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| Home - Past Webinars - ECG Boot Camp: Basic Training in 12-Lead Electrocardiography: Arrhythmias CEU |
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ECG Boot Camp: |
Basic Training in 12-Lead Electrocardiography: Arrhythmias |
| 9 Content Hours |
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Course Description:
Cardiac care clinicians are required to know
the bare essentials in reading an
electrocardiogram (ECG). Commonly, the
preparation is a short course on arrhythmias
(and those courses often teach arrhythmia
recognition from lead II only).
Consequently, in practice, much more is
expected and necessary for competent patient
care. This 6-hour course will give the
clinician a basic understanding of the
fundamentals of 12-lead ECG interpretation
of arrhythmias. It is designed for nurses,
therapists, or exercise physiologists
working in cardiac rehabilitation, telemetry
units, emergency departments, intensive care
units, or anywhere cardiac ECG monitoring is
required. This course focusing on basic
arrhythmia interpretation is the first in a
series of 12-lead ECG interpretation
courses.
Who Should Be Interested:
Nurses, therapists or exercise therapists working in cardiac
rehabilitation, telemetry units, emergency departments, intensive care
units, or anywhere cardiac ECG monitoring is required.
Presenters:
Patricia Lounsbury, RN, BSN, MEd, CCRN, FAACVPR
Class Schedule:
- Cardiac Anatomy, Physiology, and Electrophysiology
- Absolute Necessities: Leads, Axis, Principles of Monitoring, What’s Normal
- Absolute Necessities: The Sinus Rhythms
- Absolute Necessities: Atrial Rhythm Disturbances and Supraventricular Tachycardias
- Necessities: AV Junctional Rhythm Disturbances and AV Blocks
- Absolute Necessities: Ventricular Rhythm Disturbances
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#1 - Cardiac Anatomy, Physiology, and Electrophysiology
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Topics:
The first step in reading an ECG is understanding how the ECG is
generated and what it represents in the heart. While you have studied
much of this in your basic health care education, this class will
reiterate what you have already learned, adding to it and stressing
additional factors that relate to the ECG. This is the foundation for
everything that follows in this six-hour course.I. Gross cardiac
anatomy
A. Atria
B. Ventricles
C. Vessels
D. Normal circulation through the heart
E. Coronary arteries
II. Conduction system
III. Electrophysiology terms
IV. Components of the electrocardiogram
A. P wave
B. PR interval
C. QRS complex
D. ST segment
E. T wave
F. U wave
V. ECG paper, measurements, settings, voltage
VI. Determining rate on the ECG
VII. Rules for interpreting cardiac rhythms
A. Rate
B. Rhythm
C. P waves
D. PR interval
E. QRS complex
Behavioral/Learning Objectives:
- Describe the sequence of circulation through the heart and the supply of blood to the heart through the coronary arteries.
- List structures of the conduction system, explain the sequence of normal cardiac activation, and describe the resultant wave forms produced on the ECG.
- Define the electrophysiologic terms depolarization, repolarization, refractory period, and conduction.
- Define time and voltage values on the ECG and compute heart rate and rhythm.
- Explain the derivation of the P-wave, QRS complex, PR interval, PR segment, ST segment, T-wave, and U-wave and define the normal durations and amplitudes of each.
- Explain the QRS descriptors.
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#2 - Absolute Necessities: Leads, Axis, Principles of Monitoring, What’s Normal |
Topics:
To determine what’s abnormal in a 12-lead ECG, it is imperative to know
what is normal and be able to make that determination quickly.
Determining the QRS axis on the frontal plane, if the T wave and ST
segments are directed normally, and thoroughly understanding leads and
how to manipulate them are skills fundamental to rapid 12-lead ECG
interpretation. Often not taught in arrhythmia interpretation courses,
this information is basic and necessary to understand the remaining
sessions in this series.I. Leads of the frontal plane
A. Standard, bipolar limb leads
B. Unipolar limb leads
C. Determination of axis
II. Leads of the horizontal plane
A. Two very important leads for monitoring
(V1 and V5)
B. Bipolar substitutes for V-leads
III. Lead choices for various populations
IV. Other leads (posterior, right ventricular,
etc.)
V. Rules for monitoring
A. One lead is not enough!
B. Choose lead based on patient, not policy!
Behavioral/Learning Objectives:
- Identify a normal 12-lead ECG.
- Explain how the P wave, QRS complex, and T wave should look in all 12 leads.
- Identify the electrical axis of the ECG in seconds.
- Describe the normal precordial pattern and how it is derived.
