# EKG's and pronounciation of "Lead"



## Raf (Jun 20, 2006)

In the context of EKG's do you pronounce lead like lead in a pencil or lead like in leader.

Do all EKG's use the same number of leads? What are the different amounts?


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## disassociative (Jun 20, 2006)

*...*

Lead as in "Leed - Long E"

3 lead, 5 lead, 12 lead, etc.


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## rescuecpt (Jun 20, 2006)

3 lead and 12 lead are the most widely used in the field.


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## Jon (Jun 21, 2006)

These days, many co's use a "4-lead" system, which gives you the first leads for a 12-lead.


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## divinewind_007 (Jun 21, 2006)

we use the 4 lead system...i think all the surrounding counties here have went to the 4 lead


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## MMiz (Jun 21, 2006)

We use 12 leads.  I always thought that having four leads was standard for a "three lead EKG'?


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## MedicPrincess (Jun 21, 2006)

We use the 4 leads.  Then add 6 more for a 12 lead.  But since that only equals 10 leads, why is it called a 12 lead vs. a 10 lead?  Which ones read more than one area?


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## Guardian (Jun 22, 2006)

The number of electrodes does not determine the number of leads.  In fact, it takes at least 2 electrodes to make 1 lead.  The most common and useful lead, lead 2, looks at the hearts electrical activity from the negative right arm electrode to the positive left arm electrode.  Because the electrical activity is moving from negative to positive, the ECG reading is upright which is in contrast to other leads.  With 12-leads, the unipolar limb leads are used with precordial (chest) leads and augmented limb leads to give 12 total leads.  It is best that you learn three leads first and then try and learn about 12 leads.  That said, I will give you a little taste of 12-leads by explaining where every lead comes from.  Note, the right leg electrode acts as a ground and is not a lead!

1) Lead 1 = Right arm electrode to Left arm electrode
2) Lead 2 = R arm electrode to L leg electrode
3) Lead 3 = L arm electrode to L led electrode
4) Augmented Limb lead Right arm aVR = R arm to spliced L Arm and L Leg
5) aVL = L arm to spliced R arm and R Leg
6) aVF (F=foot) = L let to spliced R arm and L arm
7) Precordial leads use aVR with V1
8) aVR with V2
9) aVR with V3
10) ditto V4
11) ditto V5
12) ditto V6

There you have it, 12 leads.  I think I got them all right but then again its late and I'm tired.  I'm sure I'll hear about it if I got one wrong however.  BTW, if you don't completely understand 12-leads now, don't feel bad.  This was just meant to wet your appetite and really is only the beginning.


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## Guardian (Jun 22, 2006)

Please note, Augmented Limb leads are similar to regular leads.  The only difference is that instead of using only 2 electrodes, Dr. Einthoven (inventor of ECG) decided to use 3 electrodes, 2 of which would be hooked together and opposite the 3rd electrode.  Thus, these leads are augmented and allow for different views from slightly different angles from the heart which can make all the difference in the world when diagnosing MI from a 12-Lead.  As you can probably tell, I'm an ECG nut and Dr. Willem Einthoven is one of my heroes.


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## Guardian (Jun 22, 2006)

Guardian said:
			
		

> The number of electrodes does not determine the number of leads.  In fact, it takes at least 2 electrodes to make 1 lead.  The most common and useful lead, lead 2, looks at the hearts electrical activity from the negative right arm electrode to the positive left arm electrode.  Because the electrical activity is moving from negative to positive, the ECG reading is upright which is in contrast to other leads.  With 12-leads, the unipolar limb leads are used with precordial (chest) leads and augmented limb leads to give 12 total leads.  It is best that you learn three leads first and then try and learn about 12 leads.  That said, I will give you a little taste of 12-leads by explaining where every lead comes from.  Note, the right leg electrode acts as a ground and is not a lead!
> 
> 1) Lead 1 = Right arm electrode to Left arm electrode
> 2) Lead 2 = R arm electrode to L leg electrode
> ...








I can see a mistake already, in the first paragraph, i said lead 2 looks at right arm to left arm. It's actually right arm to left leg


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## Wingnut (Jun 22, 2006)

Lead like in leader. 

We always start off with a 4 lead then do a 12 and we have this thing called an Audicore for the 12 lead, I'm not sure what the purpose is, but I guess it reads better than our monitor does.


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## Raf (Jun 23, 2006)

So there's just 4 and 12 lead? There is no really such thing as 3 lead?


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## Guardian (Jun 23, 2006)

There is no such thing as 4 lead.  There are 3 leads, then augmented leads, and lastly precordial leads.  When people say 4 lead, what they mean is 3 lead with an augmented lead.  If you look on the LP12's, you will notice there is no IIII Lead because it doesn't exist.


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## bowhkr (Jun 23, 2006)

L    E    D


WHITE...................................BLACK


             Looks like four to me



GREEN...................................RED


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## Firechic (Jun 23, 2006)

Guardian - very good description!

The green lead would be the ground lead - 4 electrodes giving a recording of 3 leads.

We use 3 leads, 12 leads and for certain patients we place V7 V8 V9 and V4R.
Very helpful!


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## Guardian (Jun 24, 2006)

bowhkr said:
			
		

> L E D
> 
> 
> WHITE...................................BLACK
> ...


 
Intuitively, this appears to be correct and therefore is a common misconception among some paramedics and especially BLS providers. The colors you listed are electrodes, not leads. To make a lead, the heart monitor (LP12) looks at and displays the electrical activity that occurs between 2 electrodes, or in this case colors. To get lead 1, the LP12 looks at the electrical activity between the white and black electrode. To get lead 2, the LP12 looks at the electrical activity between the white and red electrode. Back in the old days when we carried paddles, you could do a "quick look" by placing the paddles in the standard position which also give or take a little is the position of the white and red electrodes. The "quick look" therefore would be the 2nd lead on the monitor. The third lead is between the black and red electrode. Notice I didn't say anything about the green electrode as it only acts as a ground. I hope this helps to clear up some confusion. Also, if you have time, read my earlier posts on this thread which goes into a little detail about the other leads which make up a 12-lead.


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## Ridryder911 (Jun 24, 2006)

Good points, it is immaterial where one place the ground lead... There are preferred places, but it is all semantics. The same is true, we do not really have XII leads as well. 

R/r


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## Anomalous (Jun 25, 2006)

Anyone know a good website for practicing reading ekg's? Maybe something interactive?


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## Guardian (Jun 25, 2006)

Anomalous said:
			
		

> Anyone know a good website for practicing reading ekg's? Maybe something interactive?




http://www.skillstat.com/ECG_Sim_demo.html


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