Procedure 15 — Assessment: ECG and 12 Lead Placement

What is the purpose of the ECG and 12-Lead Placement policy?

To provide EMS personnel a visual reference guide for placing ECG limb leads and the 12-lead ECG.

What is the first clinical indication for this procedure?

Cardiac monitor limb lead placement.

What is the second clinical indication for this procedure?

12-lead ECG lead placement.

What does the abbreviation RA stand for in limb lead placement?

Right Arm.

What does the abbreviation LA stand for in limb lead placement?

Left Arm.

What does the abbreviation RL stand for in limb lead placement?

Right Leg.

What does the abbreviation LL stand for in limb lead placement?

Left Leg.

Where is the V1 electrode placed for a 12-lead ECG?

4th intercostal space to the right of the sternum.

Where is the V2 electrode placed for a 12-lead ECG?

4th intercostal space to the left of the sternum.

Where is the V3 electrode placed for a 12-lead ECG?

Midway between V2 and V4.

Where is the V4 electrode placed for a 12-lead ECG?

5th intercostal space at the mid-clavicular line.

Where is the V5 electrode placed for a 12-lead ECG?

Anterior axillary line at the same level as V4.

Where is the V6 electrode placed for a 12-lead ECG?

Mid-axillary line at the same level as V4 and V5.

Where is the RL limb lead placed for ECG monitoring?

Anywhere above the ankle and below the torso.

Where is the RA limb lead placed for ECG monitoring?

Anywhere between the shoulder and the elbow.

Where is the LL limb lead placed for ECG monitoring?

Anywhere above the ankle and below the torso.

Where is the LA limb lead placed for ECG monitoring?

Anywhere between the shoulder and the elbow.

What is the purpose of a quick V4R 12-lead placement?

To assess for posterior involvement.

What provider levels can perform ECG and 12-lead placement?

EMT-A, EMT-B, and EMT-P.