Introduction
- Wash hands; Introduce self; Patient’s name, DOB and wrist band; Explain procedure and obtain consent
- Chaperone if female patient
- Lie patient flat, expose chest
- If needed, shave skin or wipe with alcohol wipe
Apply leads
Apply limb leads
Red | Right arm, just proximal to wrist |
Yellow | Left arm, just proximal to wrist |
Green | Left leg, just proximal to ankle |
Black | Right leg, just proximal to ankle |
Apply chest leads
V1 | 4th intercostal space, right sternal edge |
V2 | 4th intercostal space, left sternal edge |
V3 | Equidistant between V2 and V4 |
V4 | 5th intercostal space, midclavicular line |
V5 | Anterior axillary line in same horizontal plane as V4 |
V6 | Midaxillary line in same horizontal plane as V4 and V5 |
NB: if female, electrodes should go under the breast (not on top).
Using the machine
- Calibrate ECG machine to: speed = 25mm/s; voltage = 10mm/mV
- Enter the patient details (name, DOB, hospital number, sex etc.) and ECG details (date, time)
- When ready, ask the patient to stay as still as possible and not speak
- Press the button to begin the trace (‘auto’)
- Check the printed trace to ensure:
- Calibration is correct (paper speed 25mm/s; 1mV calibration deflection is 2 large squares in height)
To complete
- Remove the leads and stickers
- Thank patient and restore clothing
- Label the ECG if the patient’s details are not printed
- Document procedure in patient’s notes
Learn how to interpret the results too…
ECG result interpretation is covered here!