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12 Lead ECG Tips

Did you know that 85% of problems that occur whilst trying to record a 12 lead ECG machine come from dirty crocodile clips, poor skin preparation or dry electrodes?

Follow the tips below to ensure that you don’t experience any problems when you’re next taking a 12-lead ECG:

1. Prepare the Skin Thoroughly

If the patient has significant body hair at electrode sites, gently shave the areas to ensure electrodes adhere properly. Clean the skin using a sterilising wipe to remove oils, sweat, and lotions that can impede signal quality. After cleaning, allow the skin to dry completely before proceeding.

2. Exfoliate the Skin

After cleaning, gently rub the electrode sites with a dry gauze pad. This helps remove residual oils and dead skin cells, enhancing electrode contact and reducing impedance, which can improve signal clarity.

3. Use High-Quality ECG Electrodes

Use good quality ECG electrodes with reliable performance, such as the Ambu SUPAtab. These electrodes combine wet gel with superior adhesion, ensuring optimal signal transmission and reducing the likelihood of artefacts.

4. Allow Electrodes to Settle

Once applied, allow the electrodes to remain on the skin for approximately one minute before initiating the ECG recording. This settling time enables the gel to establish effective contact with the skin, enhancing signal quality.

5. Store Electrodes Properly

Store unused electrodes in an airtight container to prevent the gel from drying out. For wet gel electrodes, use them within 14 days of opening; for solid gel electrodes, within 30 days. Proper storage ensures electrode efficacy and signal quality.

6. Maintain Crocodile Clips

Regularly clean crocodile clips to remove accumulated gel and debris, which can affect conductivity. If performing one to three ECGs per week, consider replacing the clips annually to maintain optimal performance.

Additional Best Practices

  • Patient Positioning: Ensure the patient is comfortably reclined with arms at their sides and legs uncrossed. Instruct them to remain still and breathe normally during the procedure to minimise artefacts. 

  • Electrode Placement: Accurate placement of electrodes is crucial. Refer to a lead placement guide to ensure correct positioning, which is essential for reliable ECG interpretation. 

  • Recording Format: Record the ECG in a 4 x 3 format with a rhythm strip, typically lead II, along the bottom. This standard format facilitates comprehensive analysis.

  • Documentation: Note any clinical signs or symptoms the patient experiences during the ECG, such as chest pain, on the tracing or in accompanying notes. This information is vital for accurate diagnosis.

  • Post-Procedure Care: After completing the ECG, gently remove the electrodes and dispose of them according to clinical waste protocols. Ensure the ECG is correctly labelled with the patient's details and filed appropriately.

By adhering to these enhanced guidelines, healthcare professionals can improve the accuracy and reliability of 12-lead ECG recordings, leading to better patient outcomes.

For further resources and support, visit Numed Healthcare's ECG Electrode Application Guide and 12-Lead ECG Best Practices pages. If you experience any other problems when you're using our diagnostic equipment then remember to visit our dedicated support section for more help and advice.