NAU PT Program - PT 630 Cardiopulmonary Therapeutics
I. Skin Preparation
The skin will have to be cleaned before the surface elctrodes can be placed on the chest wall. This is accomplished by :
- removing all body hair
- vigorously wiping the shaved skin with alcohol to remove all of the skin's oils - this should be evidenced by a bright reddened area
- dry the area thoroughly
II. Placement Of The EKG Electrodes
For the limb leads, place the electrodes as follows :
- Place an electrode over the prepared skin medial to the anterior superior iliac spine on both the right and left sides of the hip
- Place an electrode over the prepared skin medial to the anterior deltoid and just inferior to the lateral 1/3 of the clavicle on both the right and left shoulders
For the chest leads, place the electrodes as follows :
- For V1, place the electrode in the fourth intercostal space on the right side of the sternum at the sternocostal margin
- For V2, place the electrode in the fourth intercostal space on the left side of the sternum at the sternocostal margin
- For V3, place the electrode in between V2 and V4
- For V4, place the electrode in the fifth intercostal space in the midclavicular line beneath the nipple
- For V5, place the electrode in between V4 and V6
- For V6, place the electrode in the fifth intercostal space in the midaxillary line
III. Assignment :
- Have your 12-lead EKG taken.
- At the end of your 12 lead EKG, take in a deep breath and hold it while Lead II is running and then exhale. This will show you the effect of inhalation and expiration on your R to R intervals (heart rate).
- Next, identify each of the waves in you EKG.
- Measure the durations of the : P wave, PR interval, QRS complex, and what the amplitude displacement is for the ST segment - does it fall into the normal range ?
- Find which leads in your 12-lead EKG have upside down P waves as well as a negatively displaced QRS complex.
- Identify the limb leads which have Q waves.
- Where is an R wave progression located and is there an R wave progression present in your 12-lead EKG ?
- Which lead has the highest R wave deflection and what does that mean about the heart's electrical vector in relation to that lead ?