Procedure for recording a standard 12-lead electrocardiogram.

The 12-lead electrocardiogram (ECG) is an essential diagnostic tool, particularly in the management of coronary heart disease. It records the electrical activity of the heart from 12 different viewpoints or 'leads' by attaching ten cables to the patient's limbs and chest. The procedure for recording a standard 12-lead ECG is described, including preparation of the patient and of the equipment. It is important that the nurse is familiar with the manufacturer's recommendations regarding the use of the electrocardiograph before commencement of the ECG. Guidance is given on how to accurately locate the intercostal spaces to ensure correct positioning of the chest leads (V1-V6); alternative placements are also given. It is essential that connection or placement of the ECG electrodes/leads is accurate to prevent misdiagnosis. The ECG trace needs to be clear to enable accurate and reliable interpretation. Standardization of the procedure is important to achieve comparable results.