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ECG/Phlebotomy Student’s Name _________________________________________________________ School _______________________ Instructor _________________________________ Course Title: ECG/Phlebotomy WVEIS Code 0720 Course Description: Upon successful completion of this course students will master competencies consistent with entry-level career responsibilities in the areas of ECG Technician and Phlebotomist. Course components will focus upon an introduction to the health care delivery system, legal responsibilities, infection control and safety, communication, quality assurance, as well as theory and procedures related to the performance of phlebotomy and electrocardiography. Current technology will be utilized to master course standards. Students are provided the opportunity to participate in a Career and Technical Student Organization (CTSO). Level of Competence: 1 – No mastery 2 – Limited mastery; constant supervision needed 3 – Average or good mastery; some supervision needed 4 – Almost complete mastery; little supervision needed 5 – Complete mastery; no supervision needed Level of Competence Content Standards and Objectives 1 Health Care Delivery System Describe the various hospital departments and their major functions in which the health care worker may interact in his/her role. Identify the health care providers in hospitals, clinics and physician’s office. Describe the organizational structure of the overall hospital structure. Define the role of the clinical lab and the electrocardiography department in health care. Define the phlebotomist’s role in clinical laboratory medicine. Discuss the roles of clinical laboratory personnel and their qualifications for these professional positions. Define the ECG technician’s role in the clinical facility. Discuss the roles of the ECG technician and qualifications for the career option. Define professionalism as it relates to a phlebotomist and ECG technician. 2 3 4 Date 5 Comments Level of Competence Content Standards and Objectives 1 2 3 4 Laboratory and ECG Departments in a Health Care System List the types of laboratory procedures performed in the various sections of the Clinical Laboratory and ECG Departments. Describe how laboratory testing and cardiography is used to assess body functions and disease. Define medical terminology and abbreviations commonly used in the laboratory and cardiography department. Legal Terminology Associated with Phlebotomy Define negligence, malpractice, assault, battery, liability, and Respondent Superior. Compare and contrast legal responsibilities and action of sample scenarios. Identify the scope of practice of the phlebotomist and ECG technicians. Describe common ethical standards within the health care profession. Infection Control and Safety Identify policies and procedures for maintaining safety in the laboratory and during ECG procedures. Identify and discuss the modes of transmission of infection and methods of prevention. Discuss the universal precautions outlined by the Centers for Disease Control (CDC). Perform proper infection control techniques, such as hand washing, gowning, gloving, masking, and double bagging. Define and discuss hospital-acquired infections. Describe the electrical, radiation, biological hazards and fire safety procedures used in the hospital, including the clinical laboratory. Diagram the following hazard symbols: Radiation, biohazard, toxic or poison, carcinogen, corrosive, flammable, and NFPA chemical hazard. Identify and properly label biohazard specimens. Describe the safety measures that should be followed at all times by a phlebotomist when collecting or transporting a patient’s specimen. Communication, Personal and Patient Interaction Compare and contrast legal responsibilities and action of sample scenarios. Be able to explain the importance of maintaining patient confidentiality. Date 5 Comments Level of Competence Content Standards and Objectives 1 Describe the proper manner for greeting and interacting with a patient. Explain the major points in interviewing a patient or a patient’s representative in preparation for obtaining specimens. Describe instructions to be given to patients in preparation for routine blood collection, glucose testing, bleeding times and other procedures normally performed by the phlebotomist. Describe instructions to be given to patients in preparation for various electrocardiography procedures. Describe and discuss techniques for dealing with family and visitors during the collection of specimens and electrocardiography procedures. Describe the Patient’s Bill of Rights as it applies to the clinical laboratory personnel and ECG technicians. Discuss the importance of appearance and grooming for phlebotomists and ECG technicians. Discuss the telephone within the context of extra-laboratory communication. List and define rules of telephone etiquette appropriate for the clinical setting. Discuss the role of the computer within the laboratory and ECG department. Quality Assurance in Laboratory Testing Describe the system for monitoring quality assurance in the collection and transportation of laboratory testing. Identify policies and procedures used in the clinical laboratory to assure quality in obtaining of blood specimens. Specimen Transport and Specimen Processing Describe the laboratory criteria for identifying an appropriate request for specimen collection. Relate legal responsibilities of the laboratory and phlebotomist to the need for physicians’ request for all specimen collecting and testing. Identify methods for transporting and processing blood specimens for routine and special testing within the health care system. Explain methods for processing and transporting specimens for testing at reference laboratories. Describe the potential clerical and technical errors that may occur during specimen processing. 