- Explain how bipolar substitutes for the V leads are derived, e.g., MCL1, MCL5, CM5, etc., and when they are indicated.
- List advantages of using V1 and V5 for monitoring in cardiac rehabilitation.
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#3 -
Absolute Necessities: The Sinus Rhythms |
Topics:
The sinus rhythms differ from other anatomic classifications, such as
atrial, junctional, and ventricular arrhythmias, mainly because not all
are pathologic. Some are known as physiologic rhythms or variations of
normal sinus rhythm and are found in healthy people. While it is
important to recognize the variations, it is equally important to
remember that these rhythms are not necessarily prognostically
significant.I. Normal sinus rhythm
A. ECG characteristics
B. Normal rates for various ages
II. Sinus arrhythmia
A. ECG characteristics
B. Types
1. Respiratory
2. Nonrespiratory
C. Implications of its presence
III. Sinus tachycardia
A. ECG characteristics
B. Etiology and treatment
IV. Sinus bradycardia
A. ECG characteristics
B. Etiology and treatment
V. Sino-atrial blocks
A. ECG characteristics
1. Type 1 second degree SA block
2. Type 2 second degree SA block
B. Differential diagnosis
VI. Sick sinus syndrome
A. ECG characteristics
B. Some treatment options
Behavioral/Learning Objectives:
- Describe the features of normal sinus rhythm (NSR) for adults and children.
- Differentiate physiologic from pathologic arrhythmias and identify ECG examples and characteristics of each.
- Identify sinus tachycardia, explain factors to consider in determining clinical significance, and list ten etiologic factors associated with it.
- Define sinus bradycardia and compare and contrast its mechanism with sinus tachycardia.
- Define SA blocks and discuss recognition on the ECG, differentiating from sinus bradycardia.
- Describe “sick sinus syndrome” and common treatment for it.
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#4 -
Absolute Necessities: Atrial Rhythm Disturbances and Supraventricular Tachycardias |
Topics:
The atrial arrhythmias and supraventricular tachycardias are rhythm
disturbances that will be encountered often in electrocardiograms of all
age groups. It is essential that the clinician is able to quickly
differentiate supraventricular rhythms from ventricular, diagnose atrial
arrhythmias, and be able to distinguish significant atrial rhythm
disturbances from normal variations.I. Atrial premature beat/contraction (APB or APC or
PAC)
A. Types
1. Typical
2. Nonconducted
3. Morphology of P wave
4. P’R interval of the APB
B. Significance
C. ECG characteristics
II. Supraventricular tachycardias
A. Multiform atrial tachycardia
B. Paroxysmal supraventricular tachycardia
C. Atrial tachycardia
D. Atrial flutter
E. Atrial fibrillation
III. Wandering pacemaker
IV. Atrial escape rhythm
Behavioral/Learning Objectives:
- Explain the clinical significance of each of the atrial arrhythmias and specify which may be found in healthy people and which may be indicative of disease.
- Describe ECG features of atrial premature beats or contractions (APBs/APCs) and explain the various ways they may be displayed on the ECG.
- Define paroxysmal supraventricular tachycardia (PSVT), describe possible associated findings, and list two etiologies.
- Define atrial tachycardia with and without block and differentiate it from other atrial tachycardias, such as PSVT, atrial flutter, etc.
- Identify and explain the ECG features of atrial flutter, listing three leads that tend to exhibit flutter waves clearly, and anticipate the ventricular rate in both adult and pediatric patients prior to treatment.
- Identify atrial fibrillation, describe its hemodynamic effects, risk of thrombus formation, and treatment.
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#5 -
Necessities: AV Junctional Rhythm Disturbances and AV Blocks
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Topics:
The atrioventricular (AV) junction includes the AV node and the bundle
of His. The junctional tissue contains cells capable of automaticity.
The junction is also capable of slowing and blocking impulses from
traveling from the atria to the ventricles. Thus, this class will
discuss the AV blocks as well as the junctional arrhythmias.I.
Junctional premature beats
A. ECG characteristics
B. Comparison of APBs and JPBs
II. Junctional tachycardia
A. ECG characteristics
B. Treatment options
III. Junctional escape beats and idiojunctional
rhythm
A. ECG characteristics
B. Implications
IV. AV blocks
A. First degree
B. Second degree
1. Type I
2. Type II
C. Third degree
D. ECG characteristics of each of the AV blocks
E. Treatment options
Behavioral/Learning
Objectives:
- Describe which leads are most helpful in assessing junctional arrhythmias, differentiate junctional from atrial arrhythmias and discuss retrograde atrial depolarization.
