desired defibrillator patches. This system reduces transthoracic impedance by increasing effective pressure on desired patches through use of a manual depressor device which incorporates a deformable patient body interface and mechanical and or electronic mechanisms to provide qualitative and or quantitative feedback on the force being applied to said patches. By depressing the device over desired external adhesive electrode patches until an audio and or visual signal indicates sufficient applied pressure, increased patch to skin contact is achieved to decrease the effective transthoracic impedance of a patient upon delivery of a defibrillation shock.

Abstract: An external defibrillator can include a tray and a plurality of electrode pads located within the tray. At least one of the plurality of electrode pads can include an electrode contact structure that can be applied to a patient, a wire electrically coupling the electrode contact structure to the external defibrillator, and a release liner adhered to the electrode contact structure of the electrode pad. A portion of the release liner can be affixed to a portion of the tray such that, when an end of the electrode pad is pulled, the electrode pad is removed from the release liner, the electrode pad is removed from the tray, and the release liner remains affixed to the tray.

Abstract: Release film furnished on at least one side with a release layer (c) based on at least one cured polysiloxane, the film comprising at least one inner layer (a) based on at least one thermoplastic polymer, equipped with at least one at least oligomeric compound having a long-term antistatic effect, as antistat, and at least one layer (b) based on at least one thermoplastic polymer; method for producing the release film, and the use thereof as a detachable protective or masking film.

Abstract: A disposable electrode includes: an electrode pad; and a connector, connecting the electrode pad to a defibrillator, and including an information holder that can be provided with a transmissive opening or a light reflective member, the information holder holding information about at least an expiration date, depending on presence or absence of the transmissive opening or the light reflective member, the information holder allowing the information to be notified from the defibrillator when the connector is connected to the defibrillator.

Abstract: An apparatus includes a housing including a first side and a second side; a chest compression sensor coupled with the second side of the housing; at least one compartment partially formed by one of the first side and the second side of the housing; and at least one removable defibrillator electrode pad contained in the at least one compartment partially formed by one of the first side and the second side of the housing.

Abstract: An electrode and electrodes for a biomedical system is provided. The electrode includes a backing pad with top and bottom surfaces. A conductive element is attached to the bottom surface of the backing pad, and a conductive gel layer covers at least part of the bottom surface of the conductive element. A bonding layer is disposed at least in part between the conductive element and the conductive gel layer. The electrode can include a leadwire with a stripped end length, and at least a portion of the stripped end length is disposed between the conductive element and at least one of the bonding layer and the conductive gel layer.

Abstract: An electrode includes an adhesive backing layer including a front surface configured to adhere to skin of a subject and a rear surface, a plate including a rear surface coupled to the front surface of the adhesive backing layer and a front surface comprising a conductive material layer, a conductive hydrogel including a rear surface coupled to a front surface of the conductive material layer, and including a front surface configured to make electrical contact with the skin of the subject, a dielectric film border formed on the front surface of the conductive material layer and defining an area on the front surface of the conductive material layer, and an electrical lead in electrical contact with the area.

Abstract: Testing a thermocouple-based RF ablation system is carried out by connecting a temperature simulator to an ablator module. The ablator module is operative to vary a radiofrequency power output thereof in a predefined manner in response to predefined variations in a temperature signal from the simulator. The method is further carried out by delivering RF power from the ablator module to the temperature simulator, and while delivering RF power, performing the steps of: communicating temperature signals from the temperature simulator to the ablator module, varying the communicated temperature signals, and verifying that a variation in the power output of the ablator module in response to varying the temperature signals conforms to the predefined manner.

Abstract: An electrode assembly includes a first surface to be placed adjacent a person's skin and a second surface including a plurality of reservoirs of conductive gel. The plurality of reservoirs of conductive gel are disposed on sections of the electrode assembly that are at least partially physically separated and may move at least partially independently of one another to conform to contours of a body of a patient. The electrode assembly is configured to dispense an amount of the electrically conductive gel onto the first surface in response to an activation signal and to provide for a defibrillating shock to be applied to the patient through the amount of the electrically conductive gel.

