The 12 Leads of Christmas: V5

This article is the ninth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. We’re getting into the home-stretch in our little series. I wasn’t entirely sure if we were going to make it through since a few of the leads, though they are useful, don’t bring much that is particularly unique to the table. V5 is one of those leads (like aVF and V4), and while there is still plenty to discuss, it’s not as exciting as lead III, aVL, or aVR. Don’t lose faith, however, as I have saved three of my favorites—V2, V3, and V6—for last. Anyway, let’s get on with this V5 business. One of my favorite tricks for showing off to new techs (and letting them know that I’m keeping an eye on their work) is to guess that they were sloppy with their precordial lead placement without even seeing the patient. How do I do that? V1 is a good place to start, looking for signs of incomplete right bundle branch block that could mean the lead was placed too high on the chest. Another common error, however, is to bunch up leads V4-V6 on the anterior chest. Despite personally training many of the techs in my department, I still see this setup way too often: Crazy precordial electrode placement. V1 and V2 are way too high (cephalad) and wide (lateral), V4–V6 are bunched up on the anterior chest, and V3 is in no man’s land.   It’s hard to make a 2D diagram t...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 12-Leads of Christmas Vince DiGiulio Source Type: research