How to record a 12-lead electrocardiogram
Intended for healthcare professionals
Evidence and practice    

How to record a 12-lead electrocardiogram

Emma Menzies-Gow Senior lecturer, School of Nursing, Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, London, England

Why you should read this article:
  • To acknowledge the importance of recording a 12-lead electrocardiogram (ECG) in the assessment and diagnosis of patients with suspected arrhythmias, hypertension, coronary heart disease or heart failure

  • To optimise your practice when recording a 12-lead ECG, including correct positioning of the electrodes and appropriate patient preparation

  • To understand the evidence base that supports the practice of recording a 12-lead ECG

Rationale and key points

This article provides a step-wise, practical approach to recording a 12-lead electrocardiogram (ECG) and explores the evidence base that supports the use of this important assessment tool in clinical practice.

A 12-lead ECG is frequently used in a variety of clinical settings, including emergency care, preoperative and post-operative assessment, and primary care. It is used to assess and diagnose patients with suspected arrhythmias, hypertension, coronary heart disease or heart failure.

Correct positioning of the electrodes using anatomical landmarks is essential to ensure an accurate and high-quality ECG recording.

Skin preparation is essential, since suboptimal electrode contact or electrodes being placed where there is a significant amount of dry or dead skin cells, grease, sweat or hair, can negatively affect the quality of the ECG recording.

Reflective activity

‘How to’ articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of:

How this article might improve your practice when recording a 12-lead ECG.

How you could use this information to educate your patients and colleagues on the appropriate technique for recording a 12-lead ECG.

Nursing Standard. doi: 10.7748/ns.2018.e11066


Menzies-Gow E (2018) How to record a 12-lead electrocardiogram. Nursing Standard. doi: 10.7748/ns.2018.e11066

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software


Conflict of interest

None declared


Please note that information provided by Nursing Standard is not sufficient to make the reader competent to perform the task. All clinical skills should be formally assessed at the bedside by a nurse educator or mentor. It is the nurse’s responsibility to ensure their practice remains up to date and reflects the latest evidence

Published online: 20 April 2018

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