This article identifies the steps needed to prepare and hookup a patient for an ECG test.
Prepare the patient:
Make sure the temperature in the exam room is comfortable for the patient. If the room is too cold, the patient may shiver causing artifact or muscle tremors on the ECG.
Identify the electrode sites and thoroughly shave all body hair from the electrode sites, refer to the diagram below.
Rub skin at electrode sites with alcohol wipes, skin will appear pink. Let air dry.
Limb lead placement
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)
Inside calf, midway between knee and ankle.
LL (Red/White)
Inside calf, midway between knee and ankle.
Standard 12-Lead Placement (Precordial)
V1 (Red/Brown)
Fourth intercostal place at the right margin of the sternum.
V2 (Yellow/Brown)
Fourth 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 midclavicular line.
V5 (Orange/Brown)
At the horizontal level of V4, at the anterior axillary.
V6 (Purple/Brown)
At the horizontal level of V4, at the midaxillary line.
Attach the electrodes and lead wires:
After the locations are properly prepared; apply fresh electrodes to the patient.
Make sure the electrodes are adhering well; if not, ensure the locations are cleaned properly with alcohol wipes and the locations are dry before applying the fresh electrodes.
Attach the clips to the disposable electrodes. Refer to the label on the patient cables, see image below, for proper placement sites.
Verify the patient understands:
To lie down on the exam table and get comfortable. The test is most accurate with the patient in a supine and relaxed position. If the table is too small for the patient, ask the patient to tuck his/her palms by their side and under their thighs.
Additional resources:
If the tracing shows signs of flat lines please refer to the following article for assistance.