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EKG and Rbbb


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


suzy253 specializes in Telemetry/Med Surg.

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?

OK well how does it look if it's a LBBB? Do the rabbit ears show up somewhere else?

AnnieOaklyRN specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.


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.


cardiacRN2006 specializes in Cardiac.

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.

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.

Kinjo specializes in LTC, Med/Surg,Cardiac.

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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