Recording a 12-lead ECG

Recording a resting ECG with twelve leads: preparing the patient, placing limb and chest electrodes correctly, avoiding artefacts and passing on the result immediately.

Content created with AI assistance from public clinical sources (RKI, AWMF) – may contain mistakes; if in doubt, your textbook is right

Translated from the German original, which is authoritative. The exam itself is in German.

Material

• ECG machine with patient cable, in working order and with paper or storage
• Disposable adhesive electrodes (ten), electrode gel if needed
• Tissue or skin cleansing according to the hospital standard, disposable razor or clipper
• Blanket for warmth, privacy screen
• Disinfectant wipes for cables and machine according to the hygiene plan

Typical mistakes in the exam

• Swapping the red and yellow electrodes
• Placing V1 and V2 in the 2nd or 3rd instead of the 4th ICS
• Sticking chest electrodes onto the breast tissue in women
• Recording a person who is cold or tense and overlooking the shivering
• Filing away the ECG of a person with chest pain instead of showing it immediately
• Printout without name, date and time

What examiners ask afterwards

• How do you find the 4th intercostal space?
• What happens in the ECG if the right and left arms are swapped?
• Which artefacts do you know, and how do you avoid them?
• A patient has chest pain. What do you do in the first few minutes besides the ECG?
• What is the difference between a 12-lead ECG and a monitor ECG?

Sources

• AHA/ACCF/HRS: Recommendations for the Standardization and Interpretation of the Electrocardiogram, Part I
• ESC-Leitlinie zum Management des akuten Koronarsyndroms (deutsche Fassung als DGK-Pocket-Leitlinie)
• Gebrauchsanweisung des verwendeten EKG-Geräts