12 and 15 Lead ECG > Overview
  Next >>


This module provides an explanation of the concepts relating to 12 and 15 Lead ECG monitoring in the critically ill patient.

Learning Objectives

After successful completion of this module, you will be able to:

  • Describe the three basic principles of electrocardiography
  • Describe the difference between unipolar, bipolar, and precordial ECG leads
  • Define how the electrical axis of the QRS complex is obtained
  • Discuss the normal 12 lead ECG
  • List criteria for RA enlargement, RV hypertrophy, LA enlargement and LV hypertrophy
  • Discuss criteria for 12 lead ECG diagnosis of RBBB and LBBB
  • Describe criteria for diagnosis of a myocardial infarction
  • Define injury, infarction and ischemia in relation to ST elevation, ST depression, and pathological Q waves


The online material provides the theory of ECG monitoring and provides simulated practice. Before becoming fully responsible for reading a patient's ECG, you should engage in supervised practice and further training with an experienced nurse.


Hearns , P.A. (1994). Differentiating ischemia, injury, infarction: Expanding the 12 lead electrocardiogram. Dimensions of Critical CareNursing,13(4),172-178. (CLASSIC)

Miracle, V. and Sims, J. (1999) Making Sense of the 12-Lead ECG (Part 1), Nursing 99, July, 34-39.

Miracle, V. and Sims, J. (1999) Making Sense of the 12-Lead ECG (Part 2), Nursing 99, August, 41-46.

Urden, L.D., Lough, M.E., & Stacy, K.M. (2006) Thelan’s Critical Care Nursing (5th ed). Boston: Mosby.

  Next >>
  © 2019 Province of New Brunswick Regional Hospital Authorities