12 Lead ECG Placement Example - How to Perform a 12 Lead

In this video, I demonstrate electrode placement for recording 12 lead ECGs. I have a growing playlist of detailed tutorials for reading and interpreting 12 leads; check out the links below!
Quick note: It's important that the upper extremity electrodes are placed lower than you see me do in the video. They should be on the forearm just proximal to the wrist.
Thanks for watching! Don't forget to subscribe, like, and share!
Check out this huge ECG Interpretation Course:
Episode 1: Basic Principles - • ECG/EKG Interpretation...
Episode 2: Recording an ECG - • ECG/EKG Interpretation...
Episode 3: Regularity and Rate - • ECG/EKG Interpretation...
Episode 4: What is an arrhythmia? - Coming soon!
Episode 5: Atrial Rhythms - Coming soon!
Episode 6: Junctional Rhythms - Coming soon!
Episode 7: Pre-Excitation Syndromes - Coming soon!
Episode 8: Ventricular Rhythms - Coming soon!
Episode 9: Escapes and Extrasystoles - Coming soon!
Episode 10: Conduction Defects - Coming soon!
Episode 11: Identifying Ischemia - Coming soon!
Episode 12: The QT Interval - Coming soon!
Episode 13: Determining the Axis - Coming soon!
Episode 14: Hypertrophy and Enlargement - Coming soon!
Episode 15: A Few Final Thoughts - Coming soon!
Episode 16: Comprehensive Interpretation - Coming soon!
Bonus Mini ECG Tutorial Segments:
Performing a 12-Lead ECG (this one) - • 12 Lead ECG Placement ...
Heart Rate with 6-Second Method - • ECG Heart Rate Calcula...
Heart Rate with Big Box Method - • ECG Heart Rate Calcula...
A NOTE TO FELLOW EDUCATORS: Feel free and welcome to use my videos for your students. All I ask is that you provide your students the direct link to my videos on KZbin or embed my video into your LMS. Thanks!
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PLEASE NOTE: All of the content in this video and all other videos on this channel are solely the opinion of the creator and should NOT be used as medical advice or medical care. If you believe you have a medical condition related to the heart, you are advised to seek immediate medical attention in a hospital or medical clinic.

[@minimedlessons]

Thanks for watching! Want more detail about recording ECGs? Check out this episode - kzbin.info/www/bejne/bXWke6NjgJ2kd7c

[@melanieruiz4204]

The absolute best EKG 12 Lead video that I have ever found! I especially appreciate the specific attention provided on the palpating technique on both the skeleton model and the human model.

[@pipervibe3427]

Thank you for addressing how to find the second rib. It's something that has been overlooked in many demonstrations.

[@minimedlessons]

Absolutely! It's a very important part of correct placement of the precordial electrodes!

[@karinarahma5659]

Finally found a tutorial that matches the exact tool like the one my hospital uses.. the explanation is also great, thank you!!

[@Jade19751]

Thank for this, very helpful, I have my ecg exam tomorrow after watching this I feel more confident in passing my exam.

[@Scarlettbri_Mini3]

I'm taking an EKG class now and I have my national exam next week. This was helpful. Thank you

[@logangriffith4950]

for some reason we didn't go over this in emt school. interpreting is beyond our scope of practice, but setting this up for our medic partner really helps.

[@ThatClinicalInstructor]

Perfect placement, great video! My nursing and allied health students are learning EKG via Distance Learning because of COVID, and this was such a helpful video for them. Kudos!

[@minimedlessons]

Thanks for commenting and I'm so glad to know you found it helpful, especially during this pandemic. That's one of my goals- to provide good free resources for fellow educators out there. Feel free to share the video with any of your students anytime! Thanks for the comment!

[@LalitKumar-uj8wj]

Actually it was a great demonstration I am also a nursing student😊

[@kathyannrosendahl7270]

Very informative. Thank you!

[@bblastos]

good am starting my externship for my MA; needed a refresher! have seen it in our clinic a few times excellent review! I wanted to reestablish the landmarks for finding the intercostal spaces! excellent video! please keep them coming!! thank you!

[@minimedlessons]

I'm so glad you found it helpful! Best wishes with the externship!

[@bblastos]

@@minimedlessons thank you!!!

[@misheropurako6077]

Informative and on point 👍

[@michelle.ovando]

Love this channel!

[@italiawhaley9057]

Very interesting and helpful!

[@lovenessmumba5641]

Really helpful, thank you.

