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ECG Workshop
Dr Jeremy Wright
Cardiologist
Hearts1st, 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 V4
V4: 5th intercostal space, Mid Clavicular line
V5: horizontally in line with V4, Anterior Auxillary line
V6: 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)
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