ECG Workshop

Dr Jeremy Wright CardiologistHearts1st, Greenslopes Private Hospital

Topics To Cover

Skin preparation

Electrode Placement

Troubleshooting – Minimise Noise / Artifact

Limb Lead Reversal

ECG Examples

Skin Preparation

Important to have good contact between the skin and electrodes

Minimises artifact and electrode movement

Things to use: - Razors / part hair to expose skin- Preparation tape - Alcohol wipes

Electrode Placement

LA = Left Arm

RA = Right Arm

LL = Left Leg

RL = Right Leg (ground)

Electrode Placement

V1: 4th intercostal space, R sternal border V2: 4th intercostal space, L sternal border V3: between V3 and V4V4: 5th intercostal space, Mid Clavicular line V5: horizontally in line with V4, Anterior Auxillary lineV6: horizontally in line with V4, Mid Auxillary line

Noise / Artifact

Bed Artifact

Limb Lead Reversal

Most common mistake made when

acquiring ECG’s.

Be sure to check all leads (especially

limb leads) before acquiring the ECG.

Limb Lead Reversal

Alternate Limb Lead Placement

How do you perform an ECG in the following situations?

- Amputee - Theatre Stockings- Patient with Parkinson's - Disease / Tremors

Normal ECG Waveforms

A: Ventricular Ectopy

A: 2nd Degree AV Block; Type II

A: Complete Heart Block

A: Sinus Rhythm with frequent atrial ectopy

A: Atrial Fibrillation

A: Idioventricular Rhythm

A: Acute Anterior MI

A: Junctional Rhythm

A: Supraventricular Tachycardia

A: Ventricular Tachycardia (VT)

A: Ventricular Fibrillation (VF)