Clinical location of the fourth and fifth intercostal spaces as a percent of the length of the sternum
AffiliationUniv Arizona, Coll Med, Sarver Heart Ctr, Div Cardiol
Univ Arizona, Res Comp UITS
MetadataShow full item record
CitationFrank Marcus, Trina Hughes, Phillip Barrios, Mark Borgstrom, Clinical location of the fourth and fifth intercostal spaces as a percent of the length of the sternum, Journal of Electrocardiology, Volume 51, Issue 1, 2018, Pages 55-59, https://doi.org/10.1016/j.jelectrocard.2017.05.006
JournalJOURNAL OF ELECTROCARDIOLOGY
Rights© 2017 Elsevier Inc. All rights reserved.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractObjectives: To verify accurate placement of the precordial ECG leads by identifying the 4th and 5th intercostal spaces as a function of the length of the sternum. This should decrease the percentage of lead misplacement leading to misdiagnoses. Methods: The population consisted of patients and healthy volunteers. The proposed method compared palpation of the 4th and 5th intercostal spaces to a percentile of the sternal length. Location of the 4th and 5th intercostal space using a simple device was evaluated to assist in proper placement of the precordial leads to obtain accurate diagnosis. Results: The location of the 4th and 5th intercostal space is related to the length of the sternum. It is 77% of the sternal length that measures 15 cm for the 4th intercostal space. The position of the VI and V2 electrodes decreases to 57% when the sternal length is 26 cm. Similar data was obtained to locate the 5th intercostal space with proper position of V4-V6 electrodes. Tables are provided to facilitate this process. An instrument was designed to measure the 4th and 5th intercostal space as a function of the sternal length. Conclusions: The location of the 4th and 5th intercostal space is identified based on the length of the sternum. (C) 2017 Elsevier Inc. All rights reserved.
Note12 month embargo; published online: 18 May 2017
VersionFinal accepted manuscript
- Identification of 4th intercostal space using sternal notch to xiphoid length for accurate electrocardiogram lead placement.
- Authors: Day K, Oliva I, Krupinski E, Marcus F
- Issue date: 2015 Nov-Dec
- Proposed bedside maneuver to facilitate accurate anatomic orientation for correct positioning of ECG precordial leads V1 and V2: a pilot study.
- Authors: Lehmann MH, Katona AM
- Issue date: 2012 Oct
- Comparison of p-wave patterns derived from correct and incorrect placement of V1-V2 electrodes.
- Authors: García-Niebla J
- Issue date: 2009 Mar-Apr
- The anterior to midaxillary line between the 4th or 5th intercostal space (Buelau position) is safe for the use of thoracostomy tubes in preterm and term infants.
- Authors: Eifinger F, Lenze M, Brisken K, Welzing L, Roth B, Koebke J
- Issue date: 2009 Jun