How to record a 12-lead electrocardiogram

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: 1.How this article might improve your practice when recording a 12-lead ECG.2.How you could use this information to educate your patients and colleagues on the appropriate technique for recording a 12-lead ECG.