Medical professional administering EKG test

Step-by-Step Guide to Electrocardiograms

Learn the procedures, steps, risks, and requirements for performing electrocardiograms.

Medical professional administering EKG test

Electrocardiograms (EKGs) are one of the simplest and quickest tests medical professionals use to evaluate the condition of a patient’s heart. In addition, this standard procedure is painless, requires little prep, and can help save lives. Mastering this skill will lead to a much better experience for healthcare practitioners and their patients.

Electrocardiograms are a vital procedure used for a number of medical diagnoses. This essential skill can be exciting for new healthcare professionals and can be very beneficial for Medical Assistants to learn the proper method of administering an EKG.

This article provides an in-depth guide on the art and science of electrocardiograms, one of the most important healthcare procedures for medical staff.

(Click here to see our full list of Medical Assisting duties and responsibilities).

Electrocardiogram Definition

What are Electrocardiograms?

Electrocardiograms are a medical test used to evaluate a patient’s heart. Electrodes are positioned on the patient’s chest, arms, and legs and are then connected to a machine by lead wires.

What is the Purpose of an EKG?

Essentially, EKGs are the standard test used by medical professionals to identify cardiovascular conditions. They allow physicians to see if a heart is damaged or lacking oxygen. An EKG may also be used to help determine or detect the following:

  • Abnormal heart rhythm
  • Blocked or narrowed arteries in your heart that could cause chest pain or a heart attack
  • If you have had a previous heart attack
  • The efficiency of some heart disease treatments, such as a pacemaker

How Long Does it Take to Perform an EKG?

On average, the test only takes about five to ten minutes. This includes attaching the electrodes and completing the procedure. However, the actual recording takes mere seconds.

Who Can Administer an EKG?

Electrocardiograms are typically performed by a variety of different healthcare professionals, including doctors, nurses, technicians, or other medical staff. In addition, some Medical Assistants may also administer this test.

The frequency by which Medical Assistants perform EKGs mostly depends on their training and location. MAs with specialized electrocardiogram training are referred to as EKG Technicians. They learn how to use and clean different types of EKG machines. They also need to know how to read heart monitors. This training should also include an MA EKG practice test. It confirms that they know how to read the results and communicate them to the patient properly.

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Students completing admissions process

Training Requirements for Electrocardiograms

Electrocardiogram requirements may vary and can depend on your location and profession. Generally, EKG certification programs take anywhere from three to six months to complete. You will need a high school diploma or GED to enter one of these programs. In addition, it’s not unheard of for EKG Technicians to earn an associate degree that includes hands-on training in medical settings.

Some employers may prefer candidates with experience in healthcare, such as an EMT or hospital volunteer. At Unitek College, we offer a Medical Assisting program that could give you a strong advantage when interviewing for EKG technician positions.

Many EKG Technicians also pursue certification. After you have acquired one year of experience in the field, you will likely be eligible for testing to become certified with the National Healthcare Association. You can also become certified as Certified Cardiographic Technician (CCT).

Electrocardiogram Procedure

With these steps, you can start to learn more about the process of electrocardiograms. Just like any other skill, EKGs require time and practice to get them right. Try not to feel disheartened if you don’t get it right the first time. And don’t hesitate to ask for help.

EKG Preparation

While electrocardiograms don’t require much prep, there are a few things you can do to speed up the process. This includes making sure the gain and paper speed is set as ordered by the physician. For example, the standard gain is 10mm/mV, and the standard speed is 25mm/sec. Ensure that an image like this indicating paper speed and gain can be seen on the 12-Lead EKG printout. Most importantly, though: If the protocols at your facility are different, always follow them.

EKG Steps

Here are some of the general guidelines you should follow when performing an EKG on adults or children:

  1. Explain the procedure to your patient.
  2. Ask your patient to remove any electrical equipment from their person, such as mobile phones or watches. They must also remove metallic objects (i.e., chains, bracelets, etc.)
  3. Instruct your patient to undress from the waist up and expose their ankles. Always ensure their modesty is not compromised by covering their torso with a sheet.
  4. Ask the patient to lie down on a stretcher near the electrocardiograph.
  5. Use an alcohol solution to disinfect the areas in which electrocardiogram electrodes will be placed.
  6. Place the EKG electrodes on the thorax, wrists, and ankles.
  7. Tell the patient not to move or speak during the test. They should breathe normally, though.
  8. Record the electrocardiogram.
  9. Check the electrocardiogram before removing the electrodes. Ensure every lead is seen and there are not many artifacts present. If you are ever in doubt, don’t hesitate to consult a doctor.
  10. Always write the patient’s full name on the electrocardiogram as well as the date and time the test was performed.

