Thomas E. O'Brien
AS CCT CRAT RMA
Upon completion of the accompanying narrative, the student will be able to:
People may choose to analyze ECG’s in a number of different ways. The sequence doesn’t necessarily matter as long as you gather and report the proper information each time.
If your protocols are different, always follow them.
Evidence of Bundle branch block (BBB) may be seen in any lead, but the best view for determining the difference between left and right BBB is lead V1.
Interruption, delay of conduction or a change in the electrical conduction pathway will cause morphologic changes in the QRS complex.
Among those changes seen will include a widening of the QRS complex measuring 0.12 seconds or greater and may include an alteration in the deflection of the ventricular depolarization.
Changes specifically seen include the QRS complex measuring 0.12 seconds or greater due to this delay.
When determining the presence of BBB there are just a few simple steps to follow.
By following the previous three steps, you will be able to determine whether a BBB is present or not.
Now it is simply a matter of one more step when analyzing the QRS in V1 to distinguish whether it is a left BBB or a right BBB.
Analyze the terminal portion of the QRS complex. Starting at the “J” point go one small box back into the QRS (moving to the left).
Identify the branch bundle block.
Learn to recognize the morphologic features and criteria for complete left or right bundle branch block. Practice exercises available.
ECG Axis Determination
Hundreds heart rhythms in this practice test. Test can be tailored for specific learning needs.
A quiz using a simulated patient monitor. Evaluate a scrolling waveform rather than a paper tracing.