ECG tips for finding intercostal spaces

[halsey]

I am struggling a bit with 12 lead ECGs. I prefer counting down the intercostal spaces from the clavicle.  I just wanted to check that the first space between the clavicle and first rib IS NOT counted as the first intercostal space  so you skip that space when counting? When counting down from clavicle is it best to start at part of clavicle that's closest to sternal notch or mid clavicular? Any tips appreciated.

[hppygr8ful, ASN, RN, EMT-I]

I just follow the little diagram thingy attached to the machine and works every time! But I applaud you wanting to do it the correct way. 

 

[chare]

@halsey, you are correct, the space between the clavicle and first rib is not the intercostal space.  There two anatomical landmarks to consider when counting intercostal spaces.  The angle of Louis is located at the level of the second rib and the sixth rib is located at the base of the sternum.

And, I agree with @hppygr8ful in applauding reaching out for suggestions to ensure you are getting an accurate ECG.