Syllabus COURSE TITLE: Advanced 12 Lead EKG COURSE NUMBER: MED 267 CLASS MEETING DAY & TIME: Tuesday, 12:30 pm COURSE DESCRIPTION: The student will receive training in 12 lead electrocardiographs (EKG) interpretation as well as the process of completing EKGs as a diagnostic tool. Students will demonstrate appropriate skills for the application of 12 lead EKG leads as well as interpretation of these EKGs for myocardial infarction, atrial hypertrophy, ventricular hypertrophy, axis deviation, bundle branch blocks, reciprocal MI changes and rhythm interpretation. Students will also receive instruction to recognize myocardial infarction signs and symptoms, assessment of coronary artery disease patients and MI treatment guidelines including medications and defibrillation. COURSE PREREQUISITES: This class will be completed prior to Stress and Holter classes. ACADEMIC CREDITS HOURS AWARDED: 4.0 Quarter Credit Hours LAB REQUIREMENTS: None INSTRUCTOR: Lisa H. Young, RN, BSN, MA Ed. INSTRUCTOR CONTACT INFORMATION: Text: 270-202-6137 Email: lyoung@daymarcollege.edu STUDENT LEARNING OUTCOMES/COURSE OBJECTIVES: Upon completion of this course, the student will: 1. State and demonstrate appropriate 12 lead EKG electrode placement with 100% accuracy. 2. Identify EKG changes that are associated with coronary artery disease with 90% accuracy. 3. Identify myocardial ischemia, injury and infraction changes on a 12 lead EKG with 90% accuracy. 4. Identify at least three different modalities for the treatment of coronary artery disease with 90% accuracy. We change lives one person at a time Revised: June 2014 Page 1
5. Identify EKG waveform changes related to electrolyte disturbances on 12 lead EKG with 80% accuracy. 6. Demonstrate utilization of resources to write and present a paper discussing a specific coronary artery disease. 7. Demonstrate correct electrode placement for 12 Lead EKG tracing with 100% accuracy. 8. Analysis of fifty 12-lead EKG tracings with 90% accuracy. INSTRUCTIONAL MATERIALS, REFERENCES, AND TEXT: The 12-Lead ECG in Acute Coronary Syndromes, Tim Phalen and Barbara Aehlert Cardiology Board Review, Michael Zevitz. METHOD OF INSTRUCTION AND TEACHING STRATEGIES: Lecture, computer usage, DVD instructional films, worksheets, quizzes and tests. 12 Lead EKG of at least 50 EKGs. Return demonstration of 12 lead EKG tracing procedures. REQUIREMENTS FOR SUCCESSFUL COMPLETION & EVALUATION: Successful completion involves class participation, attendance, and completion of work by assigned dates, and taking exams on assigned dates. If assignments are 1 week late, the grade for this work will be dropped one letter grade. Example (A will be a B). After two weeks, it will be an F. GRADING SCALE: Grade determination: Portfolio project 10% 90 100% A Worksheets 10% 80 -- 89% B EKG interpretation 20% 70 -- 79% C Paper presentation 10% 65 -- 69% D Participation 20% 64% or lower F Quizzes 10 % Final Exam 20% 100% LEARNING RESOURCE CENTER/INTERNET ASSIGNMENT: 1. Each student will be expected to visit the media resource center, find a Medical related journal or newspaper article on the internet, and give a brief summary of the information to the class. Topic: Cardiovascular Technician job opportunity. 2. The student will also complete a power point presentation or paper report concerning myocardial tissue changes related to coronary artery disease or a heart disease indicated on a 12-Lead EKG tracing. Paper or power point will be presented to the class. Credit will be given for research, preparation as well as presentation. Students may use Elibrary or Proquest database as resources for this project. LRC Information: [Provide local LRC contact information and times of operation]. The Pacific Institute (TP) Elements: Cardiographic Technologist must have the capability to correctly complete a 12 lead EKG test, analysis of the report and know when emergency interventions are needed for cardiovascular disease patients. This We change lives one person at a time Revised: June 2014 Page 2
course will provide students with this knowledge and ability to perform well in the cardiovascular department or office. PORTFOLIO PROJECT: Each student will receive an outline defining the skills they have mastered for their portfolio. Participation/Professionalism: Each student must accept responsibility in the use of the facilities at Daymar and obey the policies and procedures. The instructor will conduct this class in a mature manner. It is expected that each student will act in the same adult manner when interacting with classmates and the instructor. It is my responsibility to maintain an atmosphere conducive to learning in the classroom, and I will do so. Please spare everyone the stress and embarrassment by being courteous and obeying