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EKG and Rbbb

Cardiac   (29,654 Views 11 Comments)
by MM2007 MM2007 (Member)

1,914 Profile Views; 47 Posts

Hello,

What would i be looking for if a patient had a Right bundle branch block on their EKG.

Thanks

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suzy253 is a RN and specializes in Telemetry/Med Surg.

3,815 Posts; 16,660 Profile Views

First you'd see a wide QRS complex. To determine if it is RBBB vs LBBB you look for the "M' shaped QRS--kinda notched looking. If this appears in V1 which is the right chest lead, then it's a RBBB. Clear as mud, huh?

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AnnieOaklyRN is a BSN, RN, EMT-P and specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

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hi,

RBBB= wide qrs >.12 plus R and r prime in V1. The later part of the QRS will be upright.

LBBB= wide qrs > .12 Later part of the QRS will be negatively deflected (opposite of RBBB)

Turn signal theory: If you are driving your care and want to signal to the right you put the signal control thing up, and if you want to signal to the left you put the signal turn control thingy down which correlates with the later part of the QRS complex.

'tooth

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emtb2rn has 21 years experience as a BSN, RN, EMT-B and specializes in Emergency.

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I like the turn signal theory. That's the kind of mneumonic that works for me. Have any more?

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cardiacRN2006 is a ADN, RN and specializes in Cardiac.

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Up in lead V1 -right. Down is left..

So I remembered it as upright, down-left.

But if you just remember upright, then it's easy as pie.

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UM Review RN is a ASN, RN and specializes in Utilization Management.

7 Articles; 5,163 Posts; 27,503 Profile Views

Right BBB in a CHFer:

ekg-rbb.jpg

Left BBB

ecg_12lead013z.gif

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It will have a wide (>.12) QRS complex and will have the "bunny-ears" look to it's QRS. How to tell if it's a RBBB vs a LBBB? If you have access to a 12-lead, this is an easy way to tell: A RBBB's QRS will be upright in V1-V3, and a LBBB's QRS will be downward in V1-V3.

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Kinjo specializes in LTC, Med/Surg,Cardiac.

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some one told me if you are reading a strip on lead II that the right and left turn analogy works too, is that true? I mostly just put down BBB without specifying coz I can never get the difference.

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