SI-MET COLLEGE OF NURSING, MUTTATHARA, TRIVANDRUM
II ND YEAR BSC NURSING
MEDICAL NURSING
EVALUATION CRITERIA FOR ECG RECORDING
Name of the student:
Date:
SI Criteria Steps Remar
No. followed ks
Yes/ No
1. Identify the patient, gather equipments needed
2. Check the physician’s order
3. Explain the procedure and obtain consent. Confirm the
patient’s name and date of birth.
4. Provide comfortable supine position
5. Adequately expose the patient’s chest for the procedure (offer a
blanket to allow exposure only when required). Exposure of the
patient’s lower legs and wrists is also necessary to apply the limb
leads.
6. Ask the patient to lay on the clinical examination couch with the
head of the couch at a 45° angle.
7. check if the patient has any pain before continuing with the clinical
procedure.
8. A 12-lead ECG involves the use of 10 electrodes, six on the
chest and four on the limbs.
Begin by checking the expiry date of the electrodes to ensure they
are within date.
9. It is important to ensure each electrode has good skin contact,
which may involve cleaning or shaving the areas where you need to
place electrodes. If this is the case, make sure to explain this
clearly to the patient and gain consent before proceeding.
10.
Chest electrode and lead placement (V1 – V6)
Apply the six chest electrodes in the following locations:
V1: 4th intercostal space at the right sternal edge.
V2: 4th intercostal space at the left sternal edge.
V3: midway between the V2 and V4 electrodes.
V4: 5th intercostal space in the midclavicular line.
V5: 5th intercostal space left anterior axillary line (at the
same horizontal level as V4).
V6: 5th
intercostal space left mid-axillary line (at the same
horizontal level as V4 and V5).
11. Once all electrodes have been applied, attach the associated chest
leads, with the cable for each lead lying inferior to the electrode (to
reduce tension on the wire).
12.
Limb electrode and lead placement
Apply the four limb electrodes on a distal bony prominence in the
following locations:
Red (RA): on the ulnar styloid process of the right arm.
Yellow (LA): on the ulnar styloid process of the left arm.
Green (LL): on the medial or lateral malleolus of the left
leg.
Black (RL): on the medial or lateral malleolus of the right
leg.
13. Once all electrodes have been applied, attach the associated limb
leads, with the cable for each lead lying inferior to the electrode (to
reduce tension on the wire).
14.
Recording the ECG trace
Turn the ECG machine on and ensure ECG paper has been loaded
into the machine.
2. Double-check all the electrodes are attached in the appropriate
locations.
3. Politely ask the patient to remain still and not talk during the
recording as muscle activity can interfere with the ECG trace.
4. Press the appropriate button on the ECG machine to record the
ECG trace. If the ECG trace is poor, double-check the connections
to ensure there is good skin contact.
15.
To complete the procedure…
Once an ECG trace has been obtained, switch off the ECG
machine.
Detach the ECG leads from the electrodes and then remove the
electrodes carefully, warning the patient this may feel
uncomfortable.
Explain to the patient that the procedure is now complete.
Thank the patient for their time.
Label the ECG with the patient’s details:
Name
Date of birth
Hospital number
Indication for the ECG
Dispose of PPE (if needed) appropriately and wash your hands.
Document your findings in the patient’s notes
Mark scored out of 20
Attitude out of 2
Knowledge of scientific rationale out of 3
Total (25)
Equipments needed:
ECG machine: to record the ECG.
Self-adhesive ECG electrodes: to attach the ECG leads to the patient.
Razor: may be required to remove hair to provide adequate electrode contact
with the skin.
Remarks:
Name & Signature of Evaluator:
