The Electrocardiogram (ECG) is our bread and butter! we can not do our job if we couldn’t interpret an ECG, whether this is the standard 12 lead, or a 3/5 lead on monitoring. As part of this adventure I will also look specifically at different rhythms, as a brief introduction/education in interpretation!
An ECG picks up the electrical activity in the heart, and shows us this as a visual tracing on paper.
How do we perform the standard 12 lead ECG?
Well this involves stickers and lots of them! 10 to be exact – now I hear you cry, how does 10 stickers equal 12 leads – I do not wish to go into the physics of this, so for now lets just accept this as truth! If you want to know see here
Now as I mentioned before, as a profession we are incredibly anal about our ECG electrode positions. This is for a very good reason, standardising these positions allows us to compare ECGs where required. However more seriously, miss placement can lead to miss diagnosis. Placing an electrode too high or low can alter the ECG significantly, mimicking certain pathologies.
So what are these positions, and yes ladies we do need your bra off, we can’t get them right otherwise!
V1 – 4th Intercostal space – right sternal edge
V2 – 4th Intercostal space – left sternal edge
V3 – Half way between V2 and V4
V4 – 5th Intercostal space mid clavicular line
V5 – 5th Intercostal space anterior axillary line
V6 – 5th Intercostal space mid axillary line
Right arm and left arm – proximal to the wrist
Right leg and left leg – Proximal to the ankle
Depending on the hospital they may do some form of skin preparation, this can be an alcohol wipe or some gentle scratching, some won’t do any.
From your point of view, the best thing you can do for us is to simply relax! relax all those muscles. This test picks up the electrical activity in the heart, but can also pick up the electrical activity in your muscles, so the more you tense the longer the test will take, and please don’t put lotion on before your ECG 😉