The first thing that we want to do is explain the procedure to our patient.
We want them to know that we will be placing electrodes on their limbs
as well as removing their shirt and placing electrodes down their left side
of their heart.
The equipment that you need for this is our cardiac monitor
our electrodes, a towel to wipe away perspiration as necessary
and a razor to remove excess hair from the chest as needed.
Now that the patient has been prepped it's time to put the limb leads on.
We are going to be placing the limb leads on the medial side of the calves
and the medial sides of the forearms.
Once our limb leads have been placed we can go ahead and place our precordial leads
The first precordial lead that we are going to place is V1
V1 is going to be placed to the right of the sternum at the forth intercostal space
The next precordial lead that we will place is V2
V2 will be placed in the exact same spot just to the left of the sternum.
After V2 we will be placing V4
V4 will be placed mid clavicular in the fifth intercostal space
After that we will place V3
V3 will be placed mid line in between V2 and V4
Next we will place V6
V6 will be placed mid axillary in the fifth intercostal space
and finally V5
V5 will be placed mid line in the fifth intercostal space in between V4 and V6
After we have attached all of our leads
We want to make sure our patient is lying still, breathing normally with no talking
We are then going to turn on our cardiac monitor
and ensure that all our leads are placed and connected appropriately
We want to make sure that the picture that we are receiving on our cardiac monitor
is as clear as possible with minimal amount of artifact.
We also want to make sure that we are not receiving any error messages.
From there we are going to go to our 12 lead section of our monitor
We are going to let our patient know that we are about to take the picture
and make sure that they are remaining still.
We are going to acquire our 12 lead.
and wait while the machine analyses
Once the cardiac has printed the 12 lead
We are going to interpret the 12 lead to our local standards
as well as report any findings.
After this for any unstable patient, we want to have serial 12 leads
every five minutes and also after any intervention that we perform.