classroom rules. Attendance: Students are expected to attend all scheduled courses in order to achieve the learning goals of their program. Prospective employers are often as concerned with applicants school attendance records as with their academic records. Attendance has a direct bearing on the students final grade in each course. If a student has been out of school for 14 consecutive days, the student will be withdrawn from school. Refer to Unofficial Withdrawal in the catalog. Internet Usage: There is to be no Internet surfing during class time unless instructed by the instructor. Tardiness: Attendance is recorded during the first ten minutes of each class session. The instructor updates the attendance record at the end of each class. If you know you will be late, please call Daymar and leave a message for your instructor. Late Work: Assignment due dates will be announced in class and will allow sufficient time for each assignment to be completed. Late homework, papers, etc. will be penalized. In-class assignments, quizzes, presentations, and other daily work cannot be made up. The instructor may extend an assignment due date for a student based upon individual circumstances. However, the situation must first be discussed and approved by the instructor. Homework: [customize this according to the course, but be specific and accurate] Completion Of Course Work: All course work must be turned in by the last day of class. Work turned in after the last day of class will not be accepted for credit except under special circumstances approved by the Director of Education and/or the Campus Director. Dress: Students are required to dress in attire appropriate for a college classroom, and are to refrain from wearing clothing that might be considered distracting to others in the classroom. In addition, the curriculum has assignments in which a student s professional appearance will be evaluated as part of the overall grade of the assignment. Decorum: We change lives one person at a time Revised: June 2014 Page 3
The following are some behaviors inappropriate for a college classroom: *sleeping in class*children in class *unauthorized visitors *rude behavior * interrupting speakers *profane language Cell phones: All communication devices MUST be turned off or put on silent mode during class time. Text messaging is not allowed during instructional time. Academic Dishonesty: Plagiarism is defined as an act or instance of stealing or passing off the ideas or words of another as one s own, or to use a creative production without crediting the source. Incidences of academic dishonesty will result in severe penalty up to and including a failing grade for the course, as well as being noted on the student s permanent record. Additional incidences of academic dishonesty could result in a student s permanent expulsion from Daymar. Special Requirements: Any student who feels s/he may need an accommodation based on the impact of a disability, should contact the instructor privately to discuss your specific needs. Please contact the Director of Education (or other academic designee) to coordinate reasonable accommodations for students with documented disabilities. School Jurisdiction, Student Conduct, and Disciplinary Action Conduct considered harmful to the rights of others or to the reputation of the school will not be tolerated. The Institute reserves the right to dismiss or suspend a student who fails to maintain satisfactory grades; who is not respectful of other students or the Institute s staff; or whose behavior disrupts the normal process of instruction. All students are expected to maintain high standards of conduct and honesty. Daymar has adopted standards of conduct that clearly prohibit, at a minimum, academic dishonesty, the unlawful possession, use or distribution of illicit drugs and alcohol by students and employees on its property or as part of any of its activities. Possession or use of firearms or weapons of any kind, by any student, is prohibited on all campuses. Unauthorized Peer-to-Peer file sharing and distribution of copyrighted material is prohibited. The Institute will impose disciplinary sanctions on students and associates consistent with college policy and local, state and federal laws up to and including expulsion or termination of employment and referral for prosecution for violation of the standards of conduct. A student dismissed or suspended is entitled to due process in the form of a hearing. A student desiring a hearing should make a written request to the Director of Education or Campus Director/Campus President. Grievance Procedure: See catalogue for grievance procedure. Date of Revision: 6/2014 We change lives one person at a time Revised: June 2014 Page 4
