3.1 Ecg-3
3.1 Ecg-3
Electrocardiography (ECG) measure’s the heart’s electrical activity. Electrodes attached to the skin can
detect these electric currents and transmit them to an instrument that produces a record (the electrocardiogram)
of cardiac activity. The data are graph as waveforms. ECG can be used to identify myocardial ischemia and
infarction, rhythm and conduction disturbances, chamber enlargement, electrolyte imbalances, and drug
toxicity.
EQUIPMENT:
ECG Machine
Recording Paper
Disposable Pregelled Electrodes
Adhesive Remover swabs
4 x 4 gauze pads
Bath Blanketed
PROCEDURE:
Expose the patient’s chest. Apply the precordial lead electrodes. The tip of each lead wire is
lettered and color-coded for easy identification. The brown (or V1 to V6) leads are applied to the chest.
Peel the contact paper off the self-sticking disposable electrode and apply directly to the prepared site,
as recommended by the manufacturer. Position chest electrodes as follows:
V1- Fourth intercostal space at right sternal border
V2- Fourth intercostal space at left sternal border
V3- Halfway between V2 and V4
V4- Fifth intercostal space at the left midclavicular line (just an inch below the nipple)
V5- Fifth intercostal space at anterior axillar line (halfway between V4 and V6)
V6- Fifth intercostal space at midaxillary line, level with V4
Connect the precordial lead wires to the electrodes. Make sure the metal parts of the
electrodes are clean and bright.
After the application of all the leads, make sure the paper speed selector is set to the standard
25m/second and at the machine is set to full voltage.
If necessary, enter the appropriate patient identification data into the machine.
Ask the patient to relax and breathe normally. Instruct the patient t lie still and not to talk while
you record the ECG.
Press the AUTO button. Observe the tracing quality. The machine will record all 12 leads
automatically, recording three consecutive leads simultaneously. Some machines have a display screen
so you can preview waveforms before the machine records them on paper. Adjust waveform, if
necessary. If any part of the waveform extends beyond the paper when you record the ECG, adjust the
normal standardization and repeat. Note this adjustment on the ECG strip, because this will need to be
considered in interpreting the results.
When the machine finishes recording the 12-lead ECG, remove the electrodes and clean the
patient skin, if necessary, with adhesive remover for sticky residue.
After disconnecting the lead wires from the electrodes, dispose of the electrodes. Return the
patient to a comfortable position.
Clean ECG Machine, per facility policy. If not done electronically from data entered into the
machine, label the ECG with patient’s name, date of birth, location, date and time of recording, and
other relevant information, such as symptoms that occur during the recording.
Remove additional PPE, if used. Perform Hand Hygiene.