Hands holding a heart


After the procedure, the patient can resume their normal activities. There isn’t a recovery period for the majority of electrocardiograms. Remember, this exam is meant to be fast and noninvasive.

Necessary Equipment for an EKG

Typically, the suggested supplies for electrocardiograms include the following items:

  • Electrodes (i.e., sensors)
  • Gauze and skin prep solution that your facility has approved
  • Razor and a roll of tape for hair removal
  • Skin adhesive or antiperspirant
  • EKG Paper if your machine provides a hard copy

Potential Risks or Complications of EKGs

EKGs are often safe, painless tests that do not have any major risks. In fact, the electrodes, or sticky patches, that keep the sensors on your patient’s chest do not emit electric shocks. At most, the average patient might develop a slight rash or irritation where you attach the electrodes.

Pro Tips for Mastering the Art of EKGs

Here are some pro EKG tips that may assist you in the future.

  • Follow the Colors – To correctly place the electrodes, you might want to take another look at the color codes for the International Electrotechnical Commission (IEC) and the American Heart Association (AHA). While we don’t know a trick for the AHA, we do have one for the color code of the IEC. These colors are similar to a traffic light: red, yellow, and green, as they are placed in that order in a clockwise direction. So start with the right arm (red), left arm (yellow), left leg (green), and right leg (black).
  • Location, Location, Location – On the other hand, location is more important than colors when it comes to precordial electrodes. A common question for these ones is: How do I locate the fourth intercostal space? It’s best to count the spaces between your patient’s ribs, right along the edge of their sternum, until you reach the fourth. Then, place V1 and V2 on the right and left sides of the sternum within the fourth intercostal space.
  • Avoid Excessive Suction With suction cup type of electrodes, it’s important that you set the electrode but do not cause redness or bruises.
  • Moisten Some Types of Electrodes If you’re having a hard time getting clothespin type of electrodes to stick to the skin, you may want to moisten the electrode with an alcohol solution.
  • When to Connect It’s absolutely vital that you shave when necessary for clip types of electrodes. Also, you must connect the cable and electrode before putting it on the patient. If you do so afterward, it can put painful pressure on the patient’s skin.
  • It’s All in the Bite When it comes to seal-type electrodes, make sure you correctly attach the clamps to the electrode’s ear. Otherwise, they will likely deteriorate with each use. So, make sure the “bite” is right!

Why Should Medical Assistants Learn How to Administer EKGs?

Even though many facilities employ EKG Technicians, it can be very beneficial for some Medical Assistants to learn these skills. This is because EKG Technicians may not always be available or accessible in smaller settings or even hospitals. If a doctor orders an immediate EKG, the responsibility may fall to the Medical Assistants on duty.

While EKGs are not a job requirement in every doctor’s office, it is a valuable skill that leads to greater opportunities. Therefore, it would be advantageous for MAs or aspiring Medical Assistants to seek EKG certification. Once they are certified, an MA would likely become more indispensable to their employer and enrich their career.

Medical professionals touching hands as a symbol of teamwork

Start Your Career in Medical Assisting

Electrocardiograms are truly a crucial skill that aspiring Medical Assistants should consider learning for their careers. It’s also an essential medical practice for several diagnoses and other lifesaving procedures.

Think about it: Without electrocardiograms, we could all suffer from a host of dangers, including treatment errors, abnormal heart rhythm, blocked or narrowed arteries, heart attacks, failing pacemakers, and more.

If you’re feeling inspired and would like to pursue a career in medicine, Unitek College offers various healthcare programs, such as our Medical Assisting program.

Contact us today to learn more about our programs and tuition assistance options. Take the first step toward a rewarding future in healthcare!