12 Lead ECG Placement

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ECG electrode placement is standardised to record an accurate trace – but also ensuring comparability between records taken at different times. Poor electrode placement results in mistaken interpretation, possible misdiagnosis, patient mismanagement and inappropriate procedures.

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What is this article about?

An electrocardiogram, or ECG, is a reading assessing the magnitude and direction of the electrical currents of the heart, and measuring the depolarisation and repolarisation of the cardiac muscle cells. It is important that an ECG is recorded accurately. ECG electrode placement is standardised, allowing for the recording of an accurate trace - but also ensuring comparability between records taken at different times. Poor electrode placement can result in mistaken interpretation, which may then lead to possible misdiagnosis, patient mismanagement or inappropriate procedures. Deviation of lead placement even by 20-25mm from the correct position can create clinically significant changes on the ECG, including changes to the ST-segment.


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Meet the educator

Tom Walvin
Tom Walvin is a lecturer in adult nursing at the University of Plymouth, UK. Tom has a clinical background in Emergency Nursing, Cardiac Nursing, Pre-Hospital Care, Event Medicine and Clinical Research. His teaching interests are Deteriorating Patients, Emergency and Critical Care Skills, Resuscitation, Clinical Simulation, Pathophysiology, Anatomy & Physiology. Tom continues to work in clinical practice regularly sharing his clinical time between the Emergency Department, Cardiology and Ambulance Service.
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What do others think?

2815 reviews by Ausmed Learners
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Nicola Rainford
19 Jul 2020
This is a great resource for all, even if you do ecg’s on a regular basis
Andrea hogan
22 Sep 2020
informative and easy to understand
Kelly Shaw
15 Jan 2023
Easy to follow! Explains 12 lead ECG placement well
Jeanette Schofield
19 Jul 2020
Excellent resource it highlighted how if done incorrectly patients could be given inappropriate treatment
Portrait of Brooke Davidson
Brooke Davidson
05 May 2021
Great video and easy to read
Colin McIntosh
22 May 2022
Enrolled Nurse
very hwelpful
Linda Craske
26 Mar 2021
it is a fantastic resource
Bianca Herbert
23 Feb 2020
ECG lead placement is an important assessment in nursing which is critical to being correctly placed.
Elise Hicks
10 Sep 2021
Still nothing specific re muscle vs bone. Discussion at work about this
Larischa Roth
05 Sep 2020
Good article
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