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Performing an electrocardiogram

Graphic determination of the electrical activity of the patient’s heart during a cardiac cycle.


To obtain a graphic record of the cardiac cycle.


– Electrocardiograph. – Trough. – 4 electrocardiogram clamps.


– Single-use electrodes with gel. – Conductive gel. – Disposable non-sterile gloves. – Alcohol. – Gauze or cotton. – Shaver. – Electrocardiogram recording paper. – Nursing records.


– Perform hand washing. – Prepare material. – Preserve the patient’s privacy. – Inform the patient of the technique to be performed. – Request the collaboration of the patient and family. – Place the bed in horizontal position and the patient in supine position. – Put on non-sterile gloves. – Help the patient to uncover chest, ankles and wrists. – Clean the skin where the electrodes are applied with alcohol. – Shave if there is abundant hair. – Place electrodes and connect standard leads (See figure XVI-1). 1. Red – right wrist (AVR). 2. Yellow – left wrist (AVL). 3. Black – right leg (LR). 4. Green – left leg (AVF).

– Connect the precordial leads (See figure XVI-1). V1 – 4th intercostal space, right anterior clavicular line. V2 – 4th intercostal space, left anterior clavicular line. V3 – between V2 and V4. V4 – 5th intercostal space, left mid-clavicular line. V5 – 5th intercostal space, left anterior axillary line. V6 – 5th intercostal space, left mid-axillary line.

– Ensure correct electrode placement and cable connections. – Select on the electrocardiograph the speed and voltage parameters of 25 mm/s and 1mV. – Select the filter and mode (manual or automatic). – Ask the patient to remain still and breathe normally without speaking. – Remove electrodes and wipe off traces of conductive gel. – Help the patient to dress and place him/her in a suitable position. – Collect the material. – Remove gloves. – Wash hands. – Record in the nursing documentation: procedure, if the patient presents precordial pain at the time of the electrocardiogram, date and time, incidences and patient response.


– If the recording is manual, the recording position must be changed in the following order: I, II, III, AVR, AVL, AVL, AVF, V1, etc. V6. – If a rhythm strip is requested, it should be performed at the end of the 12-lead recording and starting in lead II.

Figure XVI-1 Schematic diagram of electrode placement

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