Contents Page

Page
Abstract 1
Section 1– Correct lead placement 2
Section 2 - Incorrect lead placement 5
Section 3 – Conclusion and recommendations 7
References
Appendices

Abstract

Recording an electrocardiogram or ECG, is a procedure which is performed daily all over the United Kingdom by thousands of healthcare workers and in particular nurses (Jacobson, 2000). The way in which this procedure is performed varies from geographical location to location and occasionally even more so, between staff on the same ward (Amos, 2000). This reason stated by Amos (2000), formed the basis of my decision to choose this topic.

The recording of an ECG is often seen as a fairly mundane, routine …show more content…
However, Cowley (2002) suggests that although this may eliminate problems of interpretation and encourage prompt review of ECG’s, the basics of lead placement remain essential knowledge.
Section Two – Incorrect lead placement
According to Cowley (2002) the analysis of the twelve lead ECG is all about measurements, the height and depth of waves which are important in the diagnosis of certain conditions such as myocardial infarction or hypertrophy. Lead placement is especially important if the extent of these conditions is to be determined and treated appropriately (Jacobson, 2000). The following changes in the twelve lead ECG have been shown to occur when the electrodes are placed incorrectly on the torso; • A shift in the cardiac axis towards the right, which has clinical significance in that, patients may be seen to have ventricular hypertrophy and subsequent incorrect medical and nursing management. • R wave becomes smaller in lead I, which could result in the missed diagnosis of ventricular hypertrophy and subsequent incorrect management. • Less prominent Q waves in inferior leads, which would result in the mis-diagnosis of an established myocardial infarction and subsequent incorrect medical and nursing management.
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