hey everyone it's Sarah threats Turner sorry and calm and in this video I want to demonstrate for you the lead placement for a 12-lead EKG first you want to gather your supplies so you don't want to get 10 of these electrode stickers next you'll want to get some alcohol prep this will help you remove those oils from that top layer of the skin so the electrode stickers will stick then you'll want to get a strip of abrasive tape which is just really this little fine gritty sand paper stuff that you'll use to rough up that top layer of the epidermis so these electrodes will stick to now if you're doing this on a patient who has a lot of hair on their chest you'll want to get some trimmers to trim that hair because sticking these electrode stickers over hair does not work and it causes a lot of artifacts so you'll want to trim those hairs okay so the first thing what we're gonna do is we're gonna place our limb leads which are which include our right arm or left arm or right leg and our left leg and then we will place our limb leads which will be v2 through v6 okay whenever you're placing limb leads you can either put them on the chest which you're gonna see me doing this video or you can put them on the extremities from where I worked in a stress lab we always use the chest for the limb leads because the patient was going to be exercising and when you exercise you move your arms and legs and that can cause a lot of artifact so to do the right arm we're gonna go right below the right clavicle and what we want to do is we want to prep that site you're going to take some alcohol prep cleanse it very well removing any oils from the skin let that dry then take your brace of tape and just gently rough up the skin that top layer so the sticker will sit good to it the electrode and each electrode has backing so you're gonna peel that backing off like that has like this gel and make sure they're not dry if they're really dry looking get new electrodes because it'll affect your connection and you're just gonna put that there and just smooth it on the skin now we're gonna put our left arm and you're going to do the same prep cleanse the skin with alcohol prep rough it up we're on Rob below that left clavicle and then we're gonna put our electrode okay now let's do our leg leads okay we're gonna do the right leg so we're going to go down to the right upper quadrant and again you could place this on the leg I'm going to cleanse the area I'm going to gently rough up the skin and put our electrode and we're going in the right upper quadrant now we're gonna do the last leg we're gonna go in the left upper quadrant again cleanse the area rough up the skin and place our electrode now let's place our test leads which again is v1 through v6 and to do that we need to find our intercostal spaces and it's best to follow this way of identifying the landmarks to find why intercostal space you're in so first what we're gonna do is we're gonna find the sternal notch which is literally is a notch and it's found in between the clavicles and then you're gonna go down just slightly and you're gonna feel this protrusion a little hump this is called the angle of Lewis also called the sternal angle and we're gonna place v1 first so we're gonna go to the right of that angle and we're going to be in the second intercostal space now v1 is in the fourth intercostal space right of the sternum so we're gonna go down there's a third there's the fourth so we're in the fourth intercostal space and this is where v1 is gonna go slightly just next to the sternum so again just gonna cleanse the area really good rough it up and then place your electrode okay now v2 is going to be literally right beside of it on the opposite side it's going to be again buying your sternal notch go down where the hump is which is your angle of Luis from the second intercostal space third and then fourth and it's going to be on the left side so cleanse the area and rough it up then place your electrode okay so right now we have v1 and v2 okay we're gonna skip v3 for a second you're gonna see why we're gonna go to v4 v 4 is found at that fifth intercostal space so again find your landmarks second third fourth fifth and we're gonna go mid clavicular ly so mid way of the clavicle and it's going to be right here so that is going to be v4 so we're gonna cleanse the skin rough it up and then we're going to place our electrode okay and now we're going to go back to V 3 and V 3 is in between v2 and v4 so we're going to go right there so we're gonna cleanse the skin wrap it up place our electrode okay so we have v1 v2 v3 v4 now we're going to do these five and these five is going to be level with v4 but it's going to be at the left anterior mid-axillary line so right here so cleanse area fit up man we're going to place our electrode okay and our last one is v6 and these six is going to be level with v5 but it's gonna be at the mid-axillary line so literally right underneath the armpit so it's going to be right here so we're going to cleanse it up our electrode okay so let's go over them again we have our limb leads right arm left arm right leg left leg now we have our test leads we have the 1 v2 v3 v4 v5 and v6 ok so that is the lead placement for a 12 lead EKG thank you so much for watching and don't forget to subscribe to our channel for more videos