ECG 3 Lead

Question 1

PPE

Answer 1

Don appropriate PPE, and undertake appropriate hand hygiene.

Question 2

Equipment

Answer 2

3 lead ECG measurement device, electrodes.
Check electrodes are in date and
apply them to the electrodes prior to applying them to the patient’s skin.

Question 3

Indications

Answer 3

Any seriously unwell or
unstable patient
Patients with arrythmias

Question 4

Contraindications

Answer 4

Do not perform if the patient is in
cardiac arrest. Assess the rhythm via the defibrillator pads instead

Question 5

Cautions

Answer 5

ECG dots may cause irritation or skin tearing on removal, especially in those with delicate skin.

Question 6

Consent

Answer 6

Explain procedure. Obtain informed consent.

Question 7

Prepare Patient

Answer 7

Place the patient in a semi-
recumbent or
seated position.

Support feet and arms, legs
uncrossed.

Expose patient sufficiently for limb
or chest electrode application.

Prepare the skin, this will include
shaving at the electrode sites,
cleaning oily skin with an alcohol
wipe, and gently scraping the skin to
remove the surface layer of dead
skin cells.

Patients with perfuse sweating may
cause poor electrode adhesion,
clean and dry skin with an alcohol
wipe or gauze.
This will improve electrical
conduction.

Question 8

Place limb lead

Answer 8

Avoid placing electrodes over
tendons and major muscle masses.
Apply the limb leads to the wrists
and ankles where possible. A more
proximal location may reduce
artefact in cases of patient movement

Question 9

Acquire ECG

Answer 9

Ensure ambulance or stretcher not
moving. Have patient remain
as still as possible, breathing
normally.
Press acquisition on ECG device.
Correctly enter patient details
as prompted (in 12 lead function).
Inspect ECG recording for sufficient
quality. Repeat if necessary.

Question 10

Report

Answer 10

Report on ECG rhythm and
diagnostic observations