2 3 4 Date 5 Comments Level of Competence Content Standards and Objectives 1 Explain the general effects of time on test quality and patient care in regard to processing and transporting of specimens. Describe the conditions that must be met if blood specimens and laboratory tests are to be used as legal evidence. Collection Equipment and Precautions Identify the various types of additives used in blood collection, and explain the reasons for their use. Identify the evacuated tube color codes associated with the additives. List and select the types of equipment needed to collect blood by venipuncture, capillary, and arterial punctures. List the supplies that should be carried on a phlebotomist’s tray. Identify special precautions necessary during blood collections. Describe substances that can interfere in clinical analysis of blood constituents. Identify the mode of action for each anticoagulant. Define the following terms and list possible causes of each of these situations: Demolished Sample, Short Draw, Clotting in Whole Blood Tubes, Lipemic, and Icteric. List the effects of the tourniquet, hand squeezing, and heating pads on capillary and venipuncture. Define the following terms and list appropriate first aid for each of these circumstances: Petechiae, Hematoma, Infection, Syncope, Emesis, Osteomyelitis, and Sepsis. Identify a winged infusion set. Define situations appropriate for the use of a winged infusion needle. Identify a syringe and explain when you would use this technique. Specimen Collection Procedures Define “chain of custody” as it relates to blood specimens collected to rule out illegal drug use. Define the following terms: TDM, Peak Levels, Trough Levels, Random Sampling, Toxic Levels, Untramuscularly, and Intravascular. List the steps used in specimen collection techniques for glucose testing: 2 hour, random, fasting, and glucose tolerance testing. 2 3 4 Date 5 Comments Level of Competence Content Standards and Objectives 1 Correctly time and label specimen. List the steps in the procedure for blood alcohol specimen collection. Describe the phlebotomist’s role in the collection of urine specimens for routine urinalysis, culture and sensitivity, and timed specimens. Perform a multi-draw venipuncture. Appropriately approach the steps in a skin puncture procedure. Appropriately identify the patient. List and perform the steps in a skin puncture procedure. List and perform the steps in a venipuncture. Appropriately collect, label, and transport specimens for the following analyses: cold agglutinins, type, and antibody screen, cross match and blood cultures. Circulatory System Describe the structures of the heart. Explain the pumping action of the heart. Diagram and describe the flow of blood through the heart. Distinguish between systemic and pulmonary circulation. List the components of the conduction system. Give the sequence of impulse origination of the conduction system. State four properties of the cardiac cells. Name the four chambers of the heart. Name the four valves of the heart, give their location, and describe how they function. Define blood and lists its components. Label each blood vessel. Identify structures of the heart valves, blood vessels, and conduction system on diagrams. Basic Electrophysiology Trace the electrical conduction pathway of the heart and explain the location where they are in relation to the heartbeat. Explain each of the conduction pathway component’s relationship to the heartbeat. Label the waveforms and segments of the heartbeat. List causes of dysrhythmias. Define isoelectric line. Electrocardiography Explain the difference between electrocardiogram and electrocardiograph. Explain the reasons for performing an ECG. 2 3 4 Date 5 Comments Level of Competence Content Standards and Objectives 1 Explain the universal marking codes for a manual 12 lead ECG and the auto 12 lead. Diagram the limb, augmented, and chest leads of an ECG. Recognize and correct problems associated in the performance of an ECG tracing. Describe and list the placement of ECG electrodes on the body. Explain the guide used in interpreting ECG strip. Electrocardiography Paper Describe the ECG paper. Give the recording speed of the ECG paper. Explain how the time and voltage of the ECG tracing is determined. Calculate the rate of patient’s heartbeat on an ECG tracing. Electrocardiography Machine Clean and maintain ECG machine. List the supplies and other equipment used in performance of an ECG. List the parts of an ECG machine and give the purpose of each. Define the difference between electrode and sensor. Leads Describe the 12 leads in a tracing and explain the difference between unipolar and biopolar. Identify the color of the limb and chest leads for a standard 12 lead ECG. Describe the principle of Einthoven’s triangle and diagram the three leads used. List the augmented limb leads and be able to diagram on a chart. Name the precordial or chest leads in order and explain what they measure. Explain Einthoven’s Law and what it detects. List the frontal and horizontal leads of an ECG. Electrocardiograph Technique Describe the universal standard of ECG measurement. Identify the patient using proper procedure. Identify yourself and explain procedure to the patient. Document patient’s medication history and vital signs. Incorporate relaxation methods to make the patient comfortable. Place the patient into the proper recording position. 2 3 4 Date 5 Comments Level of Competence Content Standards and Objectives 1 2 Prepare the patient’s skin before placement of leads. Recognize and place sensors in proper positions on the patient. Connect the cable wires to sensors in proper sequence. Acquire ECG tracing using universal standards. Recognize, describe and correct artifacts on the ECG tracing. Describe how to identify the tracing after completion. Document any variation from a normal tracing or any information useful to the interpreting physician. Document any physical or extrinsic situation that could alter ECG vector or standard lead placement. Quality Assurance in the Performance of an ECG Verify information on ECG tracing. Recognize and remove artifacts. Identify proper supplies and equipment. Describe the documentation of variation from normal ECG tracing. Correct standardization of voltage. Prioritize time and follow proper sequence of events. Utilization of ECG Tracing Identify lethal arrhythmias. Describe proper reporting of lethal arrhythmias immediately to a nurse or physician for diagnosis and treatment. List criteria for a normal ECG. Describe utilization of the components of rhythm strip analysis. Define the following terms associated with the ECG training: normal sinus rhythm, sinus arrhythmia, sinus arrest, bradycardia and tachycardia. Technology Integrate the use of software, hardware, and the Internet to practice and master standards identified in the course. Utilize the Internet as a resource/research tool. Student Organization Participate in Health Occupations Students of America (HOSA) or SkillsUSA/Vocational Industrial Clubs of America (SkillsUSA/VICA). Apply parliamentary procedure in organization meetings. 3 4 Date 5 Comments Level of Competence Content Standards and Objectives 1 Demonstrate team membership skills, such as cooperation and leadership. Take part in local, state, and national health care and education projects. 2 3 4 Date 5 Comments