- Identify premature junctional contractions (PJCs) and differentiate from APCs.
- Define junctional tachycardia and explain how it is different from atrial tachycardias.
- Identify first, second (both type I and type II), and third degree AV blocks.
- Describe AV dissociation.
- Define the Wenckebach phenomenon and describe two of its ECG manifestations.
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#6 -
Absolute Necessities: Ventricular
Rhythm Disturbances |
Topics:
The ventricular arrhythmias are the most important of the cardiac rhythm
disturbances because the ventricles are responsible for pumping blood to
the body. If faulty ventricular depolarization results in little or no
ventricular pumping, the result may be lethal. Yet, as will be seen in
this class, ventricular arrhythmias are ubiquitous and may be benign or
malignant. The trick is distinguishing lethal or potentially lethal from
benign ventricular arrhythmias.I. Ventricular premature beat or
contraction (VPB or VPC or PVC)
A. ECG characteristics
B. Incidence and implications
II. Ventricular tachycardia (VT)
A. ECG characteristics
B. Incidence and implications
III. Ventricular fibrillation
A. ECG characteristics
B. Treatment
IV. Accelerated idioventricular rhythm
A. ECG characteristics
B. Implications
V. Idioventricular rhythm
A. ECG characteristics
B. Implications
Behavioral/Learning Objectives:
- Define sudden cardiac death and relate the arrhythmias most often responsible for it and the type of patient most likely to be at higher risk.
- List five causes of ventricular premature beats (or contractions) (VPBs, VPCs, or PVCs) and describe the ECG features and patterns of occurrence.
- Recognize ventricular tachycardia and contrast it with supraventricular tachycardia.
- Differentiate accelerated idioventricular rhythm and ventricular tachycardia, explaining differences in treatment and outcome.
- Describe ventricular fibrillation and delineate treatment.
- Identify ventricular asystole and discuss treatment options.
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Accreditation Information |
Nurses – Academy Medical Systems is
an approved provider of continuing nursing
education by the Illinois Nurses Association, an accredited approver by the
American Nurses Credentialing Center’s
Commission on Accreditation. 9.0 contact
hours will be rewarded to nursing
professionals at the completion of this
workshop.Academy medical Systems is also a provider
approved by the California Board of
Registered Nursing, provider #CEP14413, for
9.0 hours. And we are also a provider
approved by the Florida Board of Nursing,
provider #50-19, for 9.0 hours.
Iowa Nurses – Academy Medical Systems has
submitted an application for n Iowa approved
provider number for live webinar
presentations. Please contact us regarding
the application status. The Iowa Board of
Nurses will recognize the recorded webinars
as a home study program. They recognize our
ANCC approved provider status as well as our
CA and Fl Board of Nursing provider approval
for home study products for nurses in Iowa.
All other states recognize our approved
provider status listed in the above text for
continuing education credit for nurses.
Respiratory therapist – This program
has been approved for 9.0 contact hours
Continuing Respiratory Care Education (CRCE)
credit by the American Association for
Respiratory Care, 9425 N. MacArthur Blvd.
Ste 100, Irving TX 75063. Course #
281591000.
Dietitians - Academy Medical Systems
is a Continuing Professional Education (CPE)
Accredited Provider with the Commission on
Dietetic Registration (CDR). Registered
dietitians (RDs) and dietetic technicians,
registered (DTRs) will receive 9.0
continuing professional education units (CPEUs)
for completion of this program/material.
Occupational Therapist - Occupational
Therapist will receive 9, continuing education hours
for completion this program and a test score of 70%
or better. AMS is an approved provider for the AOTA
, provider # 5470. This course is an intermediate
education level.
Exercise Physiologist – ACSM
recognizes AMS’s approved provider status
with the ANCC and will honor our continuing
education for Certified Exercise
Physiologist recertification purposes.
Certified Athletic Trainers – Academy
Medical Systems is recognized by the Board
of Certification (BOC) to offer continuing
education for certified athletic trainers. 9
hours will be awarded at the completion of
this program.
Physical Therapists - PTs
in the following states will receive
9 contact hours for completion of
all 6 webinars: AK, CA, CO, CT, HI,
IA, ID, IN, KS (Cat 2), MA, ME, MI,
MN (Cat 2), MT, NE, NM, ND, OR, PA, RI, SC,
SD, UT, VA (Type 2), VT, VI, WA, WY.
Because each state’s continuing education
requirements for physical therapists is subject to
change, please verify this information with your
state board. Thank you.
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