Cardiac care clinicians are often frustrated
in clinical practice because they typically
have had just the bare essentials in terms
of preparation for reading an
electrocardiogram (ECG). Commonly, the
preparation is a short course on arrhythmias
(and those courses often teach recognition
from only one lead II). Consequently, in
practice, much more is expected and
necessary for competent patient care. This
6-hour course will give the clinician a good
understanding of the 12-lead ECG. While it
is designed for the cardiac rehabilitation
clinician, it is applicable for other
clinicians, such as nurses working in
telemetry units, emergency departments, or
intensive care units.
Class Description To determine whats 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.
Absolute Necessities:
Leads, Axis, Principles of Monitoring, Whats Normal (Part I) topics
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
1.
Recognize a normal
12-lead ECG.
2.
Explain how the P wave,
QRS complex, and T wave should look in all 12 leads.
3.
Determine the electrical
axis of the ECG in seconds.
4.
Describe the normal
precordial pattern and how it is derived.
5.
Explain how bipolar
substitutes for the V leads are derived, e.g., MCL1, MCL5, CM5, etc.,
and when they are indicated.
6.
List advantages of using
V1 and V5 for monitoring in cardiac rehabilitation.
Class Description Wide QRS complexes are caused by a number of factors; among the most
common are bundle branch blocks (BBB). Determining whether wide beats
are a result of BBB should take only seconds and is imperative to
accurate diagnosis. Hemiblocks, while not increasing the QRS much,
change its appearance and may indicate worsening condition. Often not
taught in basic arrhythmia interpretation courses, this information is
easy, fundamental and necessary to understand the remaining sessions in
this series.
Wide
QRS basics: Its either BBB or ventricular (or rarely preexcitation)
II.
Diagnosis of bundle
branch blocks (BBB)
A.
Right BBB
B.
Left BBB
III.
Aberration
IV.
Wide QRS in atrial
fibrillation
A.
Criteria supporting aberration
B.
Criteria supporting ventricular
ectopy
V.
Diagnosing hemiblocks
and hemiblock aberration
Behavioral/Learning Objectives
1.
Explain the classification of
intraventricular conduction delays and identify which may be found in
healthy individuals and which may represent disease.
2.
Contrast the ECG characteristics and
clinical significance of right bundle branch block (RBBB) with left
bundle branch block (LBBB) and recognize each on the ECG.
3.
Define aberration and differentiate
supraventricular complexes conducted with aberration from ventricular
ectopy.
4.
Identify left anterior fascicular
block and left posterior fascicular block.
5.
Describe which leads would be best
to identify BBBs and which to identify fascicular blocks.
N/A
Fat Tachs: Differential Diagnosis of Wide Complex Tachycardias
Class Description The wide complex tachycardia may deteriorate within seconds to
ventricular fibrillation or be tolerated for hours. Rapid differential
diagnosis is imperative in treating this life-threatening arrhythmia.
Often not taught in basic arrhythmia interpretation courses, this
information is crucial for any practitioner responsible for treating
critical arrhythmias. ECG techniques presented will equip the
practitioner with the necessary tools to correctly diagnose the etiology
of wide complex tachycardias in well over 90% of cases.
Fat Tachs: Differential Diagnosis of Wide Complex Tachycardias Topics
I.
Misdiagnosis and consequences of
wide-QRS-complex tachycardias.
II.
VT versus SVT with aberrant
conduction: Rules
III.
ECG differential diagnosis: 6 steps
IV.
Preexcitation: 3 ways to fat tachs
V.
Wide QRS tachycardia treatment
Behavioral/Learning Objectives
1.
Explain various clinical physical
signs useful in differential diagnosis of wide complex tachycardias.
2.
Determine ECG leads useful in
differential diagnosis of wide complex tachycardias.
3.
List at least 3 criteria supporting
the diagnosis of ventricular tachycardia.
4.
List at least 3 criteria supporting
the diagnosis of supraventricular tachycardia with aberrant conduction.
5.
Explain characteristics of accessory
pathway conducted tachycardias and ways to differentiate from VT and SVT
with aberration.
Class Description Myocardial ischemia and infarction are two conditions the cardiac
rehabilitation practitioner must be able to recognize and treat
competently. Ischemia and infarction manifest differently and require
astute and informed examination of the 12-lead ECG.
Ischemia and Obvious Infarction Topics
I.
Myocardial ischemia
A.
Best leads for identification
B.
ECG characteristics: 7 contours
C.
Diagnosing ischemia in presence of
RBBB
II.
Myocardial infarction
A.
ECG diagnosis of ST segment
elevation MI (STEMI)
B.
Location of STEMI
C.
Diagnosing in presence of BBB
III.
Early repolarization
Behavioral/Learning Objectives
1.
Recognize ST-segment elevation
myocardial infarction (STEMI) infarction on the 12-lead ECG.
2.
Explain the significance of
asymptomatic exercise-induced ST segment elevation in leads with Q-waves
in the post STEMI patient.
3.
Discuss the locations of STEMI:
Septal, anterior, inferior, lateral, true posterior, right ventricular.
4.
Describe ECG manifestations of
myocardial ischemia.
5.
Recognize myocardial ischemia in the
presence of RBBB.
