Skin Prep and Placing Electrodes - Performing 12-Lead ECGs
Poor skin prep leads to unwanted artifact and not placing the electrodes where they should be can change the morphology (shape) of the waveforms the doctor is going to interpret.
The skin prep is as important as any other part of this procedure. A poor skin prep will yield poor results (artifact laden). Apply a moderate amount of pressure when prepping the skin.
I use a circular motion when prepping the skin. The intent of a good skin prep is to remove dirt, dead skin cells, oils, skin moisturizer, fake tan, body powder, sweat etc. All of these sources can lead to poor contact with the sensors and artifact.
Placement of the electrodes is very important when performing a 12-Lead EKG. When placing limb sensors, I prefer to stay away from large muscles due to the potential for movement and increased somatic tremor.
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
Electrocardiography for Healthcare Professionals, 5th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019
Rapid Interpretation of EKG's, Sixth Edition
Cover Publishing Company
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
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