Setting Up a Twelve-Lead ECG

In practice

The provider orders a twelve-lead ECG for a middle-aged patient. The medical assistant confirms the order and identifies the patient by name and date of birth. She checks for allergies, including allergies to adhesive, and asks about cardiac medications and any chest pain, noting the answers. She explains that the test takes a few minutes, that he will need to lie still, and that the machine sends no electricity into his body. She provides a gown and privacy, then helps him lie on the exam table with his arms at his sides. She asks him to put his phone and smartwatch on the counter, and moves a lamp's power cord away from the table. She wipes the electrode sites to remove oil and trims hair where needed. She checks the electrodes' expiration date, then places the four limb electrodes on his arms and legs, away from bony points. For the chest, she finds the fourth intercostal space at the right and left edges of the sternum for V one and V two. She places V four in the fifth intercostal space at the midclavicular line, V three midway between V two and V four, and V five and V six level with V four. She attaches each lead wire to its labeled electrode, asks him to lie still, and records. The printout is clean, so she removes the electrodes, checks his skin, and gives the tracing to the provider.