6.
Explain when exercise should be
curtailed in the presence of myocardial ischemia.
7.
List ways to eliminate myocardial
ischemia during exercise.
N/A
Repolarization Rascals and Ischemia Impostors: Panic, Punt, or Pray?
Class Description Left ventricular hypertrophy, electrolyte imbalances, digitalis,
pericarditis, cor pulmonale, acute pancreatitis, intracranial
hemorrhage, and normal variants are among the many impostors of
myocardial infarction and ischemia. A practitioner must be able to
differentiate ST segment elevation secondary to infarction from
aneurysm, pericarditis, and other causes.
Repolarization Rascals and Ischemia Impostors: Panic, Punt, or Pray? Topics
I.
Repolarization rascals
A.
Digitalis
B.
LVH
C.
Potassium
D.
Pericarditis
E.
Ventricular aneurysm
F.
Early repolarization
II.
MI mimics
A.
Pericarditis
B.
Acute Cor Pulmonale, pulmonary
embolism
C.
Variant angina and others
Behavioral/Learning Objectives
1.
Describe the ECG effects of
digitalis and compare with ischemia.
2.
Compare and contrast the ECG in left
ventricular hypertrophy, digitalis, and ischemia.
3.
List 3 causes of ST segment
depression, not including myocardial ischemia.
4.
List 3 causes of ST segment
elevation, not including myocardial infarction.
N/A
Exercise Testing in Cardiac Rehabilitation and Case Studies
Class Description The final class in the series will present principles of evaluating
the patient in cardiac rehabilitation and discuss case studies
representative of typical and atypical patients. Testing is something
that many cardiac rehabilitation programs undergo at the beginning and
end of the prescribed sessions; and for some programs, each session is a
test.
Exercise Testing in Cardiac Rehabilitation and Case Studies Topics
I.
Exercise testing
A.
Protocols
B.
Modes
C.
Target heart rates
D.
Termination points
II.
Case studies
A.
Typical cases
B.
Atypical cases
Behavioral/Learning Objectives
1.
Discuss protocols for exercise
testing.
2.
Describe electrode placement for exercise testing and compare with
standard 12-lead ECG electrode placement.
3.
List 3 reasons to terminate a test.
4.
Discuss typical and atypical
patients in cardiovascular rehabilitation
5.
Define AV dissociation
Who Should Attend?
Nurses, Advanced Practice Nurses, Nurse Practioners and Clinicians
in Cardiac Rehab will benefit from this program. Nurses in CCU/ICU,
Emergency Departments and ECG and Telemetry Technicians can benefit as
well.
Nurses Academy Medical Systems is
an approved provider of continuing nursing
education by the Michigan Nurses
Association, an accredited approver by the
American Nurses Credentialing Centers
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 - 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. 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. Exercise Physiologists ACSM
recognizes AMSs 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: CA, CO, CT, DE, IA, ID, KS, MI,
MA, MT, NE, NH, NM, NC, ND, PA, RI,
SC, SD, TN, UT, VA, VT, WA, WY.
Advanced Case Management: Practical Solutions to Apply Today - A Webinar Series
Identifying valid tools and
collecting meaningful data
International Classification System
of Functioning, Disability, and Health: the World Health Organizations
new system for creating international standards for measurement
Using the ICS as a case management
tool for assessment and planning
Behavioral/Learning Objectives
1.
Identify the scope of comprehensive functional assessment functional
assessment and how to use the data gathered.
2.
Discuss the emergence of a new international data gathering process and
the possible benefits for the case manager.
Case Managers - The Commission for
Case Managers Certification has approved The
Advanced Case Management Webinar Series for
9.0 hours, approval #6201060062. Nurses - Academy Medical Systems is
an approved provider of continuing nursing
education by the Michigan Nurses
Association, an accredited approver by the
American Nurses Credentialing Center's
Commission on Accreditation. 9 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 hours. AMS is an approved provider of the
Florida Board of Nursing, provider # 50-19,
for 9 hours and we are listed on CE Brokers.
Iowa Nurses - 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. Social Workers - Academy Medical
Systems is an Approved Provider for the CA
Board of Behavioral Sciences. 9 contact
hours will be awarded for completion of the
6 webinars and post tests. Most Social
Worker State Boards recognize other state
board approvals for continuing education
credit. Please contact your state board for
verification. Occupational Therapists - will
receive 9, type I, 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.
Intermediate educational level.
Call our Accreditation Dept at 866-414-3500
with questions.
Certified Diabetes Educators
Academy Medical Systems' approved Provider
Status with the ANCC (nurses) and the CDR
(dietitians) is recognized by the National
Certification Board of Diabetes Educators (NCBDE). Nurses Academy Medical Systems is
an approved provider of continuing nursing
education by the Michigan Nurses
Association, an accredited approver by the
American Nurses Credentialing Centers
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 - 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. 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. Exercise Physiologist ACSM
recognizes AMSs 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: CA, CO, CT, DE, IA, ID, KS, MI, MA, MT, NE, NH, NM, NC, ND, PA, RI,
SC, SD, TN, UT, VA, VT, WA, WY.
The Nuts and Bolts of Phase 2 Cardiac Rehab Webinar Series
