As a nursing student and new nurse, I had trouble remembering where to place electrodes (RA, RL, LA, LL, V1, V2, V3, V4, V5 & V6) on a patient for a 12 lead EKG. However, after much practice I have finally got it. In this article, I want to prepare you for how to place electrode stickers on a patient for a 12 lead ECG (EKG) so you will be prepared in clinicals and as a new nurse. In addition, I’m going to demonstrate how to place electrodes for a 12 lead ECG in a video tutorial.
In the hospital and clinic setting, you will be expected to obtain a 12 lead EKG on a patient. This is done at the bedside with a machine. The machine analyzes various angles of the heart and interprets the patient’s heart rhythm and rate.
You can tell so much about a patient’s cardiac status from an EKG. For instance, if a patient is having chest pain, you can look at an EKG and tell if they are having an active myocardial infraction (in most patients). In addition, you can tell if they are in any type of abnormal rhythm such as atrial fibrillation or atrial flutter etc.
Video Tutorial on 12 Lead EKG Placement
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Supplies you will need
- 10 Electrode Stickers
- 1 strip of abrasive tape (this roughs up the epidermis so you can get a good connection)
- Alcohol prep pads (cleans the skin’s oils so you can get a good connection)
- Hair Trimmers (used to remove excessive hair on men)
Prep the Skin
First clean the electrode site placements with alcohol prep to remove oils and dirt from the skin. Then gently “rough up” the area with the abrasive tape so the electrodes will stick properly.
Tip: Always make sure your electrodes are not expired or the gel is dry because this can affect the connection. In addition, never place an electrode over an implanted device in the skin.
EKG 12 Lead Placement
There are a total of 10 leads (4 limb leads & 6 chest/precordial leads) and they are the following:
- Right arm (RA)
- Left arm (LA
- Right leg (RL)
- Left leg (LL)
Location of EKG 12 Lead Placement
- RA: Placed on the right arm or right below the right clavicle
- LA: Placed on the left arm or right below the left clavicle
- RL: Placed on the right leg or upper right quadrant
- LL: Placed on the left leg or upper left quadrant
- V1: Placed in the fourth intercostal space to the right of the sternum
- V2: Placed in the fourth intercostal space to the left of the sternum
- V3: Placed directly between leads V2 and V4
- V4: Placed in the fifth intercostal space in the mid-clavicular line
- V5: Placed directly between leads V4 and V6
- V6: Placed horizontal with V4 in the mid-axillary line
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