Standard 12-Lead EKG Training

The electrical activities in our heart are so strong that they can be detected by electrodes placed on our skin. An electrocardiogram, also known as ECG or EKG, uses 12 electrodes (leads) on the body to record electrical activity that occurs in the heart. Physicians use EKG results as a diagnostic tool for heart conditions. Proper placement of the leads through standardized training is essential to ensure accuracy.

How Accurate Are EKG Results?

• The EKG is a straightforward but significant clinical procedure. The accuracy of the EKG results is dependent on the technician placing the 12 electrodes on the body. In 2009, in an article titled “Technical Mistakes During the Acquisition of the Electrocardiogram,” writers Garcia-Niebla et al. showed that incorrect placement of leads is the most common technical problem. Inaccurate placement of the limb and chest leads may show EKG patterns that appear to be heart problems, but are not. Standardized 12-lead EKG training is essential for accurate results.

Lead Placement, Artifacts and Filters

• According to Garcia-Niebla et al., some common errors for placing electrodes are the proximal or distal placement of the limb leads; placing ground lead to an upper limb; and changing places of the electrodes between arms and legs. Some errors are easily detected, while others are not. The most common error is placing the precordial (chest) leads. These errors are cause by “vertical and horizontal displacement which are more difficult to detect. Also the changing places of the electrodes per their assigned places, but this error can be easily seen on the tracing. Artifacts are caused by patient movement during the EKG, or because the electrode is not sticking well enough to the body. Also, EKG machine filters need to conform to AHA standards. Proper filters minimize signals, noise, and interference that can create artifacts.

Standardized Training

• Researchers conclude that standardized 12-lead EKG training programs are the key to assure interpretation is based on the patient’s medical condition and not on errors. A first step is to properly train and document training for technicians.