[@nursekamilah]

Thank you for posting this video! I will definitely be a great resource as I navigate through my transition from Medical-Telemetry Nursing to Critical Care Nursing!

[@minimedlessons]

Glad you found it!

[@shaimazargari6366]

Thank you it was very helpful for me

[@jasondarak1755]

Great video!

[@bbyeileengaray7664]

thank you this video helped alot ill be getting tested during my zoom meeting since ill be needing it so much

[@mariahernandez-wl5sg]

Thanks very well explained .

[@dr.varsha8810]

Great explanation

[@NishaS252]

Well done ! Nice refresher

[@minimedlessons]

Thank you! Cheers!

[@Nora-ob5tl]

Thanks you , very helpful

[@mubarakmuhammad2945]

That's very sweet and interested helpful video

[@nursinggrads]

very helpful, thank you so much

[@minimedlessons]

You’re welcome! Thanks for watching!

[@deejax7413]

Thank you!

[@tnami09]

Great video. I have to sign off some RN’s today on their ekg placement. This video is a great crash refresher prior to administering instruction.

[@minimedlessons]

Thanks for commenting and I'm so glad to know you find it helpful. That's one of my goals- to provide good free resources for fellow educators out there. Feel free to share the video with any of your students anytime.

[@georgeneilson6070]

Very intelligent man. Thanks for video.

[@minimedlessons]

Thanks for watching and commenting!

[@benjaminjaojoco268]

Tyler's an amazing teacher!

[@minimedlessons]

Benjamin Jaojoco thanks! That’s very kind of you!

[@octaviarose1857]

Thank you. This was very helpful

[@minimedlessons]

I'm so glad it was helpful!

[@cardrencejnr2620]

Thanks Doctor. I really found this helpful.

[@Teetee101]

Thank you for the information.

[@minimedlessons]

You're welcome! Thanks for watching, commenting, and (hopefully) subscribing! :)

[@aisha848]

THANKYOU!

[@sabirasolaiman]

very helpful, thank you!

[@minimedlessons]

You're welcome!

[@bayetaylor3930]

Thank you

[@klebonew7280]

I'm new thanks for your video very helpful

[@caseyjoe232]

Thank you recieved

[@marknorris6669]

The limb leads should be placed on the distal aspects of the limbs, i.e., proximal to the wrists and ankles, as per AHA guidelines. Placement on the upper aspects of the limb displaces the vectors of the augmented leads, which ultimately affects the QRS axis and frontal plane amplitudes. Otherwise, nice demo of the precordial leads

[@minimedlessons]

Hi Mark, thanks for commenting and for watching the video. I'm glad you enjoyed it. Your comment is spot on and you'll actually find I address this exact point in one of my EKG interpretation videos (kzbin.info/www/bejne/bXWke6NjgJ2kd7c). I personally always put them on the distal extremities when performing EKGs and train my students that way too. The main point I was trying to make in this video (and a huge problem I see in hospitals) is that limb leads do not belong on the shoulder or hips. I've seen that done far too often. But yes, unless not possible electrodes should be on the legs proximal to the ankle and arms just proximal to the wrist. Thanks for your comment! Check out that other video, starting at about 27:01 (kzbin.info/www/bejne/bXWke6NjgJ2kd7c?t=1621). Thanks!

[@emeelsaka]

Thanks

[@MohamadAsjadh-bd9uc]

Simple amazing ❤

[@audreysweeney5338]

That was great! Thanks so much!

[@simsim5265]

Thanks you !!!

[@minimedlessons]

You're welcome!

[@ressie4700]

Viewed once complete

[@attygarland6909]

Should include a follow-up so that you can tell if any of the chest leads are incorrectly placed by looking at the strip (if that is possible?). Too bad there isn't some kind of sensor gizmo you can use to quickly and easily detect the ribs (and intercostal spaces) that would help make sure placement is correct, btw, kinda analogous to those "stud finders" carpenters use to detect/locate the studs behind a wall.

[@TessHere]

Your explanation is very clear. thanks. Do you have a video that shows the whole process ? Eg. after all the leads are positioned, then enter patient info etc. (even though the machines may be different in different offices ). Its been a whle and I don't get to do it often or at all where i am now. thanks. Do you have any more tips on feeling for the ribs ? I find it hard to feel for the ribs after the 3rd rib, esp when someone is more fleshy,

[@akhilaramachandram7738]

Thank you for information 🙏

[@minimedlessons]

Thank you for watching!

