How to Place a 5-Lead ECG: Electrode Placement Explained
ECG Lead Placement: This lecture reviews an acronym mnemonic on how to place a 5 lead ECG, and a diagram for electrode location/positioning for telemetry, cardiac monitoring, etc.
Save Time with a Video!
Save time! Watch the video as you follow along with the lecture below!
Click below to view the EZmed video library. Subscribe to stay in the loop!
Pass Your Classes & Exams!
Become a member to access HUNDREDS of study guides, flashcards, & PDF lectures!
Master 5-Lead ECG Placement!
Download the study guide below!
What is the 5 Lead ECG used for?
A 5 lead ECG is typically used for cardiac monitoring or telemetry, as it provides a continuous live reading of the electrical activity of the heart.
In other words, a 5 lead ECG is used when the patient’s heart rate and rhythm must be continuously monitored, such as in the hospital or emergency room.
A 5 lead ECG differs from a 12 lead ECG in that it provides continuous monitoring of the heart, whereas a 12 lead ECG provides a static more comprehensive reading of the heart at that specific time.
A 5 lead ECG uses 5 electrodes and 5 lead wires.
Electrodes are sticky conductive pads placed on the skin, and they allow the electrical activity of the heart to be recorded.
The lead wires connect to the electrodes, and they transmit the electrical activity of the heart to the ECG machine.
The 5 electrodes are placed in certain positions on the body, and each of the 5 electrodes is connected to a different colored lead wire.
Let’s review where the electrodes and different colored lead wires are placed….and a mnemonic to remember it all!
Please leave a comment down below if this lecture helps you!
ECG = Electrocardiogram = A test that records the electrical activity of the heart to check for various heart conditions.
Note: The image below is used for definitions and is not a 5 lead ECG.
ECG Lead Placement: Electrode vs lead wire definition and meanings
5 Lead ECG Placement
As previously mentioned, a 5 lead ECG uses 5 electrodes and 5 lead wires.
The 5 electrodes and lead wires include:
Right Arm (RA) = White (clouds)
Right Leg (RL) = Green (grass)
Left Arm (LA) = Black (smoke)
Left Leg (LL) = Red (fire)
Chest (V1 or C) = Brown (chocolate)
Note: The colors and positions of the lead wires vary in different countries.
5 Lead ECG Placement: Diagram using an acronym mnemonic to remember the location and colors of the electrodes and lead wires
5 Lead ECG: Mnemonic
The acronym, mnemonic, or rhyme to remember ECG lead placement and the color codes for a 5 lead ECG is:
White on the Right
Clouds over Grass
Smoke over Fire
I Heart Chocolate
Let’s review how to place a 5 lead ECG and where to place each lead using this acronym mnemonic!
5 Lead ECG Placement: Acronym mnemonic to remember where to place the leads and a colored diagram showing their location
White on the Right
First, use “white on the right” to remember the white lead (RA) goes on the right side.
5 Lead ECG Placement: Use the acronym mnemonic “white on right” to remember the white lead goes on the right side
Clouds over Grass
Next, use “clouds over grass” to remember the white lead (clouds) goes over the green lead (grass).
We already know “white on the right”.
So the white lead (RA) is placed below the right clavicle at about the 2nd intercostal space midclavicular line.
The green lead (RL) is placed on the lower edge of the rib cage at about the 7th or 8th right intercostal space midclavicular line.
Note: The RA and RL leads are typically placed on the chest rather than the actual limbs (right arm and right leg) to reduce artifact from the patient moving their limbs.
5 Lead ECG Placement: Use the acronym mnemonic “clouds over grass” to remember the white lead (clouds) goes over the green lead (grass)
Smoke over Fire
Next, use “smoke over fire” to remember the black lead (smoke) goes over the red lead (fire).
We will perform the same steps as before, but on the left side now.
So the black lead (LA) is placed below the left clavicle at about the 2nd intercostal space midclavicular line.
The red lead (LL) is placed on the lower edge of the rib cage at about the 7th or 8th left intercostal space midclavicular line.
Note: The LA and LL leads are typically placed on the chest rather than the actual limbs (left arm and left leg) to reduce artifact from the patient moving their limbs.
5 Lead ECG Placement: Use the acronym mnemonic “smoke over fire” to remember the black lead (smoke) goes over the red lead (fire)
I Heart Chocolate
Finally, use “I heart chocolate” to remember the brown lead (chocolate) goes in the center of the chest near the heart.
The brown lead is the chest or V1 lead, and it is placed in the 4th intercostal space just right of the sternum.
5 Lead ECG Placement: Use the acronym mnemonic “I heart chocolate” to remember the brown lead (chocolate) goes in the center of the chest by the heart
Before You Go….
Leave a comment down below if you enjoyed the lecture!
SAVE TIME studying and PASS your classes - Get free lectures and videos sent right to your inbox below!
ReferencesCadogan M.; ECG Lead Placement; Life in the Fastlane; Jan 2022; Accessed Aug 2023; https://litfl.com/ecg-lead-positioning/Johns Hopkins Medicine; Electrocardiogram; Accessed Aug 2023; https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/electrocardiogram