Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur
COLLEGE OF HEALTH SCIENCES

Name of Student:
Year level: Section: Group: Grade:

PROCEDURE CHECKLIST
ELECTROCARDIOGRAPHY PLACEMENT

Instruction: Below is the grading scale which will be used in rating your performance.

5 = Well done 95-100 (Excellent)

4 = Normally done 88-94 (Very Satisfactory)
3 = Fairly done 82-87 (Satisfactory)
2 = Poorly done 76-81 (Fair)
1 = Not done 70-75 (Needs Improvement)

Procedure 5 4 3 2 1
Prepare the materials
• Hand sanitizer (in the absence of water for handwashing)
• ECG machine with proper grounding
• Sticky pads OR rubber suction where the electrodes should be
attached
• Wipes and/or razor for skin preparation
1. Wash your hands and introduce yourself to the patient and
clarify their identity.
2. Explain what you are going to do and gain consent to
proceed. Clarify whether the patient knows why the test is
being performed e.g. chest pain.
3. Ensure the patient is comfortable, provide privacy and ask the
patient to undress, exposing chest, wrists, and ankles. Assist
with draping as appropriate.
4. Patient Positioning
• Place the patient in a supine or semi-Fowler’s position. If the
patient cannot tolerate being flat, you can do the ECG in a more
upright position.
• Instruct the patient to place their arms down by their side and
to relax their shoulders.
• Make sure the patient’s legs are uncrossed.
• Move any electrical devices, such as cell phones, away from
the patient as they may interfere with the machine.
5. Skin Preparation
• Dry the skin if it is moist or diaphoretic.
• Shave any hair that interferes with electrode placement. This
will ensure a better electrode contact with the skin.
• Rub an alcohol prep pad or benzoin tincture on the skin to
remove any oils and help with electrode adhesion
6. Electrode Application/Placement
• Check the electrodes.
• Do not place the electrodes over bones.
• Do not place the electrodes over areas where there is a lot of
muscle movement
a. Right wrist (or shoulder)
b. Left wrist (or shoulder)
c. Right ankle, laterally
d. Left ankle, laterally
 Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES
Nabua, Camarines Sur
COLLEGE OF HEALTH SCIENCES

e. V1 in 4th intercostal space at right sternal edge

f. V2 in 4th intercostal space at left sternal edge
g. V3 between V2 and V4
h. V4 in 5th intercostal space in the mid-clavicular line
i. V5 horizontal to V4 in anterior axillary line
j. V6 horizontal to V4 and V5 in mid-axillary line
7. Once all the leads are attached, ask the patient to lie as still as
possible, avoiding movement, coughing, or talking to avoid
artifacts.
8. Make sure ECG machine is plugged in and grounded. If it is
battery operated, be sure it is fully charged and in good working
condition. Operate according to manufacturer’s directions.
Record the reading and print a copy. If the patient had any chest
pain at the time of recording you should record this on the ECG.
9. Disconnect the leads from the pads and allow the patient to
remove the pads OR rubber suction themselves, or offer
assistance if needed. Offer a tissue if using the pads to wipe
off the sticky feeling.
10. Allow the patient to dress and thank them.
Sub-Total

Grand Total

Remarks:

Signature of Student:

Date / Time:

Signature of Clinical Instructor: ALVIN FRANCO A. AGTARAP, M.A.N.