Cardiopulmonary Services Diagnostic Section Proc 15.10.

Proper Limb Lead/Chest Lead Placement of 12 Lead EKG

Purpose: Procedure: 1. All adult EKGs will be performed with the same limb/chest lead placement. 2. The standard lead placement will be as follows: To define a standard limb lead/chest lead placement for 12 lead EKGs to insure continuity of tracings and quality patient care.

LEAD V1 V2 V3 V4 V5 V6 RA,LA RL, LL

ELECTRODE PLACEMENT Fourth intercostal space at the right border of the sternum. Fourth intercostal space at the left border of the sternum. Midway between locations V2 and V4. At the mid clavicular line in the fifth intercostal space. At the anterior axillary line on the same horizontal level as V4. At the mid-axillary line on the same horizontal level as V4 and V5. Midway between the elbow and the shoulder on right and left arms. A few inches above the ankle on the right and left legs.

3. In the event that lead placement has to be modified due to bandages, CABG, or with burn patients, a note should be added to the EKG stating that lead placement has been modified and state reason why. Written: April 1995 Reviewed: November 1997 Reviewed: September 2000 Reviewed: July 2003