As a nursing student and new nurse, I had trouble remembering where to place electrodes (RA, RL, LA, LL, V1, V2, V3, V4, V5 & V6) on a patient for a 12 lead EKG. However, after much practice I have finally got it. In this article, I want to prepare you for how to place electrode stickers on a patient for a 12 lead ECG (EKG) so you will be prepared in clinicals and as a new nurse. In addition, I’m going to demonstrate how to place electrodes for a 12 lead ECG in a video tutorial.
Índice
- Video Tutorial on 12 Lead EKG Placement
- Supplies you will need
- Prep the Skin
- EKG 12 Lead Placement
- Location of EKG 12 Lead Placement
- Where should a medical assistant place the electrode?
- What is a rhythm strip?
- Can a medical assistant read an EKG?
- How to calculate heart rate from rhythm strip?
- How to calculate 6 second interval on EKG strip?
In the hospital and clinic setting, you will be expected to obtain a 12 lead EKG on a patient. This is done at the bedside with a machine. The machine analyzes various angles of the heart and interprets the patient’s heart rhythm and rate.
You can tell so much about a patient’s cardiac status from an EKG. For instance, if a patient is having chest pain, you can look at an EKG and tell if they are having an active myocardial infraction (in most patients). In addition, you can tell if they are in any type of abnormal rhythm such as atrial fibrillation or atrial flutter etc.
Video Tutorial on 12 Lead EKG Placement
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Supplies you will need
- 10 Electrode Stickers
- 1 strip of abrasive tape (this roughs up the epidermis so you can get a good connection)
- Alcohol prep pads (cleans the skin’s oils so you can get a good connection)
- Hair Trimmers (used to remove excessive hair on men)
Prep the Skin
First clean the electrode site placements with alcohol prep to remove oils and dirt from the skin. Then gently “rough up” the area with the abrasive tape so the electrodes will stick properly.
Tip: Always make sure your electrodes are not expired or the gel is dry because this can affect the connection. In addition, never place an electrode over an implanted device in the skin.
EKG 12 Lead Placement
There are a total of 10 leads (4 limb leads & 6 chest/precordial leads) and they are the following:
- Right arm (RA)
- Left arm (LA
- Right leg (RL)
- Left leg (LL)
- V1
- V2
- V3
- V4
- V5
- V6
Location of EKG 12 Lead Placement
- RA: Placed on the right arm or right below the right clavicle
- LA: Placed on the left arm or right below the left clavicle
- RL: Placed on the right leg or upper right quadrant
- LL: Placed on the left leg or upper left quadrant
- V1: Placed in the fourth intercostal space to the right of the sternum
- V2: Placed in the fourth intercostal space to the left of the sternum
- V3: Placed directly between leads V2 and V4
- V4: Placed in the fifth intercostal space in the mid-clavicular line
- V5: Placed level with V4 at the left anterior mid-axillary line
- V6: Placed level with V5 at the mid-axillary line
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To assess the cardiac rhythm accurately, a prolonged recording from one lead is used to provide a rhythm strip. Lead II, which usually gives a good view of the P wave, is most commonly used to record the rhythm strip.
Where should a medical assistant place the electrode?
Where should a medical assistant place the electrode for lead V5? On the left anterior auxiliary line horizontal to V4.
In which one of the following locations should an EKG technician place the electrode for lead V5?
Proper 12-Lead ECG Placement
| V4 | 5th Intercostal space at the midclavicular line |
| V5 | Anterior axillary line at the same level as V4 |
| V6 | Midaxillary line at the same level as V4 and V5 |
| RL | Anywhere above the right ankle and below the torso |
Why is it important for a medical assistant to recognize abnormal heart rhythms?
A medical assistant may be responsible for setting up and performing electrocardiogram (EKG or ECG) testing. It is also important to be able to recognize heart rhythms which may indicate cardiac problems requiring immediate intervention by the doctor.
What is a rhythm strip?
Electrocardiogram (EKG)/Rhythm Strip This test records the electrical activity of the heart. Changes can indicate such things as heart damage, decreased blood flow, and irritability of the heart muscle. For this test you will be lying on your back while electrodes are applied to your chest, arms and legs.
Can a medical assistant read an EKG?
Medical assistants with correct training can do EKGs — they are called EKG technicians. EKG training for a medical assistant is absolutely necessary if they want to be able to reliably conduct an EKG test.
Which method do we use to calculate irregular rhythm?
When you are dealing with an irregular heart rhythm, you can use the six-second strip method. The first step in calculating heart rate with the six-second strip method is to first ensure you are dealing with a 6-second EKG strip. A 6-second strip is made up of 30 big boxes.
How do you do the 1500 method?
To use the 1500 method count the number of small squares between two consecutive R waves and divide 1500 by that number. A heart rate less than 60 beats per minute is called bradycardia.
How to calculate heart rate from rhythm strip?
Analyzing a Rhythm Strip Heart Rate –Methods of calculation 3. Caliper Method (1,500 Method) –Use calipers to measure the number of 1mm (small) boxes between R-R interval. Divide 1500 by this #.
How to calculate 6 second interval on EKG strip?
The 6 second method Denotes a 6 second interval on EKG strip Strip is marked by 3 or 6 second tick marks on the top or bottom of the graph paper Count the number of QRS complexes occurring within the 6 second interval, and then multiply that number by 10
Can a 12 lead EKG be a lethal rhythm?
When evaluating lethal rhythms on a 12 lead EKG, it is important to remember the rhythm alone can be lethal as well as what the EKG is showing you in terms of heart function. A rhythm that does not perfuse well can lead to impending heart failure quickly if not addressed.
What does the MA need to know about ECG?
The MA must be able to recognize problems with the recording and make appropriate corrections so that the physician has a clear record of the patient’s cardiac activity. The goal is to obtain the most accurate ECG possible. What is the average length of time for a healthy adult cardiac cycle?