This document provides instructions for performing a 12-lead electrocardiogram (ECG). It describes introducing yourself to the patient, obtaining consent, preparing the patient by removing chest hair or washing the skin, and properly placing the 10 electrodes on the chest and limbs in their designated positions. The student is asked to explain each step out loud as they perform the procedure. Once the ECG is obtained, the electrodes are removed and the patient is covered. Key details like the patient's name, date and time are documented, along with any presence of chest pain. The clinical area is then tidied and hand hygiene is performed.

1. C. Riedinger 1
ECG notes
12 lead ECG – 5 min station
Task:
- Impersonate stage 1 medical student on ward
- Patient Mr x needs a 12 lead ECG
- Act as if manikin is the real patient
- Explain to examiner what you are doing as you go along
Procedure
- Introduce self, gain consent and co-operation
- Hand hygiene…
- Ensure privacy, curtains, chaperone?
- Prepare patient: remove chest hair if necessary, wash/dry skin if necessary
(with chlorhexidine wipe)
- Place electrodes: (first place sticker, then attach cables)
o 6 chest leads: V1, V2, V3, V4, V5, V6
V1 – 4th intercostal space at R sternal angle
V2 – 4th intercostals space at L sternal angle
V4 – mid-clavicular line in 5th R intercostals space
V3 – halfway between V2 and V4
V6 – mid-axillary line horizontal to V4
V5 – anterior axillary line nearly horizontal to V4
o 4 limb leads:
Red = R arm, yellow = L arm, Green = L foot, black = R foot
These 4 electrodes produce 6 views in the vertical plane:
I, II, III, aVL, aVR and a VF (6)
- press button to obtain ECG
- once it has been obtained, remove
2. V2
electrodes and cover the patient up
4. V3
3. V4 - document onto ECG the patient’s name,
hospital number, time and date
1. V1
6. V5 - DOCUMENT PRESENCE OF CHEST
PAIN!
5. V6
- live clinical area tidy
- perform hand hygiene