Abstract: Non-invasive electrical nerve stimulation devices and magnetic stimulation devices are disclosed, along with methods of treating medical disorders using energy that is delivered noninvasively by such devices. The disorders comprise migraine and other primary headaches such as cluster headaches, including sinus symptoms that resemble an immune-mediated response (“sinus” headaches), irrespective of whether those symptoms arise from an allergy that is co-morbid with the headache. The disclosed methods may also be used to treat other disorders that may be co-morbid with migraine headaches, such as anxiety disorders. In preferred embodiments of the disclosed methods, one or both of the patient's vagus nerves are stimulated non-invasively. In other embodiments, parts of the sympathetic nervous system and/or the adrenal glands are stimulated.

Abstract: The present invention relates to a system and method for using the system. In particular, the present invention relates to an application, executable by a processing device to assess the organization of a non-nutritive suck (NNS) pattern of a patient and to entrain an organized NNS pattern in the patient. The software system receives data from an orofacial stimulation appliance to assess the patient's natural NNS pattern and generates a precise therapeutic pulse profile that is actuated as a tactile stimulus via the orofacial stimulation appliance to entrain an organized NNS pattern.

Abstract: An electrode assembly that includes an electrically conductive layer, a first impedance reduction system, and a second impedance reduction system. The electrically conductive layer forms an electrode portion of the electrode assembly and a first surface to be placed adjacent a person's skin. The first impedance reduction system is configured to dispense a first amount of an electrically conductive gel onto the first surface of the electrically conductive layer in response to a first activation signal. The second impedance reduction system is configured to dispense a second amount of the electrically conductive gel onto the first surface of the electrically conductive layer in response to a second activation signal.

Abstract: Non-invasive electrical nerve stimulation devices and magnetic stimulation devices are disclosed, along with methods of treating medical disorders using energy that is delivered noninvasively by such devices. The disorders comprise migraine and other primary headaches such as cluster headaches, including sinus symptoms that resemble an immune-mediated response (“sinus” headaches), irrespective of whether those symptoms arise from an allergy that is co-morbid with the headache. The disclosed methods may also be used to treat other disorders that may be co-morbid with migraine headaches, such as anxiety disorders. In preferred embodiments of the disclosed methods, one or both of the patient's vagus nerves are stimulated non-invasively. In other embodiments, parts of the sympathetic nervous system and/or the adrenal glands are stimulated.

Abstract: An electrode for use with an external defibrillator for a patient includes a first combination circuit including a circuit node electrically coupled to an adapter for coupling to the defibrillator. The circuit node is further coupled to a monitoring node defined by a monitoring segment of a first pad of the electrode and to a therapy node defined by a therapy segment of the first pad of the electrode. The therapy segment is electrically insulated from the monitoring segment. The first combination circuit further includes a capacitor coupled between the circuit node and the therapy node. The electrode of this disclosure hence provides additional solutions for reducing ECG artifact during the operation of the electrode.

Abstract: A wearable therapeutic device that includes a garment configured to contain an external defibrillator. The garment is configured to house at least one of an alarm module and a monitor and to house a first therapy electrode and a second therapy electrode. The garment is also configured to releasably receive a receptacle that contains a conductive fluid proximate to at least one of the first therapy electrode and the second therapy electrode, and to electrically couple the receptacle with the garment.

Abstract: Defibrillator electrodes are sealed to the inside of a rigid enclosure. The enclosure is hinged to open and expose the electrodes for deployment. The electrode gel is sealed against moisture loss between the moisture impervious electrode backing and the inner surface of the enclosure. The enclosure may further include an electrical circuit for electrode self-testing, the circuit being broken when the enclosure is opened.

Abstract: Methods and systems of applying treatment to a subject experiencing cardiac distress. In one example, a therapy electrode package includes a first therapy electrode disposed within the package, a second therapy electrode disposed within the package, and a CPR assistance device disposed within the package. The first therapy electrode, the second therapy electrode, and the CPR assistance device are arranged within the therapy electrode package such that when the electrode package is in an open configuration, the relative positions of the first therapy electrode, the second therapy electrode, and the CPR assistance device approximate the relative positions at to which the first therapy electrode, the second therapy electrode, and the CPR assistance device should be placed on a subject for treatment of the subject.

Abstract: Methods and systems of applying treatment to a subject experiencing cardiac distress. In one example, there is provided a defibrillation electrode. The defibrillation electrode includes a non-volatile memory element and a circuit configured to store an indication of a level of energy delivered to a subject during the application of a defibrillation shock to the subject in the non-volatile memory element.

