ECG lead placement: cheat sheet

22 Nov

always good to know where to hook up the leads

  • not only to be able to do it on your own
  • but also handy for checking placement if your ECG looks inexplicably odd (hint: go back and see where the stickers/leads are sitting on your patient’s chest)

 

for the LIMB LEADS:

if you’re lucky, they’re labeled and not faded, with RA (right arm), LL (left leg), etc.

in the UNITED STATES (colors are apparently different in Europe), here’s the mnemonic I learned:

think of it like 4 corners of your torso (where your limbs start):

  • smoke over fire (black over red)limb
  • white on right (hey, it rhymes)
  • by process of elimination the green lead goes in the one remaining corner of their torso (RL)

in EUROPE, the colors are apparently different, so if anyone has a mnemonic from across the pond, please feel free to share.

us-eu

 

PRECORDIAL LEADS (V1-V6):

here’s how I remember placement:

  • V1 is on the right sternal border, V2 is on the left sternal border: both are ~4th intercostal = nipple line
  • V4 is mid-clavicular, so I put it at the lower edge of pectoral/breast under the left nipple
  • V6 is mid-axillary, easy enough
  • then fill in the blanks: V3 (placed halfway between V2 and V4), then V5 (between V4 and V6)

there you go.

 

References: limb leads picture; european/us lead colors; precordial leads + picture

 

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3 Responses to “ECG lead placement: cheat sheet”

  1. Robert March 25, 2016 at 11:19 #

    i remember it as white is right, black is opposite of white (in both color and placement), smoke over fire (red under black), snow on grass (green under white) and 5th lead is apparently variable. Seem to remember in my class that brown is ground and would go on the inner thigh of the right leg on a 5 lead (which is what we worked with in class)

  2. Хедра March 20, 2017 at 01:52 #

    In Europe the mnemonic is yellow flower on a green meadow – and you don’t want to see red (blood) on the side of the heart, so I follows red is on right. I like it like more like the stop lights – red-yellow-green. Red on the right arm and then comes yellow on the left arm and green on the left leg, so black is for the right leg.

  3. jp April 2, 2017 at 13:46 #

    here is another mnemonic in https://www.thedoc.org/forums/topic/105-12-lead-ecg-placement-mnemonics/

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