[@dawnr7798]

Thank you very much for this video. I haven't performed EKGs in a long time and changed job positions in which I am performing them ALOT more, this was a great refresher. If all of my patients had the anatomy of your test subject in the video, then EKGs would be simple every time. I find my greatest challenge are females with large breasts, and it would be great if this was addressed as well. In many of those cases I'm placing the precordial leads as close as possible to where they should be, but it's still a challenge. Again, thank you for this video!

[@jsand5389]

I know what you mean. I perform EKG's in my office. Those are challenging, along with the very ticklish, men with large amounts of chest/limb hair, uncooperative children, etc.

[@roda515]

Please finish the EKG series.

[@ANonyMouse627]

Wow, I was never formally trained on this as a CNA and just realized I've been doing it wrong the whole time!

[@amyboyce4257]

That’s scary

[@alkashokeen1013]

Is there colour coding always same in leads like red green organ please tell me which color to be put were

[@attygarland6909]

Always wondered why it is called a "12-lead" EKG if there are only 10 leads attached to the body. ???

[@minimedlessons]

Great question! I talk about that in one of my EKG interpretation videos - Episode 2: kzbin.info/www/bejne/bXWke6NjgJ2kd7c Enjoy!

[@Samuel-xs2yv]

The 10 electrodes create 12 different paths to record the heart's electrical activity. The leads are the spaces between the electrode stickers, so only 10 stickers are needed to create the 12 paths.

[@ANonyMouse627]

What about the other two leads, they go at the bottom of the rib cage, right?

[@vanessaphillips3120]

I was hoping to see him fix the peeling off electrode ; to demonstrate how to apply tape to help hold everything in place. Also, I was hoping to see him apply all LEADs. As a beginner, this would be helpful to see the setup of procedure done entirely.

[@timjones3486]

If your skin preparation is excellent to begin with , ie no hair and lightly exfoliate with a skin preparation pad then the electrodes will always stay in place.

[@mattamon5302]

i have trouble finding the sternal angle

[@chelseysmith4735]

You forgot to mention those with lost limbs DO go on the lower abdomen.

[@kathyp374]

No, they go as close to the stump of the lost limb as possible. Limb leads would ONLY go on the abdomen if the patient was missing limbs up to the torso. Same for those with skin issues and Parkinson's.

[@zanahrina3213]

Thank you so much for the video BUT what about on females? all the videos I have seen so far places on males only, which seems easy to do. also how I do I go about in obese patients?

[@spectralcodec]

Do you still do it the same way if their heart is on the other side?

[@zahramasoumi3844]

I don't know why our professor said we don't place electrodes on right leg?

[@thechosenone1727]

What if the patients has hand tremors, Parkinson? I thought such cases would warrant placing the limb leads on the chest/abdomen? Also, if a patient was to perform a stress test, wouldn't placing them on the chest better than on moving arms? Honest question. Thanks

[@Princesshannah44]

Does it matter if limb leads are facing up or down?

[@Veronicadijasper]

Is it that a mistake if the line gets tangled?

[@o.m9514]

Does tight clothing affect the results?

[@apudey4088]

PLEASE SUGGEST ME A GOOD COMPANY 12 LEAD ECG MACHINE. OR FAR BETTER FROM 12 LEADS.

[@suldaantimacade9943]

🙏👌🙏👌🙏👌

[@minimedlessons]

Thanks for watching!

[@deekshamaheshwari4835]

Sir t wave abnormality h to kya koi problem h

[@joshr8466]

I was taught that V5 and V6 should be in the 5th intercostal space. Is this wrong? In the video, it looks like they're inferior to the 5th intercostal space

[@user-ju3eo1pm7s]

They're at the 5th intercostal space. Lead V4, V5, and V6 are at the same horizontal line

[@quadruplelatte]

V4 is 5th ICS. V5 and V6 are same horizontal line as V4, do not curve up following 5th ICS. This is a common confusion and my main criticism of an otherwise very good placement video. I wish he wouldn’t have presented 5th ICS and horizontal line as synonymous for V5-6

[@-naufanfaqiih]

Om itu beli dimana tengkoraknya?

[@chethanavirajini9129]

✌️✌️✌️

[@deannedgers5111]

We would like to discuss using this video for training purposes. Could we connect through email?

[@minimedlessons]

Yes, you should be able to find my email address under “About” on my channel’s main page. I look forward to hearing from you. Thanks!

