5 Lead ECG Placement Mneumonic

If you’ve been following along, you know that I absolutely love mneumonic devices and think they are one of the most effective ways to remember the immense amounts of weird, random information that nursing school will throw at you. As a nurse, you will be performing plenty of ECGs throughout your career, and this 5 lead ECG placement mneumonic has never (ever) steered me wrong. 

The first time I performed an ECG on a patient as a nursing assistant, the nurse looked at me and said

Don’t panic! It’s actually really easy. White on the right. Clouds over grass. Smoke over fire. Dirt in the middle.

I stared at her like she was absolutely crazy until I realized what she was saying, and I’ve literally never had a problem remembering lead placement since. Allow me to explain with some visuals.

Though I don’t personally use “poop comes from the tummy” or “green goes last” (because it doesn’t really matter), this one is similar and helpful too!

Next time you’re looking at a patient in preparation to perform a 5 lead ECG, remember your 5 lead ECG placement mneumonic and follow these easy steps

1. Approach the patient from the correct side. Remember that your right is their left. This sounds very simple but I promise I have made this mistake and at some point you probably will too.
2. Start with white on the right, clouds over grass. This means the white (RA) electrode goes on the top right side.
3. Then, because of clouds over grass, you know that the green (RL) goes on the bottom right.
4. Move to the left side. Smoke over fire means the black electrode (LA) is on the upper left.
5. Smoke over fire means the red electrode (LL) is on the lower left.
6. Ground (or shit) in the middle. Dead center of the chest (essentially in between the two boobs if it’s a female).
7. That’s it! You did your ECG!

*Remember that if you ever panic and forget these, the electrodes will always say RA (right arm), RL (right leg), LA (left arm), LL (left leg), and V (nobody knows but it’s the only different one so it’s just chest). The electrodes tell you exactly where to put them, so you never have to worry!