RSPT 2239 -01 & 02 Advanced Cardiac Life Support Syllabus-Fall 2011

INSTRUCTOR: Diane Flatland E-MAIL: dflatland@alvincollege.edu

OFFICE: S-108A PHONE: 281-756-5660

OFFICE HOURS: As posted on door to S-108A

INSTRUCTOR: Jessica Murphy E-MAIL: jmurphy@alvincollege.edu

OFFICE: S-108D PHONE: 281-756-5650

OFFICE HOURS: As posted on door to S-108D

INSTRUCTOR: Marby McKinney E-MAIL: mmckinney@alvincollege.edu

OFFICE: S-149 PHONE: 281-756-5661

OFFICE HOURS: As posted on door to S-149

A. COMMUNICATING WITH YOUR INSTRUCTOR The preferred method of communicating with your instructor is through the ACC email or you may call me at 281-756-5660. Please leave your first and last name, a phone number or an e-mail address where I can contact you and explain what you need to discuss with me. I will normally respond within 24 hours Monday-Thursday and by the next business day on Friday-Sunday.

B. COURSE DESCRIPTION This course is designed to develop the cognitive and psychomotor skills necessary for resuscitation of the adult patient. Strategies for managing and stabilizing the cardiopulmonary arrested patient will be included. Recognizing and interpreting EKGs and their treatment, IV insertion and phlebotomy will be emphasized.

C. PRE-REQUISITES/CO-REQUISITES Students in this course must be a currently active healthcare provider whose daily occupation demands proficiency in the knowledge and skills of ACLS and have attended a BLS course within the past two (2) years.

D. TEXTBOOK INFORMATION Required Textbooks:

Aehlert, B. Rapid ACLS, 2nd

Edition, ISBN:978-0-323-06924-3 Aehlert, B. ECGS Made Easy, 4

th Edition, ISBN-13: 978-0-323-08320-1

Additional References:

Cohn. Flip and See ECG AHA. ACLS Provider Manual, 2011

This textbook can be purchased at the ACC bookstore, which is open Monday through Thursday 7:30 a.m. to 7:00 p.m. and Friday 7:30 a.m. to 2:00 p.m. Bookstore hours can vary during holidays so please call the bookstore at 281-756-3681 for more information. The textbook can also be purchased online and mailed directly to your residence from: http://www.alvinccstore.com/

E. CLASS ATTENDANCE POLICY Attendance in all courses in the Respiratory Care Program is crucial to the complete learning experience. Vitally

important topics related to patient care and, specifically, in this class life and death treatments are presented each day. Students will find it difficult to make up absences and are strongly encouraged to attend class and lab regularly. If a student accumulates more than 2 weeks of absences, he or she will be referred to the Dean of Instruction and may be dropped from the program.

Students are responsible for all information that is missed. The student is required to call the instructor when absent to make arrangements for missed assignments, notes, and exams. Students are also encouraged to contact fellow classmates to obtain notes when absent. All absences must be reported to the Respiratory Care Office prior to the period of absence. Such prior notification automatically constitutes an excused absence. Quizzes cannot be made up if missed. A grade of “0” will be used for any missed quizzes to calculate the quiz average.

F. DISCLAIMER The instructor reserves the right to modify this syllabus as needed and will notify the students of any changes using the ACC e-mail or MyBlackboard e-mail or announcements

G. DISCLAIMER The instructor reserves the right to modify this syllabus as needed and will notify the students of any changes using the ACC e-mail or MyBlackboard e-mail or announcements.

H. LATE COURSE WORK POLICY Ten points will be deducted for each day an assignment is late. A second late assignment will be given a grade of zero.

I. EXAM POLICY An exam will be given at the end of each unit. Students should make every effort to attend class on test day. If a student is going to be absent on an exam day, he or she must call the instructor. Unit examinations may be made up only if the student has an excused absence. The test will be made up prior to the next class day before the student returns to class. THERE WILL BE NO EXCEPTIONS TO THIS! In the event the of an unexcused absence, no make up exam will be given and the student must then take the comprehensive final to replace that missed exam. Students will be allowed to miss one (1) exam, if the student is absent for the second test, the final exam grade will be used in place of that exam, as no make up will be given. Any missed exam after the second one, will count as a zero (0). You must have a passing average of 75 or above on all exams in order to pass the course.

