ECG Best Practices with the CORE 500™


The Eko CORE 500™ Digital Stethoscope is a powerful tool designed to elevate patient care by combining traditional stethoscope functionality with advanced digital capabilities, including a 3-lead ECG. Whether you’re an experienced clinician or new to digital auscultation, here’s a guide to ensure you get the best ECG readings every time.
ECG Best Practices with the CORE 500™
ECG quick tips
  1. Skin contact is required. Don’t place over clothing.
  2. Wet the skin, not the device. Immediately place it on the patient while skin is moist.
  3. Use more pressure than is standard. Skin should be indented by a few millimeters. Device should be settled so as to not rub on chest hair.
  4. Your hand and the patient must be steady during a recording. Place your free hand on the patient’s back to steady them.
  5. Wait 2-5 seconds to confirm a strong connection. Don’t move the device while waiting for the ECG to stabilize.
Understanding the CORE 500™’s ECG capabilities

The CORE 500™ is equipped with three modified leads corresponding to specific ECG waveforms viewable on both the chestpiece and in the Eko App. These leads provide a comprehensive view of cardiac activity, which is crucial for accurate diagnostics.

Optimal patient positioning

Proper patient positioning is key to obtaining a clear ECG reading. While a patient is seated upright, apply counter pressure to their back. Ensure the patient is calm, still, with uncrossed legs and arms relaxed at their sides. This minimizes muscle tension, which can interfere with ECG accuracy​. 

CORE 500™ placement

To replicate the accuracy of a traditional 12-lead ECG without the need for electrodes, position the CORE 500™ at key anatomical landmarks:

  • Left Upper Sternal Border (LUSB)
  • Right Upper Sternal Border (RUSB)
  • Left Lower Sternal Border (LLSB)

Apply firm, steady pressure and hold the stethoscope still to avoid any movement that could disrupt the signal. For patients with larger body types, gently displace any excess tissue to ensure a better connection​.

Handling the CORE 500™

Grip the stethoscope in a “Y” or reverse “Y” hold, a “C” hold, or a palming position to stabilize. Avoid letting the earpiece dangle, as this can introduce unwanted sounds. Always hold the device securely but comfortably to maintain control without causing patient discomfort​.

Keep the device still

Movement can significantly impact ECG quality. Ensure both you and your patient remain still during the recording. Avoid any rubbing or contact between the stethoscope and clothing, jewelry, or other surfaces that could disrupt the ECG. If there’s any interruption or the patient moves around, begin a fresh recording​​.

Skin prep for optimal contact

Proper skin preparation is essential for a clean and accurate ECG signal. Before placing the CORE 500™, ensure the skin is clean. Use an alcohol wipe to fully wet the area where the stethoscope will be placed. This step provides moisture which improves ECG signal by reducing impedance on the skin. It also removes oils, dirt, and sweat that can interfere with electrode contact and signal quality. You can wet the electrodes on the CORE 500™ as well, but directly wetting the skin is the best way to improve ECG quality.

  • Why use alcohol wipes? Alcohol wipes effectively wet the skin and remove natural oils and debris that may create a barrier between the skin and the stethoscope's contact points. This ensures a better connection, resulting in a clearer, more reliable ECG reading.
  • How to prep the skin: Simply wipe the area in a circular motion with an alcohol pad, place the stethoscope while the skin is still wet. This quick step can significantly enhance the quality of your ECG recording by reducing impedance and improving signal clarity​.

If the patient has chest hair, try to “settle” the stethoscope into the hair. You can also proactively use two alcohol wipes, as hair will absorb the wetness. There is no need to shave the patient.

Checking for arrhythmias

The CORE 500™ automatically flags unclassified rhythms, including arrhythmias, and can indicate poor ECG signals. Always review the summary screen for any alerts that require attention. This feature helps ensure no critical findings are missed, enhancing your confidence in the accuracy of each diagnosis​.

Practicing your skills

Like any skill, mastering ECG readings with the CORE 500™ takes practice. Familiarize yourself with the device’s features and spend time reviewing both good and bad recordings to understand the differences. Over time, you’ll gain the expertise needed to leverage the full potential of this advanced stethoscope.

The Eko CORE 500™ Digital Stethoscope is a game-changer for cardiac assessment, offering high-quality ECG readings that are both accessible and easy to interpret. By following these best practices, you can maximize the accuracy of your readings, ultimately leading to better patient outcomes and enhanced care.

Remember — quiet environments, proper positioning, and correct handling are your best allies in achieving the best possible results with the CORE 500™.

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