How to Do a 15-Lead ECG

Healthcare personnel use 15-lead electrocardiograms (ECGs) to confirm myocardial infarctions (MI), a.k.a. heart attacks, in patients suspected of having a blockage in the heart or an arrhythmia, an irregular heartbeat. ECGs help doctors confirm the MI and administer treatment quickly, preventing as little tissue death as possible. Through the use of leads placed in various spots on the thoracic region of the body during an ECG, doctors can investigate the existence or progression of heart disease.

Things You'll Need

• Razor
• Pen or marker
• Conductive gel
• Damp towel
• Dry towel

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Instructions

• 1

  Remove hair from the mid-chest area by shaving it with a razor. There should be no hair within 1 inch of all sides of the nipple.

• 2

  Tell your patient to stand and to place his left arm on your right shoulder. Look for a skin indention just under the collarbone and next to the shoulder joint. Mark it with a pen to note where to place a lead. Repeat this process with the right arm.

• 3

  Place a small dot at the top of the hip bone on both sides of the body; it should be in line with the navel.

• 4

  Place two fingers just below the clavicle (collar bone) and above the top rib on the right side of the body. Mark this spot with a small dot.

• 5

  Place two fingers at the top of the sternum, or breast bone, and move the fingers downward, counting the intercostal spaces, the muscles between the ribs. When you reach the fourth space, place a small dot just on the right side the sternum. Repeat this on the left side, but do not make a mark.

• 6

  Move your finger down one more space on the left side and place a dot there. Move your finger so that is in line with the middle of the left clavicle. Place a dot mark there.

• 7

  Find the two marks that you made in steps 4 and 5. Place a mark diagonally in the middle of these spaces; if it happens to be on top of a rib, move the mark down until it isn't.

• 8

  Tell the patient to stand facing you. Tell her to raise her left arm straight in front of her and then above her head; she should fully extend her arm keep it there. Locate the middle of the armpit with your fingers. Move them down the side of the body while staying on this midline and place a mark at the same level as the one made in step 6.

• 9

  Place another mark between those made in step 6 and step 8 at the same level.

• 10

  Place a mark on the inside of both ankles and on both wrists.

• 11

  Place a small amount of conductive gel on each of the spots. Then remove it with a damp towel. Towel-dry each of the sites.

• 12

  Place an electrode on each area. Review the lead wires and correctly attach each one to the leads.