ECG leads are flat when performing an ECG test.
Flat lines normally occur due to the disconnection of specific ECG leads. When performing an ECG test, a 'Leads OFF' indicator located at the bottom right-hand corner of the test screen will inform the end-user where the problem may be.
Verify which leads are disconnected.
The disconnection of the following leads will cause flat lines on all leads.
RA Off
RL Off
LA & LL Off
LA Off
The disconnection of the LA lead will cause flat lines on lead I and all chest leads.
LL Off
The disconnection of the LL lead will cause flat lines on lead II and all chest leads.
All Chest Leads Off
Step 2:
Once the problem lead has been identified perform the following.
Consider alternate lead placement.
Listed below are the recommended lead placements.
RA (White/White)
Right lateral side of the upper arm below the shoulder.
LA (Black/White)
Left lateral side of the upper arm below the shoulder.
RL (Green/White)
Lower leg, inside of the upper calf.
LL (Red/White)
Lower leg, inside of the upper calf.
V1 (Red/Brown)
Forth intercostal place at the right margin of the sternum.
V2 (Yellow/Brown)
Forth intercostal place at the left margin of the sternum.
V3 (Green/Brown)
Midway between V2 and V4 (on top of the 5th rib).
V4 (Blue/Brown)
Fifth intercostal place at the left mid-clavicular line.
V5 (Orange/Brown)
At the horizontal level of V4, at the left anterior line.
V6 (Purple/Brown)
At the horizontal level of V4, at the mid-axillary line.
Re-prep electrode location with alcohol and allow to dry before placing new electrode.
Swap out or clean (metal contact) ECG clip if needed.
NOTE: If the problem lead is a chest lead, one can temporarily swap the lead with another to verify if the problem is with the electrode location or the lead itself (i.e. swap V1 and V6 leads around, if the flat line stays on the original V lead it is not the electrode or the prep; if the flat line moves to the other V lead it is the electrode or the prep).
If the flat lining is still occurring, especially if it is consistent, there may be a hardware failure with the ECG patient cable or module. Please contact Midmark Diagnostics Technical Services for additional support, 844.856.1230 opt 2.