If you, like me, have never internalised the whole HISS thing for areas of the heart and are fed up with people telling you it’s easy, or to visualise it, STOP trying. Keep it simple. People think this is simple but it is only for them. Instead, think about where you apply the ECG leads. Visualise that.

V1 and V2 are placed on the sternum. You can think sternum for septal, or ‘high anterior’ (as they are high up on the front of the chest).

Leads v3 and v4 are placed on the front of the chest. They are anterior.

To see where leads V5 and V6 go, you have to turn an image of the heart to the left. They are lateral leads!

Try imagining you are the photographer in this 3D image. To see V5 and V6 clearly, you have to be standing on the patient’s left side.

To remember the limb leads, inFerior is avF, which has two more: ii, and iii. Now all you need to remember is that lateral is I and avL.

Does it work for you? Let me know. Now to go back and tell my old student paramedic self….