Students will be expected to take the examination on the day it is scheduled no matter when they come in on that day. If the student is late or absent from the class the test is scheduled for but returns later in the day, they will take the test. The comprehensive final exam is optional for those students who have not missed ANY unit examinations. Then the student may use the final exam grade to replace the lowest test score. Graded test can be reviewed when returned and students should record their grades in the syllabus. Please do not take notes regarding specific questions and answers or copy the exams in any way. All cell phones and materials must be put away when taking or reviewing exams.

J. GRADING SUMMARY

The final grade is based upon class and lab attendance and participation, assignments, and unit exams. Please record your grades as the papers are returned to you to keep track of your average. Please so not hesitate to come and see the instructor if your performance is not up to your expectations before the problem gets out of hand.

Grading System: 93-100 =A 84-92 = B 75-83 = C <75 = F denotes failure of the course

Course Outline

Weight: Unit: Subject: Instructor

10% Unit 1 – Basic ECG Jessica 10% Unit 2 – Arrhythmia recognition Jessica 10% Unit 3 – Airway Adjuncts Diane 15% Unit 4 – IV Techniques Diane 15% Unit 5 – Resuscitation Pharmacology Marby Unit 6 – Electrical Therapy Diane 15% Unit 7 – Algorithms and Final Jessica & Diane 25% Mega Codes, Assignments and Quizzes Jessica & Diane

LOG YOUR GRADES HERE Unit Exams: Assignments: Grade:

Unit 1: _____ x .10 ______ _____ Unit 2: _____ x .10 ______ _____ Unit 3: _____ x .10 ______ _____ Mid-term Avg. ____ Unit 4: _____ x .15 ______ _____ Unit 5: _____ x .15 ______ _____ & 6 Unit 7: _____ x .15 ______ _____ Final: _____ Assn Avg: _____ x .25 _____

Final Grade: _________

Bonus Points

Bonus points may be awarded for this course up to two (2) added to the final average. The instructor will announce bonus point activities during the course. A bonus point activity card must be submitted prior to the grade due date to be applied to the final average.

I.…..Incomplete. No Incompletes or “I” grades will be given except for extreme circumstances. If an “I” grade is assigned and the course work is not completed by the pre-arranged time limit, this grade will convert to an “F”.

W….Withdrawal. Students who file withdrawal requests by the published deadline will receive a grade of W. It is recommended that the student talk to the instructor before withdrawing. If a decision is made to withdraw, the student must start the process at the Enrollment Services Center, room A-100. Failure to withdraw by the deadline may result in a grade of F.

K. CLASSROOM PROTOCOL It is the right of each student to participate in his or her learning, and it is the responsibility of each student to not interfere with the learning of other students. Policies governing the classroom are provided in the ACC student Handbook and students who repeatedly violate one or more of these policies will be subject to disciplinary action.

L. ACADEMIC SUCCESS AND SUPPORT SERVICES: 1. Americans With Disabilities Act

ACC complies with ADA and 504 Federal guidelines by affording equal access to individuals who are seeking an education. Students who have a disability and would like classroom accommodations must register with the Office of Disability Services, A 136, (281)756-3533. Instructors are not able to provide accommodations until the proper process has been followed.

2. Behavioral Intervention Team (BIT) – Letting someone know The Behavioral Intervention Team (BIT) at Alvin Community College is committed to improving community safety through a proactive, collaborative, coordinated, objective and thoughtful approach to the prevention, identification, assessment, intervention and management of situations that pose, or may reasonably pose, a threat to the safety and well-being to the campus community. College faculty, staff, students and community members may communicate concerns to the BIT by email, BIT@alvincollege.edu , or through an electronic reporting option located on the BIT page of the college website, http://www.alvincollege.edu .

