12 Lead ECG Instructor Video Skills Check Off

12 Lead ECG Instructor Video Skills Check Off

Supplies needed:

• ECG unit

• Recording paper

• Electrodes

• Alcohol sponges

• 4 x 4 gauze pads

• Razor

• Plastic bag for used supplies

1. Perform your beginning procedure actions.

2. If necessary, shave excess hair. Shaving is usually not necessary, but excess hair will interfere with electrode adherence to the skin. Remove skin oil with the alcohol sponges. Allow to dry. Rub the area of electrode placement briskly with the 4 x 4 sponge to abrade the area slightly. The area will appear slightly red. This removes dead skin cells, promoting better contact.

3. Position the limb electrodes. Connect the lead wires. For easy visual identification, each is color-coded and lettered. Right arm lead wire is white, and labeled RA Right leg lead wire is green, and labeled RL Left leg lead wire is red, and labeled LL Left arm lead wire is black, and labeled LA.

4. Apply electrodes to the chest. Avoid positioning the electrodes directly on bone, which will cause interference. In the female, position the electrodes below the breast tissue. If the breasts are large, you may have to position the breast laterally.

a. Palpate the clavicle (collarbone), which is considered the first rib. Continue palpating downward to the fourth rib. Move down slightly to the space between the fourth and fifth ribs. Position lead V1 in the fourth intercostal space, to the right of the sternum.

b. Position lead V2 directly opposite V1 at the left sternal border.

c. Next, position lead V4 in the fifth intercostal space at the midclavicular line.

d. Position lead V3 halfway between V2 and V4.

e. Position leads V5 and V6 laterally to V4. Position V5 in the anterior axillary line. V6 is positioned in the midaxillary line.

5. After applying the electrodes, enter information required by the facility into the ECG cart. Applying electrodes first allows the electrode gel to contact and penetrate the skin surface.

6. Attach the correct lead wire to each electrode.

Please make sure to instruct while doing the demonstration!