Correct ECG lead placement

Written by daviduregbula
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Correct ECG lead placement
An ECG (ecg image by Zbigniew Nowak from

The placement of ECG leads is universal. It is essential that these specific positions are adhered to, as when reviewing a patient's ECG there must be consistency in the way in which the ECG was conducted. To produce a 12-lead ECG, ten wires must be connected to the individual. These are split into two groups -- four limb leads and six precordial leads which are placed on the chest. The limb leads are labelled aVR, aVL, aVF and N, and the chest leads are labelled V1 to V6.

Skill level:

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Things you need

  • ECG machine
  • Electrode tabs

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  1. 1

    Place your fingers at the top of the sternum and run them down until you reach a bony lump. This is the angle of Louis. Move your fingers into the rib space on the right side of this point.

  2. 2

    Move down two rib spaces to the fourth intercostal space and place the first electrode tab. This is V1.

  3. 3

    Locate the fourth intercostal space on the left side of the sternum and place the tab for V2.

  4. 4

    Slip your fingers down into the fifth intercostal space and line them up with the middle of the left clavicle, mid-clavicular line. Place the V4 tab here.

  5. 5

    Place the V3 tab midway between V2 and V4.

  6. 6

    Run your fingers along the fifth intercostal space to the beginning of the axilla. This is in line with the front of the shoulder. V5 will be placed here.

  7. 7

    Follow further around the fifth intercostal space to the mid-axilla, or middle of the armpit. Place the V6 tab here.

  8. 8

    Place the tab for aVR on the right wrist, tab for aVL on the left wrist and tab for aVF on the left foot.

  9. 9

    Stick a tab for the N lead on the right foot.

  10. 10

    Connect the corresponding wires from the ECG machine to the respective tabs.

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