3. The ACC Learning Lab, located upstairs in building A, provides students with a variety of services including tutoring (math, writing, and other disciplines); computers and printers; a testing facility; and tables/carrels for studying. Learning Lab hours are M-TH 8:00am – 9:00pm and F 8:00am – 4:00pm. Testing hours are M-TH 10:00am – 7:30pm (Tests must be completed by 8:30pm) and F 10:00am – 12:00pm (Tests must be completed by 1:00pm). *Closed on Fridays in the Summer. Call 281-756-3566 for more information.

4. MyBlackboard -Any technical problems or issues with MyBlackboard should be directed to the Distance Education Department at de@alvincollege.edu . Include your first and last name, student ID number and a description of the problem. Students will not be penalized if there is an interruption in MyBlackboard service and the instructor is notified of such an issue by the Distance Education Department.

5. WEBACCESS, Passwords or ACC Computer Lab Information- contact the IT Dept. Help Desk at 281-756-3544.

M. CODE OF ACADEMIC INTEGRITY AND HONESTY Alvin Community College students are members of an institution dedicated to the pursuit of knowledge through a formalized program of instruction and learning. At the heart of this endeavor, lie the core values of academic integrity which include honesty, truth, and freedom from lies and fraud. Because personal integrity is important in all aspects of life, students at Alvin Community College are expected to conduct themselves with honesty and integrity both in and out of the classroom. Incidents of academic dishonesty will not be tolerated and students guilty of such conduct are subject to severe disciplinary measures.

N. COURSE GOALS & OBJECTIVES Upon completion of this course, the student will be able to:

6. Review, organize and prioritize the skills and information needed to handle a cardiac arrest, events that lead

to a cardiac arrest, and the events that follow a cardiac arrest. *(C1, C2, C3, C4, C5, C7, C9, C12, C13, C14, C18, C19, C20, F5, F6, F8, F9, F12, F13, F14, F15)

7. Adequately demonstrate basic electrocardiography procedures such as ECG and cardiac monitoring. *(C10, C11, C13, C8, C18, C19, C20, F8, F12, F13, F14, F15, F16, F17)

8. Interpret normal and basic dysrhythmias. *(F8, F7, F9, C13, F12)

9. Identify the components of a normal electrical cardiac waveform. *(C5, C6, C7)

10. Identify the appropriate treatment methods for common electrical disturbances. 11. *(F1, F5, F6, F12)

12. List, identify, and correct technical artifacts encountered when performing cardiac monitoring and ECG

analysis. *(F1, F5, C20, C17, C8)

13. Recognize the need to respond to an emergency, conduct the primary and secondary ABCD surveys. *(F7, F8, F9, F10, F12, C5, C7, C11)

14. Assess and manage the resuscitation of an adult who experiences a sudden, witnessed, ventricular fibrillation induced cardiac arrest.

15. *(C5, C6, C7, C9, C11, C12, C13, C14, C19, C20, F7, F8, F9, F12)

16. Provide a concise summary of the recommended assessment and management actions for these core cases *(C15, F12, C5,C6): Case 1 – Respiratory Compromise Case 2 – VF, CPR, AED Case 3 – VF/Pulseless VT Case 4 – PEA Case 5 – Asystole Case 6 – Acute Coronary Syndromes Case 7 – Bradycardia Case 8 – Unstable Tachycardia Case 9 – Stable Tachycardia Case10 - Acute Ischemic Stroke

17. Direct others at the scene of a resuscitative effort. *(C9, C10, C11, C12)

Unit 1 Objectives – Basic ECG Performance and Interpretation

By the end of this unit, the students will be able to…

1. Draw and Label the basic components of the standard ECG waveform. P, QRS, T, U 2. Differentiate depolarization from repolarization on the waveform. 3. Identify the phases of the cardiac cycle on the ECG. 4. Prepare patient and skin for lead placement. 5. Properly place ECG electrodes for optimal recording. 6. Recognize and correct artifacts. 7. Interpret basic ECG waveforms and rhythms including NSR, Bradycardia, Tachycardia, and Asystole. 8. Calculate rate, rhythm, regularity, PRI, QRS, and QT duration. 9. Locate and define the following items on the graphical recording in terms of direction, voltage, isoelectric line,

