12-Lead and 15-Lead ECG
Electrocardiogram (ECG) 12-Lead ECG
12 different views of the heart’s
A graphic representation of the electrical activity
electrical activity in the heart
ECG Tips Indications
Electrode Lead Place limb leads on a Chest pain
muscle, avoiding bone Syncope
Adhesive pads placed on A single view of the Dyspnea
Ask the client not to talk
the body which transmits heart provided by Palpitations
Ask the client to remain still
a detected electrical the electrodes Tachycardia
Lay client in a low Fowler’s
current to the monitor Dizziness
position
Shave the client’s chest hair Electrolyte
5 Lead Monitoring
if necessary imbalances
12-Lead ECG Placement
Use the electrodes for 5 lead monitoring,
placing the limb leads on the extremities
then add extra chest leads
Additional Placements
V2: 4th intercostal space, left sternal border
V4: 5th intercostal space, left midclavicular line
V6: 5th intercostal space, left midaxillary line
RA LA
White on V3: in between V2 and V4
the right Smoke V5: in between V4 and V6
V
I heart
Anatomical Significance of the 12-Lead
chocolate!
RL LL
Clouds over over Fire
grass
I Lateral aVR V1 Septal V4 Anterior
II Inferior aVL Lateral V2 Septal V5 Lateral
LCA III Inferior aVF Inferior V3 Anterior V6 Lateral
LCx
RCA
LAD Lateral
I, aVL, V5, V6
15-Lead ECG Placement
Placement changes
V4R
V4 moves to the 5th intercostal
Septal/Anterior
Inferior space, right midclavicular line
V1, V2, V3, V4 V8
II, III, aVF
V5 moves to the left posterior,
mid scapular at the same
If you suspect... horizontal margin as V4
V9
Inferior STEMI Posterior STEMI V6 moves to the left posterior,
ST elevation in lead ST depression in Do a 15-lead at the same horizontal margin
II, III and/or aVF leads V1-V4 ECG! as V8 beside the spine
