Recording an ECG

Click to collapse Click to expand

This page will discuss general information on how to perform and record an ECG

Click the Title to expand and collapse each section

Paper Speed & Standardisation

Click to collapse Click to expand
  • Small boxes on ECG paper are 1mm x 1mm
  • Recordings are usually made at 25mm/sec
  • Amplitude of ECG deflection is measured vertically
  • Duration of the ECG is measured horizontally
  • A standard deflection should be at the beginning or end of the ECG (a half rectangle)

Descriptive image here

Artefacts

Click to collapse Click to expand

Artefacts can cause missenterpretations in ECG readings.

3 common causes of artefacts

  1. Mains interference
  2. Patient movement
  3. wandering baseline

Mains interference

Causes fuzzy trace, lines are too thick or thin

Reasons: patient is in contact with metal, ecg lead in contact with metal (eg watch), ECG leads are tangled

Patient movement

Causes artefact

Reasons: nurse making patient uncomfortable

wandering baseline

Causes artefact

Reasons: poor electrode contact (eg hair or sweat)

Lead Placement

Click to collapse Click to expand

ECG electrodes must be placed in the correct positions on the body.

Patient should be positioned: supine with 2x pillows under head

Limb leads are labelled: R (Right), L (Left), F (Foot), N (Neutral)

Chest electrodes [names]: positions

  • V1: patient's fourth intercostal space adjacent to right sternal notch
  • V2: patient's fourth intercostal space adjacent to left sternal notch
  • V3: Midway between V2 and V4
  • V4: patient's fifth intercostal space, midclavicular line
  • V5: inline with V4 but on anteriror axillary line
  • V6: inline with V4 but on midaxillary line