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12-lead EKG
Uses 10 electrodes to produce 12 leads
P wave
Atrial depolarization
QRS complex
Ventricular depolarization
T wave
Ventricular repolarization
PR interval
Normally about 0.12 to 0.20 seconds
V1
4th intercostal space at the right sternal border
V2
4th intercostal space at the left sternal border
V4
5th intercostal space at the midclavicular line
Somatic tremor artifact
Caused by shivering or muscle movement
AC interference
Electrical interference that can cause EKG artifact
Interrupted baseline
Often caused by a loose or disconnected electrode
Wandering baseline
May result from movement, breathing, or poor electrode contact
Preparing skin for EKG
Clean and dry the skin to improve electrode contact
EKG patient instruction
Remain still and breathe normally
Life-threatening EKG finding
Report to the provider immediately