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A 12-Lead EKG is a measure of the electrical activity of the heart. The steps that follow, will aid you in placing the electrodes on the subject in the specified areas. Please note that the names of each of the leads are standard.
Important Terminology: Intercostal Space: The space between two ribs on the same side of the body.
Part 1 of 4: Preparing for the Procedure
Part 2 of 4: Marking the Spots Using a Marker
1Mark the left arm lead. Stand, facing your subject. Ask the subject raise their left arm, and place it on your right shoulder. There should be a small indention in the skin, right next to the shoulder joint and under the collarbone. Using a dry erase marker, place a dot in this indention. This will be the location of the Left Arm Lead.
- Mark the right arm lead. Use the the same process, with the subject’s right arm.
2Mark the leg leads. Locate the subject’s two hip bones. Using the marker, place a dot just above the top of the hip bone, at the same level as the navel. Complete this on both sides of the navel. These two dots will be the Leg Leads.
3Mark the first chest lead. Locate the clavicle on the subject’s right side. Place two fingers, just below the clavicle, and just above the top rib in the first intercostal space.
4Mark the second chest lead. Make your way down the subject’s chest counting intercostal spaces. When you get to the fourth space, STOP. (you should be about to the bottom of the sternum)
- Note for female patients, the placement should be under the breast.
Part 3 of 4: Marking V1 to V6
1Mark lead V1. Using your marker, place a dot in the fourth intercostal space, where you stopped, just to the side of the sternum.
2Mark lead V2. At the same level as V1, on the opposite side of the sternum, place another dot in the fourth intercostal space of the subject’s left side.
3Mark leads V3 and V4. Remaining on the left side of the chest, count down one more intercostal space. Place your left index finger here.
- Locate the subject’s left clavicle, and approximate the middle of it.
- Move your left index finger, which is in the intercostal space, so that it is in line with the middle of the subject’s left clavicle. Using your marker, place a dot at this site. This is lead V4.
- Locate the two dots on the left side of the chest (leads V2 and V4). At a diagonal line, place a dot in the middle of these two dots. If this dot is on top of a rib, move the dot down, just below it. This is Lead V3.
4Mark leads V5 and V6. Have the subject stand, so that their left side is facing you. Have them raise, their left arm straight out, and above their head.
- Locate the mid line of the arm pit. Staying on this mid line, place a dot at the same level as lead V4, on this mid line. This is Lead V6.
- Locate the dots for Leads V4 and V6. Place one more dot, at the same level as these two, in the middle of them. This is Lead V5.
Part 4 of 4: Placing the Electrodes
1Clean the spots. Using a mildly abrasive gel that will probably be provided, place a small amount on each of the ten dots that you just made.
2Remove the gel. Using a damp towel, remove the gel from each of the ten sites. Towel dry each of the sites afterward.
3Place an electrode at each of the ten, now clean, areas.
4Hook the electrodes to the computer. Depending on the computer setup, hook each of the electrodes to the computer via the provided lead wires. Make sure to place the right lead wire to the specific area that it is designated to.
- A diagram to aid in electrode placement can usually be found on the packaging.
- Many people wonder why a 12 Lead EKG is put only in 10 places. It is because the procedure gives 12 pictures from the procedure.
- When removing the mildly abrasive gel, the area on the skin might appear slightly pink in color.
- Correct placement of the leads is very important. A mistake can cause issues such as false diagnosis of infarction.
Categories: Medication and Medical Equipment
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