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Objectives
The learner will verbalize indications to perform 12 lead EKG
The learner will Identify components of the 12 lead EKG
machine, their function and data input process
PURPOSE OF EKG
EKG = electrocardiograph (also ECG)
Records and displays electrical activity of the heart
between two points.
The direction in which the electric current flows toward
the machine determines how the waveforms appear on
the EKG tracing.
EQUIPMENT
EKG machine
Display
Keyboard
Lead wires
Electrodes
Paper
EKG MACHINE
EKG KEYBOARD
Different Attachment
Types, may clip or
button
EKG electrodes
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Last name
First name
ID number (Medical record #)
Age
Gender
Be sure to identify
patient as per
NSLIJHS policy
Electrode Placement
Underlying Structures
Heart Surfaces
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Electrode Placement
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Electrode Placement
Four (4) Electrodes are attached to
Right Arm, Left Arm, Right Leg, Left Leg
RA, RL, LA, LL
2 Options
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PRECORDIAL (CHEST)
V4 = 5th ICS,
at mid-clavicular line
V5 = 5th ICS,
at anterior axillary line
V6 = 5th ICS,
at mid-axillary line
V1 = 4th ICS,
at right sternum border
V2 = 4th ICS,
at left sternum border
V3 = Equidistant
between V2 & V4
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By Special
Order
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Electrode location
V3R =
Halfway between
V1 and V4R
V4R =
Mid-clavicular line in
Right 5th ICS
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http://www.youtube.com/watch?v=GUIKXnot-1k
EKG Waveform
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MUSCLE TREMORS
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TROUBLE SHOOTING
When no signal or a poor signal is observed, consider:
Have the cables been correctly connected?
Is the equipment functioning correctly?
Could external electrical equipment interference be a
problem?
Was skin preparation adequate?
Could the electrodes suffer from gel dry out? or poor
adhesion?
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http://www.m2hnursing.com/ecg_demo/12lead.php
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References
Thaler, M. (2012). The Only EKG Book Youll Ever Need (7th ed.). Philadeplphia, PA:
Lippincott Williams & Wilkins.
Wagner, Galen S., Marriott's Practical Electrocardiography 11th Edition, Lippincott
Williams & Wilkins, Philadelphia, PA , 2008, Chapter Author: Wagner, Galen S.; Lim, Tobin
H. Chapter Title: Recording the Electrocardiogram.
Drew, et. Al, AHA Scientific Statement . Practice Standards for Electrocardiographic
Monitoring in Hospital Settings: An American Heart Association Scientific Statement From
the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease
in the Young: Endorsed by the International Society of Computerized Electrocardiology
and the American Association of Critical-Care Nurses . Circulation. 2004; 110: 2721-2746
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Post Test
It is required that you take an online post test after
module completion.
Click on this Link to Access:
https://nslijhp.northshorelij.com/nursing/EWD/Pages/NursingQu
izSystemSYS.aspx?user_facility=system&user_quiz=systemEKG-Lead
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