Performing 12-Lead ECGs

Communication - Performing 12-Lead ECGs

Part 1

When performing the EKG on a patient it is important to first introduce yourself, then identify the patient. Tell them why you are there. “Dr. X has asked me to come and perform and EKG on you”.

Ask the patient if they have ever had an EKG before. If they have, ask them to tell you what they remember. They may remember something similar, but it wasn’t an EKG. Either way, use that to your advantage.

The patient’s participation in the procedure (even minimally) goes a long way in reducing anxiety and increasing cooperation.

Explain that you are going prepare their skin with a cold solution, then place sensors on their skin in those specific locations on their chest and limbs (perhaps in alternate locations by medical necessity or local protocol).

Part 2

Always tell the patient what you are going to do before you do it. Remind them the solution and the gel of the sensors is cold, but that it will warm up very quickly.

I avoid the use of the word “electrode” to reduce the potential for anxiety due to thoughts of electricity and shock. Instead I use the term sensor. It is a term that accurately describes what the electrode is there for anyway.

Ask the patient to reverse their gown with the opening to the front. If it is a female patient, ask her to remove her bra and provide an additional towel to be placed underneath the gown to provide additional coverage of her breasts. We do not need to see the patient’s breasts to perform an EKG!

Step outside of the room or the other side of the curtain while the patient dresses for the procedure. Ask them to tell you when they are ready.

Authors and Sources

Authors and Reviewers

EKG heart rhythm modules: Thomas O'Brien.
EKG monitor simulation developer: Steve Collmann
12 Lead Course: Dr. Michael Mazzini, MD.
Spanish language EKG: Breena R. Taira, MD, MPH
Medical review: Dr. Jonathan Keroes, MD
Medical review: Dr. Pedro Azevedo, MD, Cardiology
Last Update: 11/8/2021

Sources

Electrocardiography for Healthcare Professionals, 6th Edition Kathryn Booth and Thomas O'Brien
ISBN10: 1265013470, ISBN13: 9781265013479
McGraw Hill, 2023
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company
EKG Reference Guide
EKG.Academy
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
ECG Reference Guide
PracticalClinicalSkills.com