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12-Lead Electrocardiography Placement Guidelines for Emergency Medical Services, Lecture notes of Medical Sciences

The procedure for placing 12-lead electrodes on patients during emergency medical situations. Indications and contraindications, equipment required, and step-by-step instructions are provided. Figure (1) illustrates the placement of each lead.

Typology: Lecture notes

2021/2022

Uploaded on 09/12/2022

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Orange County Health Care Agency
Emergency Medical Services Treatment Guidelines #: B-30
Page: 1 of 2
Date: 9/09
12-LEAD ELECTROCARDIOGRAPHY PLACEMENT PROCEDURE
Approved: TxGuide: 12-Lead: B-30
Implementation Date: 10-01-09
INDICATIONS:
For use on any patient as directed by ALS personnel on scene
CONTRAINDICATIONS:
None
EQUIPMENT:
12-lead capable cardiac monitor
Skin prep to include: alcohol swabs, razor, and 4x4 bandages
Sufficient quantity of electrodes for procedure
PROCEDURE:
1. Expose chest as necessary for placement of electrodes
2. Prepare chest skin by carefully removing body hair as needed for electrode placement
3. Place 12-lead pads under the direction of on-site ALS personnel. Refer to figure (1)
4. For female patients, use dorsal surface of hand to lift any body parts interfering with lead placement.
Do not place leads on top of breast.
DOCUMENTATION:
Document time for procedure
NOTES:
Leave leads in place unless directed to remove by ALS personnel.
Do not place defibrillator-pacer pads over electrocardiogram leads; remove leads before placing pads.
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Orange County Health Care Agency Emergency Medical Services Treatment Guidelines #: B- Page: 1 of 2 Date: 9/

12-LEAD ELECTROCARDIOGRAPHY PLACEMENT PROCEDURE

Approved: TxGuide: 12-Lead: B-

Implementation Date: 10-01-

INDICATIONS:

 For use on any patient as directed by ALS personnel on scene CONTRAINDICATIONS:  None EQUIPMENT:  12-lead capable cardiac monitor  Skin prep to include: alcohol swabs, razor, and 4x4 bandages  Sufficient quantity of electrodes for procedure

PROCEDURE:

  1. Expose chest as necessary for placement of electrodes
  2. Prepare chest skin by carefully removing body hair as needed for electrode placement
  3. Place 12-lead pads under the direction of on-site ALS personnel. Refer to figure (1)
  4. For female patients, use dorsal surface of hand to lift any body parts interfering with lead placement. Do not place leads on top of breast. DOCUMENTATION:  Document time for procedure

NOTES:

 Leave leads in place unless directed to remove by ALS personnel.  Do not place defibrillator-pacer pads over electrocardiogram leads; remove leads before placing pads.

Orange County Health Care Agency Emergency Medical Services Treatment Guidelines #: B- Page: 2 of 2 Date: 9/

12-LEAD ELECTROCARDIOGRAPHY PLACEMENT PROCEDURE

Figure (1) 12-Lead Electrode Placement

 Attach ECG leads to the patient (limb leads to the upper arms and lower abdomen or legs, and six chest leads)  V1: right 4th^ intercostal space  V2: left 4th^ intercostal space  V3: halfway between V2 and V  V4: Left 5th^ intercostal space, mid-clavicular line  V5: horizontal to V4, anterior axillary line  V6: horizontal to V5, mid-axillary line

Approved: TxGuide: 12-Lead: B-

Implementation Date: 9-04-