12-Lead ECG Placement Guide
What is ECG Lead Placement?
ECG lead placement is the process of attaching electrodes to the patient’s body to measure and record the electrical activity of the heart. Each lead measures one particular type of electrical activity for a specific location on the patient’s body.
Correct lead placement can ensure accurate ECG readings and provide insight into a patient’s heart health, such as detecting various heart conditions and previous heart attacks.
A Guide to 12-Lead ECG Placement
12-lead ECG’s include 12 leads obtained with 10 electrodes. These 10 electrodes consists of 4 limb leads (RA, RL, LA, LL) and 6 precordial (chest) leads (V1, V2, V3, V4, V5, and V6). Here is a step-by-step guide on how to correctly place ECG leads:
Preparing the Patient
Before placing the ECG leads, it is important to ensure that the patient is adequately prepared. Make sure that the patient’s skin is clean and dry. Remove any necessary clothing for proper lead placement.
- Ensure patient is in a supine position, with arms at their sides
- Shave hair that can interfere with electrodes
- Remove clothes that can interfere with electrodes
- Other checklist items
Placing the Leads
In a 12-lead ECG, there are 10 electrodes that provide various angles on the heart’s activity. Place the limb leads on the patient’s arms and legs, and place the precordial leads on the patient’s chest. Use the graphic below as a reference. For a 3 and 5-electrode system guide, click here.
Chest Electrodes and Placement
- V1 – 4th intercostal space on the right margin of the sternum
- V2 – 4th intercostal space at the left margin of the sternum
- V3 – Midway between V2 and V4
- V4 – 5th intercostal space, mid-clavicular line
- V5 – 5th intercostal space, anterior axillary line (same level as V4)
- V6 – 5th intercostal space, mid-axillary line (same level as V4 and V5)
Limb Electrodes and Placement
- RA (Right Arm) – Anywhere between the right shoulder and right elbow
- RL (Right Leg) – Anywhere below the right torso and above the right ankle
- LA (Left Arm) – Anywhere between the left shoulder and the left elbow
- LL (Left Leg) – Anywhere below the left torso and above the left ankle
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