ECG

Definition:
- A diagnostic tool used in assessing the cardiovascular system. It is a graphic
recorder of the electrical activity of the heart.
Purpose:
- To diagnose electrical aberrations in the electrical activity of the heart
 Angina pectoris
 Cardiac Dysrhythmias
 Cardiomegaly
 Electrolyte disturbances
 Inflammatory disease of the heart
 Effects of drugs
Principles:
- Place leads properly to get accurate reading
- Explain the procedure that the procedure is painless and he or she will not
experience electrical shock
- Provide privacy
Equipment:
- ECG machine
- Cotton balls with alcohol
Procedure Rationale
1. Explain the procedure to the To gain trust and cooperation from the
patient patient and to reduce the anxiety
2. Assemble equipment To save time and effort and promote
a. ECG machine organization
b. Electrode paste
3. Close room door or bedside To provide privacy to the patient
swab
4. Place client in supine or semi-To provide comfort to the patient and
Fowler’s position allow easy access to the chest are
5. Remove clothing chest to waist To expose the area where electrodes
line will be placed
6. Instruct to lie still without talking
To gain accurate reading
7. Standardize the ECG machine For proper use and in order to get
accurate reading
8. Cleanse and prepare skin: wipe To disinfect the site
site with alcohol
9. Attach leads To ensure correct reading
Lim leads: Right arm – Red
 Left arm – Yellow
Right leg – Black
Left leg – Green
Precordial or chest leads:
a. V1 – Rt 4th intercostals space
sternal boarder – Red
b. V2 – Lt 4th intercostals space
sternal boarder – Yellow
c. V3 – Midway between V1 and
V4, left - Green
d. V4 – 5th ICS, midclavicular left
- Brown
e. V5 – 5th ICS, anterior axillary
left - Black
f. V6 – 5th ICS, midaxillary left -
Lavender
For 15 Lead ECG in addition to
12 – Lead:
a. V3R – Rt ICS at Level of V3
b. V4R – Rt ICS midclavicular
c. V7 – 5th ICS posterior left
10. Start run the ECG machine 12- To start reading the activity of the heart
lead and long Lead-II
a. Bipolar limb lead – L1, L2, L3
b. Unipolar limb lead – AVR,
AVL, AVF
c. Chest Lead – V1, V2, V3, V4,
V5, V6
11. Disconnect electrodes and leads To prepare machine for next use
and wipe electrode paste if any
12. On ECG strip, check the tracing, To identify patient and obtain baseline
write the name of the patient, data for succeeding ECG result
age, date, and time taken comparison
13. Mount to the ECG sheet For easy access/reading of ECG results
by the physician
14. Refer to the doctor For proper interpretation and
intervention
15. Return the ECG machine To prepare the machine for next use
properly