ECG monitoring is a standard of care set forth by both the ASA and AANA. Itsí application requires all of 15 seconds, costs almost nothing, and has an unquestionable risk/benefit ratio. Iím surprised some providers consider omission of this technology an option.
Routine ECG monitoring of a healthy heart provides no useful information and can be distracting to the point of causing death.
True example, from the days before routine EtCO2 and SpO2 monitoring and when hanging ventilator bellows were common place:
A poorly supervised very 'young' trainee did not recognize a circuit disconnect during an abdominal surgical procdure on a healthy 30 some year old. As he had been taught, the trainee treated bradycardia with atropine, all the time paying more attebtion to the ECG than to anything else. The patient did not survive her hypoxic brain damage.
Such an incident is unlikely to occur today in a well equipt OR, but attending to abberrent ECG tracings in normal patients can still be a dangerous distraction. When anesthesia has to be given "in the field", the least used monitor is the ECG.