PACIFIC MEDICAL TRAINING Arrhythmia Interpretation

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1 PACIFIC MEDICAL TRAINING Arrhythmia Interpretation Introduction Activity Summary Target Audience Educational Objectives Nursing Educational Objective Faculty Physician Continuing Medical Education Nursing Continuing Education Disclosure of Conflicts of Interest Method of Participation and Request for Credit Media Disclosure of Unlabeled Use Disclaimer SECTION 1: Anatomy and Physiology of the Heart Pericardium The Heart Walls Cells in the Heart Internal Heart Heart Valves Blood Supply of the Heart Coronary Arteries Three Main Arteries1 Blood Flow through the Heart

2 The Cardiac Cycle Systole Diastole Important terms The Electrical System Sinoatrial (SA) Node Atrioventricular (AV) Node Purkinje Fibers What does athe cardiac cycle look like on paper? SECTION 2: What is the Electrocardiogram? The Monitoring Process1 Parts of a Normal Adult Rhythm Strip2 Artifact 12-Lead Electrocardiogram Analyzing the ECG Rhythm Strip Normal Sinus Rhythm Sinus Bradycardia Sinus Tachycardia Regularity Determining Regularity Caliper Method Paper and Pen Method Types of Irregularity P Waves QRS Complex

3 PR Interval SECTION 3: Rhythms Originating from the Sinus Node Normal Sinus Rhythm Sinus Bradycardia Sinus Tachycardia Sinus Dysrhythmia (Sinus Arrhythmia)1 Sinus Arrest SECTION 4: Rhythms Originating in the Atria Wandering Atrial Pacemaker Premature Atrial Contraction (PAC)2 Atrial Tachycardia Multifocal Atrial Tachycardia Supraventricular Tachycardia (SVT) Atrial Flutter3 Atrial Fibrillation SECTION 5: Junctional Arrhythmias including Heart Blocks Premature Junctional Contraction (PJC) Junctional Escape Rhythm Accelerated Junctional Rhythm Junctional Tachycardia2 Heart Blocks First Degree AV Block Second Degree AV Block Mobitz I (Wenckebach)3

4 Second Degree AV Block Mobitz II3 Third Degree or Complete Heart Block SECTION 6: Rhythms Originating in the Ventricles Premature Ventricular Contraction (PVC) Ventricular Escape Rhythm Accelerated Idioventricular Rhythm Ventricular Tachycardia4 Ventricular Fibrillation Introduction Activity Summary Activity Title: Arrhythmia Interpretation Release date: Expiration date: Estimated time to complete activity: 8 hours This course is accessible with any web browser. We recommend recent versions of Google Chrome, Internet Explorer 9 and later, or Apple ipad. This course is jointly provided by Pacific Medical Training and PIM. You may reach PIM at Target Audience This activity has been designed to meet the educational needs of physicians, physician assistants, nurse practitioners and registered nurses involved in the care of patients experiencing life-threatening cardiovascular emergencies. Educational Objectives After completing this activity, the participant should be better able to: Describe salient features of cardiac anatomy Describe key parameters checked on a normal rhythm strip Demonstrate measurement of heart rate from a rhythm strip

5 Recall the importance of ruling out artifact before drawing a conclusion Identify common characteristics of rhythms originating from the sinus node Describe an ectopic beat and a compensatory pause Recognize different arrhythmias originating from the atria Describe common characteristics of junctional rhythms Distinguish between an accelerated junctional rhythm and junctional tachycardia Differentiate between Mobitz I and Mobitz II second degree heart blocks Recall the characteristic AV dissociation in third degree heart blocks Describe why and how QRS complexes change when they originate in the ventricles Nursing Educational Objective Provide appropriate care and counsel for patients and their families. Faculty Judith Haluka, EMT-Paramedic State of Pennsylvania Dr. Waqar-Ul-Haq Shafaat, MD Physician Continuing Medical Education Accreditation Statement This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Postgraduate Institute for Medicine and Pacific Medical Training. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians. Credit Designation The Postgraduate Institute for Medicine designates this enduring material for a maximum of 8.0 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nursing Continuing Education Credit Designation This educational activity for 8 contact hours is provided by Postgraduate Institute for Medicine. Accreditation Statement Postgraduate Institute for Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation.

6 Disclosure of Conflicts of Interest Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity: Judith Haluka Has no real or apparent conflicts of interest to report Waqar-ul-Haq Shafaat, MD Has no real or apparent conflicts of interest to report. The planners and managers reported no financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity. The following PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, RN, BSN and Jan Schultz, RN, MSN, CHCP, hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months. The following Pacific Medical Training planner and manager, William Entriken, hereby states that he or his spouse/life partner does not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months. Method of Participation and Request for Credit During the period through participants must read the learning objectives and faculty disclosures and study the educational activity. Your CME certificate will be available online after completing a post-course evaluation, and achieving a score of 80% or better. Media Internet

7 Disclosure of Unlabeled Use This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Disclaimer Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer s product information, and comparison with recommendations of other authorities.

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