To identify conduction abnormalities, cardiac arrhythmias, myocardial ischemia or myocardial infarction (rare in children), injury, necrosis, bundle-branch block, fascicular blocks, and chamber enlargement

To document pacemaker performance

Explain the test to the child and his parents, stressing that the test is painless.

Describe the equipment that will be used for the test; show the child a picture or, if possible, the actual equipment.

Explain to the patient the need to lie still, relax, and breathe normally during the procedure. He may sit on his parent’s lap if necessary.

Explain that the child may have to lie on his left side, inhale and exhale slowly, or hold his breath at intervals during the test.

Note current cardiac drug therapy on the test request form as well as other pertinent clinical information such as the presence of a pacemaker.

Explain that the test is painless and takes 5 to 10 minutes.

Confirm the child’s identity by checking two patient identifiers.

Place the child in a supine or semi-Fowler’s position.

Expose the chest, ankles, and wrists.

Place electrodes on the inner aspect of the wrists, on the medial aspect of the lower legs, and on the chest.

After all the electrodes are in place, connect the lead wires.