Bundle Branch Blocks in Tennessee

I have recently (less than a year) transfered to a new hospital.

I work in a 10 bed icu where monitor techs watch the unit patients as well as patients throughout the facility. The monitor techs chart via computer the patients rates and rhythms. I have noticed that they are charting bbb. Am i just old school or has something changed? I was taught that it is outside an rns scope to chart bbb as it is a call to be made by the physician.

Any thoughts on how to handle this if i am correct?

[roser13, ASN, RN]

Your title made me laugh. I thought "What? Are they different in Tennessee?!"

I've never worked in cardiac and I can't knowledgeably answer your question. But if, as you say, the tech is there to monitor/record rates and rhythms, why wouldn't they document what they see? Is a BBB block different from SVT or V-tach?

I'm confused.

Yes....versus BBB's in New York.

I assume techs who monitor telemetry have received some training, even certification, in basic EKG recognition. They would, should, be able to recognize and chart basic rhythms and arrhythmias. A fib, A flutter, brady, tachy, BBb's, and most importantly V-tach. and V-fib. Probably a few other basic arrhythmias I'm missing.

I guess to be safe they could chart appears to be BBB?

[cardiacfreak, ADN]

I work telemetry and yes we can chart BBB. The QRS complex must be greater than 120msec

A Bundle Branch Block is a conduction problem in either the right or left fascicles of the Bundle of HIS, SVT is supra ventricular tachycardia which is a problem with the atria, and VTach is a problem with the ventricles.

[roser13, ASN, RN]

I work telemetry and yes we can chart BBB. The QRS complex must be greater than 120msec

A Bundle Branch Block is a conduction problem in either the right or left fascicles of the Bundle of HIS, SVT is supra ventricular tachycardia which is a problem with the atria, and VTach is a problem with the ventricles.

I guess I didn't state that very well. My question really was: Is CHARTING a BBB any different than charting SVT or V-Tach? I don't understand why charting the BBB might be out of the RN's scope of practice.

I have worked as a monitor tech and we can chart BBB. We just aren't allowed to name Right or Left- that is up to the cardiologist.

[Nurse SMS, MSN, RN]

I have never heard of RNs (or tele techs) not being allowed to identify a bundle branch block.

If the QRS complex is > 0.12 seconds it's a BBB. I'm guessing you've confused right vs left BBB, which is something the cardiologists can read from a 12-lead.

[dudette10, MSN, RN]

It's an assessment finding, like any other. If you know how to read it (and be sure you do), you can chart it. Are we not allowed to say an RR of 24 is tachypnea? Are we not allowed to say a BP of 85/40 is hypotension?

Just because tele strip reading takes more skill and practice does not mean it is out of scope for a properly trained RN. In fact, if a patient suddenly has a lethal arrhythmia, you better believe we have to interpret AND act upon it as soon as possible.

[psu_213, BSN, RN]

I too don't see any reason why a tech or RN could not determine/chart a BBB on a rhythm strip.

I have to say, when I saw the title of the thread, I was thinking it was a BBB in combination with S3 or S4 (I can never remember which is Kentucky vs. Tennessee ).

I guess I didn't state that very well. My question really was: Is CHARTING a BBB any different than charting SVT or V-Tach? I don't understand why charting the BBB might be out of the RN's scope of practice.

It's not.