Clinical guidelines by consensus: recording a standard 12-lead electrocardiogram. An approved method by the Society for Cardiological Science and Technology (SCST). 2017. http://tinyurl.com/y9l265eu (accessed 11 June 2019) Show
Cook M. Leadership and management challenges in addressing the dignity and respect agenda. J Nurs Manag. 2014; 22:(2)137-139 https://doi.org/10.1111/jonm.12230 Crawford J, Doherty L. Recording a standard 12-lead ECG: filling in gaps in knowledge. British Journal of Cardiac Nursing. 2008; 3:(12)572-577 https://doi.org/10.12968/bjca.2008.3.12.31804 Davey P. ECG at a glance.Oxford: Wiley-Blackwell; 2008 Farley A, McLafferty E, Hendry C. The cardiovascular system. Nurs Stand. 2012; 27:(9)35-39 https://doi.org/10.7748/ns.27.9.35.s52 Flott K, Darzi A, Mayer E. Care pathway and organisational features driving patient experience: statistical analysis of large NHS datasets. BMJ Open. 2018; 8:(7) https://doi.org/10.1136/bmjopen-2017-020411 Garcia TB. 12-lead ECG: the art of interpretation, 2nd edn. Burlington (MA): Jones & Bartlett Learning; 2015 Gregg RE, Zhou SH, Lindauer JM, Helfenbein ED, Giuliano KK. What is inside the electrocardiograph?. J Electrocardiol. 2008; 41:(1)8-14 https://doi.org/10.1016/j.jelectrocard.2007.08.059 Hooks R. Patient-centred care. Nurs Stand. 2016; 30:(20)61-62 https://doi.org/10.7748/ns.30.20.61.s49 Jevon P. ECGs for nurses, 2nd edn. Oxford: Wiley-Blackwell; 2009 Jevon P. Recording an accurate ECG. Practice Nursing. 2010; 21:(8)404-408 https://doi.org/10.12968/pnur.2010.21.8.63745 Macfarlane PW, Mason JW, Kligfield P Debatable issues in automated ECG reporting. J Electrocardiol. 2017; 50:(6)833-840 https://doi.org/10.1016/j.jelectrocard.2017.08.027 National Institute for Health and Care Excellence. Remote ECG interpretation consultancy services for cardiovascular disease. NICE Medtech innovation briefing 152. 2018. https://www.nice.org.uk/advice/mib152/ (accessed 11 June 2019) Nursing and Midwifery Council. The code: professional standards of practice and behaviour for nurses, midwives and nursing associates. 2018. https://tinyurl.com/gozgmtm (accessed 11 June 2019) Pegram A, Bloomfield J. Infection prevention and control. Nurs Stand. 2015; 29:(29)37-42 https://doi.org/10.7748/ns.29.29.37.e7257 Sampson M, McGrath A. Understanding the ECG. Part 1: anatomy and physiology. British Journal of Cardiac Nursing. 2015; 10:(11)548-554 https://doi.org/10.12968/bjca.2015.10.11.548 Recording a 12-lead electrocardiogram (ECG) 27 June 2019 Clinical Stephen McStay Stephen McStay Lecturer (Adult Nursing), Department of Nursing Midwifery and Healthcare, Faculty of Health and Life Sciences, Northumbria University View articles · Email Stephen 02 June 2019  Volume 28 · Issue 12 ISSN (print): 0966-0461 ISSN (online): 2052-2819 References The recording of a 12-lead electrocardiogram (ECG) has become commonplace within the healthcare environment. It is regarded as the most frequently performed cardiovascular test worldwide, with more than 200 million ECGs recorded in 2017 (). The 12-lead ECG is an important test, and in the context of presenting symptoms and a detailed history, can prove to be essential in the delivery of effective patient care (). The timely recording of the 12-lead ECG may minimise additional risk and reduce negative patient outcomes as the information obtained from the 12-lead ECG can aid diagnosis and may also signify a need for urgent intervention (; )—for example, a patient presenting with chest pain may be experiencing a myocardial infarction. However, if a poor technique is applied and the 12-lead ECG is not accurately recorded from the start, the information gained during the process may lead to the mismanagement of the patient (). Register now to continue readingThank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits: 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. 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 PlacementDon’t forget to subscribe to my YouTube channel for more videos! Supplies you will need
Prep the SkinFirst 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. What are the things that a patient must consider prior to the ECG procedure?Prepare the patient: Make sure the temperature in the exam room is comfortable for the patient. If the room is too cold, the patient may shiver causing artifact or muscle tremors on the ECG. Identify the electrode sites and thoroughly shave all body hair from the electrode sites, refer to the diagram below.
Which of the following is important to correctly prepare electrode attachment sites?Before placing your electrodes, it is very important to prepare the subject's skin by wiping the chest area thoroughly with skin cleansing (alcohol) swabs. This removes any oil that may be on the skin and which can cause drift in your ECG/EKG signals.
In which position would the nurse place the LL electrode when using a three lead ECG system?Place the left leg (LL) electrode below the level of the lowest rib on the left abdominal area. Place the chest (C) electrode in the fourth intercostal space to the right of the sternum for V1. Misplacement of this lead can change the rhythm tracing on the monitor and misdiagnosis can occur.
Where does the nurse place the electrodes on the patient for continuous ECG monitoring?The right arm electrode is placed in the third right intercostal space just to the left of mid clavicular line. Left arm electrode is placed in the fifth right intercostal space just to the right of the midclavicular line. The left leg electrode is placed in fifth right intercostal space in the mid clavicular line.
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Which action would the nurse take when preparing a patient for electrocardiography electrode placement?
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