The use of the electrocardiogram (ECG) in critical care settings is a long-established cardiovascular monitoring tool. The effectiveness of the routine 12-lead ECG relies on accurate lead placement that is consistent and replicable. Improper lead placement may display erroneous ECG patterns and affect patient management decisions. In the setting of an acute injury, such as a torso burn to the ventral surface, accurate lead placement may be compromised or impossible. The regional burn center, which is part of our organization, sees approximately 500 patients per year. Of those patients, burns to the chest accounted for 21% of admissions during 2020 and 2021. This significant fraction of burn injury patients requires modification of our standard approach to provide an accurate ECG. Baseline ECGs are routinely acquired on the burn unit per protocol and for monitoring of patient response to numerous pharmaceutical therapies.