12 Lead EKG Electrode Placement

[Jim37F]

Where on the limbs do you put the leads? Upper (like shoulders/thighs)? Or lower?

 

[fm_emt]

Where on the limbs do you put the leads? Upper (like shoulders/thighs)? Or lower?

anywhere between elbow & acromion process for the upper, below the inguinal folds for lower. I have not had too many issues with artifact. People will sit still during a 12 lead if I simply say "Dude, quit wiggling for 15 seconds."

 

[FiremanMike]

the class talked about how limb leads stuck on the torso might avoid some artifact but can cause over-augmentation and exaggerated ST segments, making a 12 lead non-diagnostic. If misplaced, they can also cause issues with axis determination. I know people say "oh, that's not true, they're fine on the torso, that's nonsense" but studies have shown placement is important.

As an FYI, Zoll claims torso leads are fine..

 

[fm_emt]

As an FYI, Zoll claims torso leads are fine..

I've seen that mentioned before. The M Series manual says "

1. When acquiring 12-lead ECG from quiet supine patients, ZOLL recommends placing the limb electrodes anywhere along the ankles and wrists. When it is difficult for the patient to remain motionless due to shivering, muscle tremors, or transport vehicle movement, better results are often obtained if limb electrodes are placed on the patient’s thorax. (Refer to the two diagrams below for limb electrode placement)"

The Phillips MRx manual said something similar as well.

In my experience, they do fine on limbs.