Electrode placement – ZOLL M Series Defibrillator Rev H User Manual

Page 5

12-lead

9650-0215-01

12-lead - 3

Electrode Placement

Location

AHA Labels IEC Labels

Right Arm

RA (white)

R (red)

Left Arm

LA (black)

L (yellow)

Right Leg

RL (green)

N (black)

Left Leg

LL (red)

F (green)

Chest

Place electrodes on the patient. All electrodes must be
connected. Proper skin preparation and use of proper
electrodes are very important for a good signal quality.
If necessary prepare the patient’s skin for electrode
application by:

•

Shaving or clipping excess hair at electrode site. Avoid
placing electrodes over tendons and major muscle
masses.

•

Cleaning oily skin with an alcohol pad.

•

Briskly rubbing site to dry.

When acquiring 12-lead ECG from quiet supine patients,
ZOLL recommends placing the limb electrodes anywhere
along the ankles and wrists. When it is difficult for the patient
to remain motionless due to shivering, muscle tremors, or
transport vehicle movement, better results are often obtained
if limb electrodes are placed on the patient’s thorax. (Refer to
the two diagrams below for limb electrode placement).

RA/R

LA/L

RL/N

LL/F

Place the precordial electrodes across the chest in the
following locations:

V1 : Fourth intercostal space, at the right sternal margin.
V2 : Fourth intercostal space, at the left sternal margin.
V3 : Fifth rib, between leads V2 and V4.
V4 : Fifth intercostal space, on the left midclavicular line.
V5 : Left anterior axillary line, at the horizontal level of V4.
V6 : Left midaxillary line, at the same horizontal level as V4

and V5.

Locating the V1 position (fourth intercostal space) is critically
important because it is the reference point for locating the
placement of the remaining V leads. To locate the V1
position:

1. Place your finger on top of the jugular notch (see figure

below).

2. Move your finger slowly downward about 1.5 inches (3.8

centimeters) until you feel a slight horizontal ridge or
elevation. This is the "Angle of Louis" where the
manubrium joins the body of the sternum.

3. Locate the second intercostals space on the right side,

lateral to and just below the Angle of Louis.

4. Move your finger down two more intercostal spaces to

the fourth intercostal space which is the V1 position.

Note: When placing electrodes on female patients, always
place leads V3-V6 under the breast rather than on the
breast.

Angle of Louis

Jugular notch