and timing intervals. 10. Define and be able to draw a schematic of the 12 lead ECG including: limb leads, chest leads, and augmented

leads. 11. Define, draw and label Einthoven’s triangle. 12. Define and identify normal sinus rhythm on a standard ECG. 13. Understand how to determine axis deviation, atrial enlargement, ventricular hypertrophy, signs of ischemia,

injury, and infarction as well as bundle branch block. 14. Recognize basic life threatening arrhythmias and the 3 I’s of Ischemia, Injury and Infarction so the student will

be able to function safely while at clinical. Unit 1 Assignment:

Read Chapters 1-3 Aehlert, ECG’s Made Easy TBA

Unit 1 Lab Activities:

Week 1-3 Practice basic 12 lead ECG techniques on your lab partner using different ECG systems. Be sure to bring a sheet, towel, and sports bra or bathing suit top to lab each day. Week 3-5 Check OFFS - 12 lead ECG check off in lab.

Additional Reference:

Wilkins, Clinical Assessment in Respiratory Care, Chapter 10

Unit 2 Objectives – Arrhythmia Recognition

By the end of this unit, the students will be able to…

1. Identify sinus bradycardia and tachycardia. 2. Identify the following arrhythmias on and ECG strip or oscilloscope:

a. Atrial Flutter b. Atrial Fibrillation c. Premature Atrial, Junctional, and Ventricular Contractions d. Ventricular Tachycardia (V-Flutter), Multifocal VT (TdP) e. Ventricular Fibrillation f. Asystole g. 1st, 2nd, 3rd degree A-V Block h. Pulseless Electrical Activity i. Paroxysmal Supraventricular Tachycardia j. Supraventricular Tachycardia k. Location of AMI’s l. Ischemia, Injury, and Infarction m. Pacemaker Rhythms

3. Define the systematic approach to arrhythmia recognition. 4. List the classifications of normal and abnormal cardiac rhythms. 5. Briefly discuss the cause and treatment for each arrhythmia. 6. Recite the treatment algorithms for each dysrhythmia. 7. Differentiate between acute and chronic changes during a myocardial infarction. 8. Differentiate between ischemia, infarction, and injury. 9. State the immediate proper course of action taken when a life-threatening arrhythmia is detected. 10. Perform interpretation of 12-lead and single channel ECG rhythms.

Unit 2 Reading:

Read ECG’s Made Easy, Aehlert, Chapters 4-10 Unit 1 & 2 Lab Activities:

Practice basic 12 lead ECG techniques on your lab partner using both systems.

12 lead ECG check off.

Practice interpretation of various arrhythmias

Unit 3 Objectives – Airway Adjuncts

By the end of this unit, the student will be able to…

1. Identify by name the types of airways used in ACLS:

a. oral, nasal, pharyngeal b. endotracheal, nasotracheal (ETT, NTT) c. Esophageal Obturator (EOA) d. Combitube e. Laryngeal Mask Airway (LMA)

2. Describe the indications, contraindications, hazards, and procedure involved for each airway. 3. Identify and explain the use of all accessory and adjunct airway equipment. 4. Demonstrate proper insertion, maintenance, and removal of each airway presented. 5. Verify placement of airways.

Unit 3 Assignments:

Readings pp 11-26 Selected Handouts

Unit 3 Lab activities:

Practice airway techniques: BVM Intubation Oral Airway LMA Combitube

Unit 4 Objectives – IV Techniques

By the end of this unit, the student will be able to:

1. Explain the rationale(s) for the insertion of intravenous catheters. 2. Describe the procedure for locating and acceptable anatomical site for the insertion of an intravenous needle. 3. List and describe the complications associated with the insertion and maintenance of an IV line. 4. Explain the maintenance of an existing IV and how to identify and troubleshoot problems with the IV line. 5. Perform the insertion techniques and calculations necessary to run a solution as the prescribed rate. 6. Demonstrate a working knowledge of the equipment used for IV insertion and venous blood collection. 7. Describe and perform venipuncture and collection technique.

