Lead Placement

Electrodes/LeadsPick-up electrical activity

• Disposable?- Throw away with

each pt. - Gel- improves

conduction of impulses

* Must use one or other can’t combine

• reusable?- Must be cleaned- Clean with mild soap,

no abrasive cleaner- Pt. contamination

Consult

• Pt. name• ID• Dr. • Consulting department• Procedure• Diagnosis• List of heart meds• Pt. history

Position

• Pt- comfortable, on back, pillows, relaxed

Relaxed= better EKG

• PCT- Left side

• Machine- left side, cord away from bed

Problems

• Oily skin

• Diaphoretic

• Hairy chest/legs/arms

• Tremors/shaking

• Large breasted women

• Amputated limbs

Lead placement

Standard leads- 1-3- records voltage

Augmented leads: avr, avl, avf- records in voltage in different views of heart

Chest (percordial) leads – V1-V6

Standard Leads

Augmented Leads

Precordial Leads

Lead placement

V1- 4th ICS R sternum

V2- 4th ICS L sternum

V3- b/t V2 and V4

V4- 5th ICS L mid-clavicular

V5- level with V4 at anterior axillary

V6- level with V4 mid axillary

Cable placement

• Point toward center of body

• Keep flat and do not loop over bed or pt.