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Discussion

V lead placement

I work with a 5 electrode monitoring systerm. I put the extremity electrodes on the 4 corners of the torso. I put the V lead electrode on any of the six V-lead positions, V1-V6. I almost always use V1, but if there is a reason to choose a different lead, I will.

This question is not about which V lead to use, but about what I see as a very common practice:

People frequently put this electrode somewhere in the middle of the chest. I often see it at about th3 6th intercostal, right in the middle.

Why? Is there some valid reason to do this. I have asked people why they do this, and usually get one of two answers:

1 "I am monitoring the V-lead" If I ask which one, I get a blank look.

2. "It's how I was taught". If I ask which lead they are monitoring, I get a blank look.

SO- Is there a valid reason for this practice? It is so widespread, I figure maybe I am missing something.

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Your not missing anything. The blank looks are from people that don't know or understand how to place a 12 lead EKG, or the reason why they are place where they are placed.

What is widespread is the lack of understanding that gets shared around. Maybe you could suggest to your education department that a 12-lead EKG course would be a good idea.

You know, it is hilarious because I do 12 leads all of the time, but it never occured to me to monitor a patient in any of the V-leads but V1. My co-workers would probably look at me strange if they went in to fix the leads on one of my patients and I were monitoring in V6- but there would be nothing wrong with doing so.

You are correct that many people are very sloppy with V lead placement, and often do just slap them somewhere in the middle of the chest and call it good.

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