Preparing for a 12 lead ECG

The 12 lead ECG machine is a valuable tool in the diagnosis of cardiovascular problems but only if performed accurately. Before performing a 12 lead ECG, it is important that you, your equipment and the patient are all well prepared. You should also ensure that enough time has been allocated to the test to enable a good-quality result. 

To help with this, we have put together the following steps to help you when you are preparing for a 12 lead ECG. This includes information on the equipment you require, and how to prepare the patient for the test that is being performed.

Preparing yourself and the equipment 

Before the patient arrives, you should ensure your equipment is correctly prepared and ready for the test you are going to perform:

• Ensure you have ready disposable high-quality ECG electrodes, razors and skin cleansing wipes available.
• Accurately record the name and date of birth of the patient. If you are using one of our I³ integrated ECG systems then this information will be pulled automatically from the clinical system.
• If you are using a portable ECG machine and need a printout, then ensure you have sufficient paper to perform the tests you need to.
• Untangle all the chest and limb cables if necessary and place them neatly ready to attach to the patient.

Preparing the patient

It is essential that the patient is comfortable and relaxed in order to achieve an accurate ECG result with minimal interference or artefact. Please see our guide on Reducing ECG Artefacts for more information on how to prevent this from occurring.

• The patient should be reclining, preferably on a bed with a pillow supporting their head. The bed should be wide enough to support the patient’s arms by their sides so they aren’t left dangling.
• Introduce yourself and ensure you have the correct patient. Explain the procedure and then obtain verbal consent and also ask them if they would like a chaperone to accompany them.
• Ask the patient to adjust their clothing so that there is unrestricted access to the chest area, wrists and ankles. Once the electrodes are in place, cover the patient to maintain their dignity.
• If excess chest hair cannot be parted, it may need to be shaved with a safety razor. Ensure you obtain consent before doing this.
• If the patient’s skin is greasy then it may need to be cleaned with soap and water or by using alcohol swabs. Any exfoliation should be performed with gauze swabs or paper towels. 

After the test is complete

Once you have completed the test, ensure you file the ECG to the patient’s medical record if required. Our I³ integrated ECG systems have the option to file this information to the correct patient for you, including a PDF report and associated Read codes. This ensures that the correct report is always filed to the correct patient's medical record.

For more tips and advice about taking an accurate ECG, please view our ECG Electrode Application Guide and 12 Lead ECG Best Practices, and why not download our ECG lead placement guide to ensure you are placing your leads in the correct position.