Republic of the Philippines

TARLACSTATEUNIVERSITY
COLLEGE OF SCIENCE
DEPARTMENT OF NURSING
Lucinda Campus, Brgy. Ungot, Tarlac City Philippines
Tel.no.: 4931865 Fax: (045) 982-0110 website: www.tsu.edu.ph
Accredited Level 2 status by the Accrediting Agency of Chartered Colleges and Universities in the Philippines, Inc,
(AACCUP)
NCM 112 –RLE SKILLS LAB
PERFORMANCE CHECKLIST
OBTAINING AN ELECTROCARDIOGRAM
Name:______________________________ Date:_______________
Year & Group:________________________ Score:______________
Instructor/Evaluator:___________________

An electrocardiogram (ECG) is a test which measures the electrical activity of the heart to
show whether or not it is working normally.
- records the heart's rhythm and activity on a moving strip of paper or a
line on a screen.
Goals: 1.To obtain a cardiac tracing via machine without any complications.
2. To help identify primary conduction abnormalities, cardiac arrhythmias, cardiac
hypertrophy, pericarditis, electrolyte imbalances, myocardial ischemia, and the site
and extent of myocardial infarction.

Equipment:
ECG machine conduction paste or gel Clippers (optional)
ECG electodes Recording paper

PROCEDURE: 40pts. 2 1 0 Comment

1. Place the electrocardiogram (ECG) machine close to the
patient’s bed and plug the power cord into the wall
outlet.

2. Perform hand hygiene. Check the patient’s identification

3. As you set up the machine to record a 12-lead ECG,

explain the procedure to the patient. Tell him that the
test records the heart’s electrical activity and it may be
repeated at certain intervals. Emphasize that no
electrical current will enter his body. Also, tell the patient
that the test typically takes about 5 minutes.

4. Have the patient lie supine in the center of the bed with
his arms at his sides. Raise the head of the bed if
necessary to promote comfort. Expose the patient’s
arms and legs and drape appropriately. Encourage the
patient to relax the arms and legs. If the bed is too
narrow, place the patient’s under his buttocks to prevent
muscle tension. Use this technique if the patient is
shivering or trembling. Make sure the feet are not
touching the bed board.

5. Select flat fleshy areas to place the electrodes. Avoid

muscular and bony areas. If the patient has an
amputated limb, choose a site on the stump.

6. If an area is excessively hairly, clip it. Clean excess oil

or other substances from the skin

7. Apply electrode paste or gel or the disposable

electrodes to the patient’s wrists and to the medial

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 aspects of his ankles. If using paste or gel, rub it into the
skin. If using disposable electrodes, peel off the contact
paper and apply electrodes directly to the prepared site,
as recommended by the manufacturer’s instructions.
Position disposable electrodes on the legs with the lead
connection pointing superiorly.

8. If using paste or gel, secure electrodes promptly after

you apply the conductive medium. Never use alcohol or
acetone pads in place of the electrode paste or gel.

9. Connect the limb lead wires to the electrodes. The tip of

each lead wire is lettered and and color coded for easy
identification.
- White or RA lead wire goes to the right arm;
- Green or RL lead wire to the right leg;
- Red or LL lead wire to the left leg
- Black or LA lead wire to the left arm
- Brown or Vi to V6 lead wires to the chest
Make sure the metal parts of the electrodes are clean
and bright.

10. Expose the patient’s chest. Put a small amount of

electrode gel or paste on a disposable electrode at each
electrode position. Position chest electrodes as follows;
- V1: 4th ICS at right sternal border
- V2: 4th ICS at left sternal border
- V3: halfway between V2 and V4
- V4: 5th ICS at midclavicular line
- V5: 5th ICS at anterior axillary line (halfway
between V4 and V6)
- V6: 5th ICS at midaxillary line, level with V4

11. Check to see that the paper speed selector is set to the
standard 25mm and that the machine is set to full
voltage.

12. If necessary, enter the appropriate patient identification

data

13. Ask the patient to relax and breath normally. Tell him to
lie still and not to talk when you record his ECG.

14. Press the AUTO button. Observe the tracing quality.

The machine will record all 12leads automatically,
recording three consecutive leads simultaneously. Some
machines have a display screen so you can preview
waveforms before the machine records them on paper.
Adjust waveform if necessary. If any part of the
waveform extends beyond the paper when you record
the ECG, adjust the normal standardization to half-
standardization and repeat. Note this adjustment on the
ECG strip because this will need to be considered in
interpreting the results

15. When the machine finishes recording the 12-lead ECG,

remove the electrodes and clean the patient’s skin.

16. After disconnecting the lead wires from the electrodes,

dispose of or clean the electrodes, as indicated.

17. Label the ECG recording with the patient’s name, room

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 number, and facility identification number, if not done by
the machine. Also record the date and time as well as
any appropriate clinical information on the ECG.

18. Document the test’s date and time as well as significant

responses by the patient in the medical record.
Score:______________________

Final Grade:___________________

Shown To Me:
__________________________________ _______________
Student’s Signature over Printed Name Date Signed

Shown By:
__________________________________ ________________
Merlie Q. Espiritu,RN,MAN Date Signed
Clinical Instructor

Noted:

Regie S. Jimenez, RN,MSN

Program Chairperson

Prof. Mary Jane N. Rigor, RN,MSN

Dean

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