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ECG Workshop
Dr Jeremy Wright CardiologistHearts1st, 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 V4V4: 5th intercostal space, Mid Clavicular line V5: horizontally in line with V4, Anterior Auxillary lineV6: 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)