[@andym7652]

I just watched another video that placed the lower extremity leads on the abdomen. 🙃🙃🙃

[@salemalnawaf468]

185 thousand watches and just 4.7K likes !!! unfear

[@timjones3486]

I was quite enjoying your video until you put the electrodes mid bicep 💪? Left and right forearm, proximal to wrists every time unless not possible! Moving the electrodes towards the torso increases the R wave amplitude in the inferior leads, decreases the R wave amplitude in the lateral leads and will encourage an axis shift to the right.

[@minimedlessons]

Tim, thanks for commenting and for watching the video. I'm glad you enjoyed it. Your comment is spot on and you'll actually find I address this exact thought in my next video (I've already recorded it, just working on editing; shooting to post it in the next 1-2 days). I personally always put them on the forearm when performing EKGs and train my students that way too. The main point I was trying to make in this video (and a huge problem I see in hospitals) is that limb leads do not belong on the shoulder or hips. I've seen that done far too often. But yes, unless not possible electrodes should be on the legs proximal to the ankle and arms just proximal to the wrist. Thanks for your comment! Check out my next video once it's up.

[@timjones3486]

MiniMedLessons I shall look forward to watching it, all the very best.Tim.

[@minimedlessons]

@@timjones3486 thanks! Same to you.

[@mohammadyasin9169]

Sometimes they using the electrodes on the wrists and some using it on the deltoid side.

[@god-la-7wins-verdad-942]

He was hugging death lol

[@tmash6732]

What about the other four leads ?

[@minimedlessons]

T Mash hello! Thanks for watching! What other four leads? There are 10 electrodes used for a 12 lead ECG.

[@sangmeshshivapooje1120]

Please explain how only 10 electrode used for 12 lead ECG,while in theory class I learnt 12 leads are used for recording,and I thought we use 12 electrodes for 12 lead ECG in practical also,but till now in any vedio I can able to find only 10 electrodes,so where are other 2 electrodes?

[@highman7520]

@@sangmeshshivapooje1120 someone doesnt pay attention and read

[@poornimaanand2488]

These were only 10 leads where are the 2 leftover leads

[@courtneyrolland7444]

Viewed

[@AllRounder-kb1kv]

It was not complete

[@aadilrasheed2984]

Well V5 and V6 should be in 5th intercoastal space so for that they should form an upward curce not horizontal because ribs on moving from backbone to sternum form a downward curve thus intercoastal space is also curved but not horizontal exactly Thus V5 should be slightly upwards than V4 and V6 inturn upwards than V5

[@briannabradley6453]

V5-V6, national standard is to follow the horizontal plane from V4, do not follow the curve of the ICS

[@Ganjatarian]

12 lead but I counted 10 on him. Am I missing something? 😂

[@minimedlessons]

Hello! The machine records and prints 12 leads from 10 electrodes. I explain how that works in this video: kzbin.info/www/bejne/bXWke6NjgJ2kd7c

[@vanessamd2020]

How do you do this on an obese patient?

[@minimedlessons]

For patients with obesity, it’s important to do you best to place the electrodes in the same intercostal/rib spaces you would on anyone else. Palpate deeply for the ribs, which are usually easier to feel superiority, and estimate as best you can in the areas where you can’t palpate ribs.

[@biloz2988]

You should not put any electrode over muscles, and the UEs electrodes should be placed over the wrists not the biceps

[@Rowgasmic]

Where is lead 11 and 12?

[@heathernay8879]

I find it difficult for women, especially women with huge breast.

[@mathewrobles1364]

Palpating like it's a mannequin. Ouch.

[@minimedlessons]

Like HE’S a mannequin, you mean? :) Need to know you’re in the right spot. Too many people are too afraid to touch people and push when needed. It’s far more important to palpate ribs and know you’re in the right location than it is to worry a little bit of palpation is going to hurt someone. Obviously you don’t push so hard it causes pain and bruising, but don’t be afraid to palpate like you would on a mannequin.

[@Dervishi11]

Don’t ever ever put tape pacient skin wow 😯

[@minimedlessons]

Hello! We actually use forms of tape on patient skin often. Paper tape is best because the adhesive is less significant. Some forms of tape should be avoided, yes, and always avoid any adhesives in those who have allergies to adhesives. Thanks!

[@Broogcastro]

Thank you!

[@ashanigunasekara9398]

Thank you

[@brittneyhipp6677]

Thank you