CONNECTIVITY AND ECG TRANSMISSION
For accurate precordial (V or C) lead placement and monitoring, it is important to locate the 4
th
intercostal space.
The 4
th
intercostal space is determined by first locating the 1
st
intercostal space. Because patients vary with respect
to body shape, it is difficult to palpate the 1
st
intercostal space with accuracy. Thus, locate the 2
nd
intercostal space
by first palpating the little bony prominence called the
Angle of Lewis
, where the body of the sternum joins the
manubrium. This rise in the sternum identifies where the second rib is located, and the space just below it is the 2
nd
intercostal space. Palpate and count down the chest until you locate the 4
th
intercostal space.
Patient Hookup Summary Table
38
AAMI Lead
IEC
Lead
Electrode
Position
Red
Red
On the 4
th
intercostal space
at the right sternal
border.
Yellow
Yellow
On the 4
th
intercostal space
at the left sternal
border.
Green
Green
Midway between
V2/C2 and V4/C4
electrodes.
Blue
Brown
On the 5
th
intercostal space
at the left
midclavicular line.
Orange
Black
Midway between
V4/C4 and V6/C6
electrodes.
Violet
Violet
On the left
midaxillary line,
horizontal with
V4/C4 electrode.
Black
Yellow
On the deltoid,
forearm, or wrist.
White
Red
Red
Green
On the thigh or
ankle.
Green
Black