1. Correct placement of electrodes is crucial.
The placement of electrodes for ECG monitoring is standardised to ensure that the information gathered is accurate and can be compared with records from other occasions. To ensure accurate results, the patient must also be correctly prepared both physically and psychologically (ADInstruments 2025).
Poor electrode placement can result in mistaken interpretation, which can lead to possible misdiagnosis, patient mismanagement and inappropriate procedures (Handzel 2023).
ECG electrodes are colour-coded, each identified by a specific code that refers to its intended placement. There are two coding systems currently in use:
The American Heart Association (AHA) system
The International Electrotechnical Commission (IEC) system.
Both systems are described in the table below.

2.Method of 5-Lead Placement

Note: The following guide uses the AHA system.

1. Prepare the patient physically and psychologically:
   • Explain the procedure in detail.
   • Obtain informed consent.
   • Maintain patient dignity (i.e. give them privacy).
   • Ensure the patient is in the supine position.
   • Ensure the patient is comfortable and relaxed.
2. Perform appropriate skin preparation:
   • Select sites away from large muscle groups. Sites should be flat with intact skin.
   • Dry, dead epidermal layers of skin should be removed. Natural oils and dirt should also be removed.
   • Shave hair at the allocated sites.
   • Wash sites thoroughly with soap and water. Rinse and dry well.
3. Place the electrodes:
   • The lead wires should be attached before the electrodes are applied.
   • The electrodes should be applied by pressing around the edges instead of in the centre (this spreads the gel out and creates air pockets).
   •