ECG (Electrocardiogram)

Prepared by: Monica Angelique P. Salayo

 WHAT IS ECG?
• An ECG is a method of measuring, displaying and
recording the electrical activity of a heart

• Interpretation of these details allows diagnosis of a

wide range of heart conditions. These conditions
can vary from minor to life threatening
 Reasons for an ECG
• Patients who complain of chest pain or shortness of
breath

• To help determine if there is an acute myocardial

infarction or heart attack present
• Can help decide whether the pain is due to angina or
narrowing of blood vessels to the heart muscle

• To determine the status of the heart prior to procedures

such as surgery and/or after treatment for conditions
such as a heart attack (myocardial infarction, or MI),
endocarditis (inflammation or infection of one or more
of the heart valves), or after procedures such as heart
surgery or cardiac catheterization
Anatomy and Function of the
Heart's Electrical System

• The heart's pumping action

is regulated by an electrical
conduction system that
coordinates the contraction
of the various chambers of
the heart.
 Nursing Considerations

• Always verify doctor’s order

• Explain the procedure to the patient and offer
opportunity to ask any questions about the
procedure.
• Generally, fasting is not required before the test.
• Ask the patient about all medications ( prescribed
and OTC drugs and herbal supplements.
• An ECG can be performed almost anywhere, as
the equipment is very compact and portable. Thus,
you may undergo an ECG in:
• physician's office,
• ECG department of the hospital or clinic,
• procedure or testing area,
• emergency department,
• hospital room or bed.
• An ECG normally takes approximately five to 10
minutes, including attaching and detaching
electrodes.
•
The area (s) where the electrodes are to be placed
may be shaves. If the chest, arms, or legs are very
hairy, it may be clip/shave small patches of hair, as
needed, so that the electrodes will stick closely to the
skin.

• Ask patient if he/she have pacemaker.

• Ask to remove any jewelry or other objects that may

interfere with the procedure.

• Have patient to lie flat in the center of a table or bed for

the procedure with his/ her arms at his/her sides.
• Make sure that the patient’s feet are not touching
the bed board.
• Ask the patient to relax to minimize muscle
trembling. It will be important for patient to lie still
and not talk during the procedure, so as not to
interfere with the tracing.
• Select flat, fleshy areas to place the electrode.
Avoid muscular and bony areas.
• If the patient has an amputated limb, choose a
site in the stump.
ELECTRODES PLACEMENT
LIMB LEADS COLOR

Right arm Red

(RA)
Left arm Yellow
(LA)
Right foot Black
(RF/ground
)
Left foot Green
(LF)
 ELECTRODES PLACEMENT
PRECORDIAL POSITION COLOR
LEADS

V1 4th ICS at the Red

right sternal
border
V2 4TH ICS at the Yellow
left sternal
border

V3 Halfway Green
between V2
and V4 (left)

V4 5th ICS at the Brown

left mid
clavicular line

V5 5th ICS at the Black

anterior axillary

V6 5th ICS at left Purple

mid-axillary line
ECG Paper
ECG Paper