Unit 4 Assignments:

Reading ACLS pp.83-86 Selected handouts View AV presentation

Unit 4 Lab Activities:

Practice IV insertion and venous phlebotomy Perform Lab Check off

Unit 5 Objectives – Resuscitation Pharmacology

By the end of this unit, the student will be able to…

1. Discuss medications commonly used to treat acute cardiovascular emergencies: a. Antiarrhythmics b. Inotropic Agents c. Chronotropic Agents d. Vasoactive Agents e. Antihypertensives f. Vasodilators g. Diuretics h. Ect.

2. For each drug presented, list the indications, contraindications, mechanism of action, dosage, route, precautions, and side effects.

3. List the generic and brand name as well as the package preparations for each drug covered.

Unit 5 Assignments: Readings pp. 87-123 ACLS support drugs found in handbook Selected Handouts

Unit 5 Lab activities:

Identify various drugs used in ACLS Prepare drugs for IV, push, and injection

Unit 6 Objectives – Electrical Therapy

By the end of this unit, the student will be able to…

1. Define and discuss the difference between defibrillation and cardioversion. 2. List the types of arrhythmias which require electrical intervention. 3. Recognize the presenting electrical disturbance and apply the appropriate amount of energy and number of

shocks required. 4. Describe the proper use and critical steps required for the use of electrical therapy. 5. Demonstrate the proper use of the AED and TCP devices. 6. List steps of “flat line” protocol used to confirm asystole.

Unit 6 Assignments:

ACLS Electrical Therapy pp. 67-82 Unit 6 Lab Activities:

Practice using - Defibrillator/Cardioversion Sync/Unsync modes Hook up monitor and pads Quick Look Paddles

Unit 7 Objectives – Algorithms and Mega Code

By the end of this unit, the student will be able to…

1. Recognize the presenting electrical disturbance and or medical condition. 2. Apply the proper course of therapy utilizing the correct algorithm. 3. Follow the recommended algorithm for each category listed:

a. Universal b. VF/Pulseless VT c. PEA d. Asystole e. Bradycardia f. Tachycardia g. AMI h. Hypotension/Shock/Acute Pulm. Edema i. Acute CVA j. SVT/PSVT

4. Manage first 10 minutes of a mega code situation as a team member and as a team leader. 5. Appropriately demonstrate primary and secondary ABCD surveys including good basic CPR.

Unit 7 Assignments:

Readings – pp. 167-182 pp. 407-468

Unit 7 Lab Activities:

Practice mega code drills using SimMan Take turns in the various roles Mega Code student check off

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Respiratory Care Program RSPT 2239 ACLS

“Tentative” Schedule

Date: Activity:

Lecture Lab Aug 29 Review Syllabus - Begin Unit 1 EKG Unit 1 - Basic EKG Interpretation - Chapters 1-3 EKG Sept 5 Labor Day Holiday Sept 12 Unit 1 EKG Sept 19 Unit 1 Exam Unit 2 - Arrhythmia Recognition - Chapters 4-10 Algorithms with EKG Interpretation Sept. 26 Unit 2 - Rhythm Strips Algorithms with EKG Interpretation Oct. 3 Unit 2 Algorithms with EKG Interpretation Oct 10 Unit 2 Algorithms with EKG Oct 17 Unit 2 Exam-BeginUnit 3 Airway Adjuncts Oct 24 Unit 3 Exam – Begin Unit 4 IV Techniques Oct 31 Unit 4 - IV Techniques IV Techniques Nov 7 Unit 4 Exam IV Tech.-check-offs Nov 14 Unit 5 – Pharmacology Unit VI- Elect. Therapy Nov 21 Units 5 & 6 Exam Mega Code Practice Nov 21, Dec 5 Unit 7 - Mega Codes Mega Code Testing Dec 7 Unit 7 Final Dec 7-13 Finals Week