Lead Placement And Acquisition Of The 12-Lead

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chapter1Lead Placement andAcquisition of the 12-LeadElectrocardiogramPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Chapter 1 Objectives Differentiate bipolar and unipolar limb leads and precordial leadsDescribe the lead placement for a 12-leadelectrocardiogramDescribe the procedure for 12-lead acquisitionDescribe the procedure for multi-leadacquisition using a 3-lead bipolar machinePage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

3Electrodes – Limb Leads RA – Right armLA – Left armLL – Left legRL – Right LegPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

4Bipolar Limb Leads Two electrodesPositive and negativePositive “looks toward negative”Einthoven’s TrianglePage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Unipolar Limb Leads Augmented by signal averaged CTaVR - right arm positiveaVL - left arm positiveaVF - left leg positivePage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

5Precordial Leads Unipolar V1–V6 Placement is basedon anatomicallandmarkPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Precordial LeadsPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Page, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

21Hexaxial System Traditional method 6 limb leads at various anglesSomewhat tediousand difficult tomasterPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Using the 12-Lead Skin prep is importantDry wet skinShave or clip chest hairGently abrade dead skinPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

7Poor Signal Quality? Proper skin preparationMinimize patient movementMove limb leads proximallyOverride the ECG to force printHold the patient’s armsPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Standard 3- or 4-Lead Monitor Can be used for “modified chestleads”Offers advantagesfor lead II monitoringAcquires a multilead ECGPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Getting the Multi-Lead ECG Run Leads I, II, and III using lead select Leave in Lead III on the lead select Move the red (LL) electrode to the V1position This is Lead MCL-1 Move to each position (V2–V6) insuccessionPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Multi-Lead ECG (9-Lead)Page, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Time to Play! Practice hooking up and running 12leads on each other Practice finding the landmarks Run at least one 12-lead every class day You should be able to get one in lessthan 2 minutesPage, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ

chapter Page, 12-Lead ECG for Acute and Critical Care Providers 2006 by Pearson Education, Inc. Upper Saddle River, NJ 1

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