Materials:

Alcohol
Alcohol Swab
ECG Machine
Tracing Paper

1. Good day! I am Ryann Jezryl M. Dizon your student nurse for today. May I know your name
and birthday to verify if you are my patient for today? *Checks arm band.
2. For today I will be preparing you for the ECG procedure. This procedure will be done in order
to provide a 2D graphical representation and recording of your heart’s electrical conductivity.
3. As I asses the client’s health history, I noticed that the client is admitted with chest pain and
has elevated serum potassium (hyperkalemia).
4. [Necessary Equipments]
Materials:
Alcohol
Alcohol Swab
2x2 Gauze Pad
ECG Machine
Tracing Paper
Shaver
5. [Provide Privacy]
In order to provide privacy, I will properly close the door and windows. I will also make sure
that the client understands the patient’s right to confidentiality. All the data from the client shall
be used only for his benefit.
6. Since the patient is critically ill, I will assist the patient by positioning him to supine position
and head slightly elevated.
7. The patient’s thorax doesn’t need to be shaved, as I observed his skin is already washed and
dried. I also check if there are any materials that can affect the electrical conductivity such as
metals, pins, and coins. After that I will check the ECG machine if it is working and check for
the tracing paper.
8. Apply the four limb leads properly.
Wipe the are with alcohol, wipe it again with gauze pad to enhance the adherence of electrodes
into the skin. RIGHT BICEP, LEFT BICEP, RIGHT SHIN OF THE KNEE OR LEG, LEFT
SHIN OF THE KNEE OR LEG.
9. I will now apply the 6 precordial leads
First is the V1, I will palpate the sternal angle and go sideways to the lateral aspect of the
sternum then go slightly downward, palpating the 2nd intercostal space and consequently finding
the 4th intercostal space. Wipe with alcohol, gauze pad, then place the V1 Electrode.
2nd Right across from the left 4th intercostal space, I will place the V2 electrode on the right side
of the same position.
Before sticking the V3 electrode, I will first put the V4 in the 5th intercostal space at the mid
clavicular line.
After that, I will place the V3 electrode on the angle between the V4 and V2 electrodes.
Following the curvature of the 5th intercostal space, I will not place the V5 electrode on the
anterior axillary line.
After that I will place the V6 electrode on the lateral aspect of the thorax, specifically in the mid
axillary line.
After placing the electrodes, I will tell the client to just relax and stand still while placing the
wires from the ECG to each electrode.
I will now turn on the ECG machine and set it according to the doctor’s need.
I will input the client’s data specifically the name, time, age, and date of ECG procedure has
done.
After that I will turn off the ECG machine.
I will now remove each electrode carefully and wipe the sticky residues clean.
After that, I will help the client position himself on a more comfortable position.
As I perform the after care, I will remove the wires from each electrode, and put to trash the
disposable items. Also I will get the tracing paper as I exit the room.

QRS:
nSmallboxes X 0.04
NORMAL RANGE: 0.06 – 0.1 seconds
RR:
nSmallboxes X 0.04
NORMAL RANGE: 0.6 – 1.2 seconds

HR:
1500 / nSmallboxes
300 / nLargeboxes
NORMAL RANGE: 60 – 100 bpm