How to Do Advanced 12 Lead ECG Monitoring With Five Leads

Electrocardiography is used for cardiac monitoring of patients who have cardiac, pulmonary, or electrolyte problems or who have had surgery. A 12-lead electrocardiogram, also called an EKG or ECG, can view the heart from 12 different angles. If you use a 5-lead ECG, you will only see seven different views of the heart. Typically a 12-lead ECG is used to get a variety of single-shot pictures of the heart, whereas the 5-lead ECG is usually used for monitoring purposes during transport.

Things You'll Need

• Cardiac monitor
• ECG cable
• 5 electrodes
• Gauze
• Scissors

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Instructions

• 1

  Explain to the patient the procedure that you are going to perform and why you are performing it.

• 2

  Clip excess hair in areas where you will place the electrodes. Do not shave these areas.

• 3

  Clean the areas where electrodes will be placed. Use soap and water and let the areas air dry. Get rid of all the dead skin by rubbing the areas with gauze until you notice redness in the areas.

• 4

  Connect the leads to the cable and monitor. Each lead should match the proper initial and color on the monitor. Connect RA (white) to RA (white), LA (black) to LA (black), LL (red) to LL (red), RL (green) to RL (green), and brown to brown.

• 5

  Place the leads in the proper areas:

  Place the white lead to the right arm just under the right clavicle.

  Place the black lead to the left arm just below the left clavicle.

  Place the red lead to the lower chest above and to the left of the belly button.

  Place the green lead to the lower chest above and to the right of the belly button.

  Place the brown lead in the 4th space between the ribs on either side of the sternum.

• 6

  Check the monitor for waveforms. Choose a lead for your patient; your choices are I, II, III, aVR, aVL, aVF and V.

• 7

  Set the alarm for 20 beats higher and 20 beats lower than your patient's heart rate. Make sure to write a note at the start of ECG monitoring and again when it's stopped. Add the reason for the monitoring, lead selections, and rhythm interpretation. Place this information in your patient's chart.