Abstract: A defibrillation electrode pad includes an electrode section and a CPR administration section. The electrode section and the CPR administration section are positioned in the defibrillation electrode pad relative to each other such that the CPR administration section is located above a sternum of an adult subject and the electrode section is located in a position appropriate for the administration of a defibrillation shock to the adult subject when the defibrillation electrode pad is oriented in a first orientation and such that the CPR administration section is located above a sternum of a pediatric subject and the electrode section is located in a position appropriate for the administration of a defibrillation shock to the pediatric subject when the defibrillation electrode pad is oriented in a second orientation different from the first orientation.

Abstract: An electrode package for use with a defibrillator, the electrode package comprising an outer shell providing a vapor barrier between an interior space inside the outer shell and an exterior environment, a breakaway connection element positioned at the perimeter of the outer shell, one or more defibrillation electrodes positioned in the interior space inside the outer shell, a further electrical element positioned in the interior space inside the outer shell, electrical paths extending from the further electrical element through the breakaway element to the exterior environment, wherein the breakaway element and electrical paths are configured so that, when the outer shell is opened and the defibrillation electrodes are removed, the electrical paths are disconnected within the breakaway element.

Abstract: A bioelectrode comprising: a skin-side, electrically conducting adhesive layer and a flexible electrical connecting cable which in an electrically insulating cable sheath includes at least one electrical conductor, wherein fitted at the electrode-side end of the connecting cable is a preassembled electrical conducting element electrically connected to the electrical conductor of the connecting cable, wherein the preassembled electrical conducting element is electrically connected in the installed condition to the skin-side, electrically conducting adhesive layer.

Abstract: Devices, systems and methods are disclosed for treating a variety of diseases and disorders that are primarily or at least partially driven by an imbalance in neurotransmitters in the brain, such as asthma, COPD, depression, anxiety, epilepsy, fibromyalgia, and the like. The invention involves the use of an energy source comprising magnetic and/or electrical energy that is transmitted non-invasively to, or in close proximity to, a selected nerve to temporarily stimulate, block and/or modulate the signals in the selected nerve such that neural pathways are activated to release inhibitory neurotransmitters in the patient's brain.

Abstract: Devices, systems and methods are disclosed for treating bronchial constriction related to asthma, anaphylaxis, chronic obstructive pulmonary disease (COPD), exercise-induced bronchospasm and post-operative bronchospasm. The treatment comprises transmitting impulses of energy non-invasively to selected nerve fibers that activate neural pathways to reduce the release of acetycholine from airway-related vagal preganglionic neurons within the brain of the patient. The transmitted energy impulses, comprising magnetic and/or electrical energy, stimulate the selected nerve fibers to produce the bronchodilation.

Abstract: A medical electrode includes an electrode member having a top face and a bottom face, an electrical conductor having an unfanned, unsheathed end portion for conducting energy between the electrode member and a medical device, and a patient contacting layer secured to at least a portion of the bottom face of the electrode member. An energy blocking layer is disposed between the unfanned conductor end portion and the electrode member to prevent immediate transfer of energy to the electrode member. A current distributing structure is described to conduct and distribute energy to the electrode member.

Abstract: An improved defibrillator electrode (100) has two separate peel tabs (114, 116). At least one of the peel tabs is located on the same edge of the electrode backing as that of the electrode wire. The disposition of the peel tabs improves the ability of the rescuer to apply the electrodes to a patient after the electrodes are removed from the release liner (110). In addition, the peel tab reduces the risk of damage to the electrode during removal from the release liner.

Abstract: Medical electrodes in embodiments of the teachings may include one or more of the following features: (a) a metallic conductor, (b) the metallic conductor sandwiched between a first dielectric layer adjacent a top surface of the metallic conductor and a second dielectric layer located on a bottom surface of the metallic conductor, (c) a conducive gel coating on at least one of the first and second dielectric layers, (e) the metallic conductor, the dielectric layers, and the conductive gel being wrapped to form a multi-tiered electrode having a plurality of conductive surfaces, (f) an adhesive adhering the metallic conductor with the dielectric layers, (g) a tab connector to provide a connection to electrical monitoring equipment and (h) an attachment connector to provide electrical connection with a patient.