COURSE OVERVIEW AND OUTLINE Class Learning Outcomes/Objectives Week 1 Electrical conduction system of the heart with rhythm review. Handout material: How to read EKG handout. MI: ischemia, injury and infarction changes on EKG 2 12 lead EKG lead placement 12 Lead EKG tracing procedure. Rhythm and rate determination from 12 lead EKG tracing 3 Introduction of axis determination on EKG. Introduction of left ventricular wall assessment on 12 lead EKG tracing for ischemia, injury and necrosis of myocardial tissue. 4 Continue to identify myocardial ischemia, injury and necrosis. Introduction of identification of reciprocal changes seen on 12 Lead EKG tracing with myocardial necrosis. Practice EKG interpretation using learned technique. 5 Mid-term review Practice EKG interpretation for heart rhythm, heart rate, axis determination, presence of myocardial ischemia, injury or necrosis and reciprocal changes with an acute myocardial infarction. Introduction of identification of ventricular hypertrophy. 6 Mid-term examination Cardiographic technology position opportunity report presentation. Review of identification of ventricular hypertrophy. Introduction of identification of atrial hypertrophy. 7 Practice EKG tracing interpretation using instructed step-bystep method presented in class. Introduction of identification of early left ventricular repolarization changes found on 12 lead EKG tracings. WIIFM I know the electrical conduction system of the heart. I can also identify heart rhythms seen on EKG tracings. I can place electrodes in the proper position for a 12 lead EKG tracing. I understand the importance of axis determination on 12 lead EKG. I understand the assessment of left ventricular myocardial damage through 12 lead EKG analyses. I understand the necessity to identify reciprocal changes on 12 lead EKG with acute myocardial infarctions. I can identify the possible presence of ventricular hypertrophy and the significance of this finding. I will successfully complete the mid-term examination. I have successfully completed analysis of 25 12-Lead EKGs. I can identify the possible presence of atrial hypertrophy and the significance of this finding. I can identify early ventricular repolarization on a 12 lead EKG tracing. We change lives one person at a time Revised: June 2014 Page 5
8 Introduction of identification of presence of bundle branch block on 12 Lead EKG tracing. 9 Introduction to 12 Lead EKG and ECG tracing changes related to electrolyte disturbances, such as hypokalemia and hyperkalemia. 10 Final exam review. Putting it all together; 12 Lead EKG interpretation practice Return demonstration of 12 lead EKG electrode placements. 11 Final Exam LRC Project due Portfolio project due I can identify the presences of a left or right bundle branch block on a 12 lead EKG tracing and the significance of this finding. I can identify electrolyte disturbances related to ECG tracings and the significance of these findings. I am prepared for the exam final. I can place 12 lead EKG electrodes properly for tracing. I successfully completed analysis of 25 12-lead EKG tracings. I have successfully completed the requirements for this course. Additional Readings: [include supplemental websites and LRC resources] *The Department of Education Regulation states that every student must complete a minimum of 2 hours out of class work for each hour of faculty-instructed course work weekly. (1 contact hour with instructor=2 hours student work out of class.) We change lives one person at a time Revised: June 2014 Page 6
MED 267: Advanced 12 Lead EKG Reading Assignment Reading Schedule Class Week Chapters Due Date Week 1 1: Reviewing the Basics Week 2 Week 2 2: Reviewing rhythm waveforms Complete Chapters 1-3 Worksheet Week 3 3: Introduction to the 12- Lead ECG Week 3 Week 4 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 4: Acquiring the 12-Lead ECG Complete Chapter 4 worksheet 4: Acute Coronary Syndromes Complete chapter 5 worksheet Complete 12 Lead EKG practice: Figures: 5-22 - 5-31 Mid Term Examination Grade evaluation 5: Myocardial Infarction: Recognition and Localization Complete chapter 6 worksheet Complete 12 Lead EKG practice: figures 5 32 5-41 6: Complications of Myocardial Infarction Complete chapter 7A worksheet Complete 12 Lead EKG practice: Figures 5-33 5-50 7: Acute Coronary Syndrome Imposters Complete chapter 7 B Worksheet Final Review Worksheet 12 Lead EKG Rhythm packet Week 5 Week 7 Week 8 Week 9 Week 10 We change lives one person at a time Revised: June 2014 Page 7
Week 10 Return demonstration for 12 Lead EKG electrode placement and recording Week 11 Final Examination 12 Lead EKG electrode placement demonstration Portfolio project due LRC project due Week 11 We change lives one person at a time Revised: June 2014 Page 8