This episode looks at the procedure of Recording a 12 Lead ECG.<\/p>\n
An electrocardiogram, or ECG, is performed to assess the rhythm and electrical activity of the heart.<\/p>\n
To record an ECG, electrodes must be placed in specific positions on the patient\u2019s limbs and chest wall, then connected via leads to an ECG machine, which records the electrical activity. The ECG machine produces a trace, which must then be analysed by a qualified member of staff. It is important that the recording of the ECG is done accurately, to ensure that the patient can be treated appropriately.<\/p>\n","protected":false},"excerpt":{"rendered":"
This episode looks at the procedure of Recording a 12 Lead ECG. An electrocardiogram, or ECG, is performed to assess the rhythm and electrical activity of the heart. To record an ECG, electrodes must be placed in specific positions on the patient\u2019s limbs and chest wall, then connected via leads to an ECG machine, which […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,1],"tags":[],"class_list":["post-8","post","type-post","status-publish","format-standard","hentry","category-tomorrows-clinicians","category-uncategorized","entry"],"youtubeVideo":"520850479\/743a667654","question1":"What are the indications for recording a 12 lead ECG?","answers1":"Shortness of breath| Severe electrolyte abnormalities| Collapse| All of the above\r\n","correctAnswer1":"3","correctAnswerText1":"A 12 lead ECG can be used to diagnose suspected acute coronary syndrome, which may present with shortness of breath. Assess the severity of hyperkalaemia and need for treatment, as well as looking for cardiac causes of collapse e.g. arrhythmias.","question2":"Why is it important to ask the patient to relax and keep them warm during an ECG recording?","answers2":"To make the experience more pleasant for the patient| To preserve their dignity| To reduce artifact produced by shivering or muscle movement| To reduce time taken by the clinician to record an ECG","correctAnswer2":"2","correctAnswerText2":"","question3":"What is the correct ECG paper speed?","answers3":"15mm\/s| 20mm\/s| 25mm\/s| 30mm\/s\r\n","correctAnswerText3":"Knowing the speed is important for correct interpretation of rate, PR interval, QRS width and QT width.","correctAnswer3":"2","question4":"What is the correct gain for recording a 12 lead ECG?","answers4":"10mm\/mV| 15mm\/mV| 20mm\/mV| 25mm\/mV\r\n","correctAnswer4":"0","correctAnswerText4":"Knowing the gain is important for interpretation of the ECG e.g. ventricular hypertrophy, hyperkalaemia.","question5":"At what frequency should the filter be set for a 12 lead ECG?","answers5":"100 Hz| 150 Hz| 200 Hz| 250 Hz","correctAnswer5":"1","correctAnswerText5":"","question6":"Where should the electrodes for the limb leads be attached?","answers6":"Just distal to the wrists and ankles| Over the acromion and the medial malleoli bilaterally| Over the olecranon and the lateral malleoli bilaterally| Just proximal to the wrist and ankle\r\n","correctAnswer6":"3","correctAnswerText6":"","question7":"Which of these chest electrode positions for a 12 lead ECG is incorrect?","answers7":"V1 - 4th intercostal space, right sternal edge, V2 - 4th intercostal space, left sternal edge| V3 - half way between V2 and V4, V4 \u2013 5th intercostal space, left midclavicular line| V5 \u2013 horizontal plane of V4, left anterior axillary line, V6 \u2013 horizontal plane of V4, left posterior axillary line| All the above\r\n","correctAnswer7":"2","correctAnswerText7":"V6 should be placed in the horizontal plane of V4, left mid-axillary line. This is important as incorrect electrode placement can produce diagnostic differences resulting in incorrect patient management.","question8":"What is the correct limb lead placement for recording a 12 lead ECG?","answers8":"Red \u2013 right upper limb, green \u2013 left upper limb, yellow \u2013 left lower limb, black \u2013 right lower limb| Red \u2013 left upper limb, yellow \u2013 left lower limb, green \u2013 right lower limb, black \u2013 right upper limb| Red \u2013 right upper limb, yellow \u2013 left upper limb, green \u2013 right lower limb, black \u2013 left lower limb| Red \u2013 right upper limb, yellow \u2013 left upper limb, green - left lower limb, black \u2013 right lower limb","correctAnswer8":"3","correctAnswerText8":"As an aide memoire, start from the left upper limb and attach leads in a clockwise direction. Remember Ride Your Green Bike for correct limb lead placement.","question9":"For a female patient the chest leads should be placed...","answers9":"Over the breast tissue| Under the breast tissue| Away from the breast tissue| Any of the above\r\n","correctAnswer9":"1","correctAnswerText9":"","question10":"Under what circumstances may the ECG electrode positions be altered?","answers10":"Posterior myocardial infarction| Dextrocardia| Paediatrics| All of the above\r\n","correctAnswer10":"3","correctAnswerText10":"For posterior MI leads, precordial leads placed posteriorly over the back can aid diagnosis. For dextrocardia, reversing the chest leads is appropriate. For the paediatric population, placing the limb leads over the shoulder and lower torso will reduce artifact from limb movement.","question11":"","answers11":"","correctAnswer11":"","correctAnswerText11":"","question12":"","answers12":"","correctAnswer12":"","correctAnswerText12":"","question13":"","answers13":"","correctAnswer13":"","correctAnswerText13":"","question14":"","answers14":"","correctAnswer14":"","correctAnswerText14":"","question15":"","answers15":"","correctAnswer15":"","correctAnswerText15":"","icon":"managing-an-ecg-monitor","parentId":"","recapId":"435","_links":{"self":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/8"}],"collection":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8"}],"version-history":[{"count":6,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/8\/revisions"}],"predecessor-version":[{"id":856,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/8\/revisions\/856"}],"wp:attachment":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}