If you’re giving an ECG test in a patient’s home, ask them to recline on their bed or couch.

If the patient is female, they may feel more comfortable with a female doctor or nurse placing the ECG leads on their chest.

It’s also a good idea to either wash your own hands or put on a pair of latex gloves before putting on the ECG leads. If you don’t have soap and water available, you can also use an alcohol cleaning pad to remove dirt and oil.

The 4 leads that you’ll place on the patient’s arms and legs should also be color coded. They may be packaged separately from the torso leads to avoid confusion.

Having the patient reclining makes it much easier to find the angle of Louis. If it helps, practice finding the angle of Louis on yourself a few times before you find it on a patient.

V1 should be located between the patient’s 4th and 5th ribs, counting down from the top.

V2 should essentially mirror the placement of V1, but on the left side of the chest.

The clavicle is the collarbone. It often slightly protrudes just below the patient’s neck.

If you’re working with a female patient, leads V3 through V6 will be positioned beneath—not on top of—the patient’s left breast.

In medical terminology, the underarm area is known as the axilla.

It’s a good idea to always position the chest leads before positioning the extremity electrodes. The chest electrodes are more important and they need to be much more precisely located.

If you can’t position the lead here for some reason (e. g. , the patient has a skin lesion), place the lead higher up on the patient’s shoulder. You can also place it farther out away from their neck if necessary. The lead for the right shoulder is usually white.

If the patient has a defibrillator on their chest or has a pacemaker, do not place the ECG lead on the electrical device. Instead, move the lead 1 inch (2. 5 cm) in any direction so it’s directly on top of the skin. The lead that goes on the left shoulder is usually color-coded black.

If the patient is wearing socks and shoes, ask the patient to remove them so you can put on the lead. The right ankle lead typically has a green color.

It’s more important that the leads be symmetrically positioned than they be on any exact location on the ankles. The lead that goes on the left ankle tends to be red.