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Date Course Title Basic EKG HSC 1000, BSC 1085/ BSC1085L, ENC 1101, PHY 2053, DMS 1020, MAC 1105, BSC 2085/ BSC 2085L, PSY 1012, SPC 1017, STA 2003 Hours 35 theory hours with lab (35 clock hours) Note: Subject to change Pre-requisite (s) Credits Course Number 2 Credits EKG 1010 Co-requisite (s) NONE Place and Time of Class Meeting International College of Health Sciences 2300 S. Congress, Suite # 105 Boynton Beach, Fl 33426 Name and Contact Information of Instructor Instructor: Juan Carlos Zamora, CCT, RCS, RDCS, RVT E-mail: [email protected] Office Hours: 9:00 am to 5:00 pm Campus Telephone: 561-202-6333 Delivery Method: On Campus Books required Reference book Title: ECG Workout Title: EKG Plain and Simple Jane Huff Karen M. Ellis Attendance Policy Failure to maintain regular attendance may lead to a failing grade. The attendance policy at ICHS is as follows: Students must attend 80 percent (80%) of the total didactic class hours per semester and 100 percent (100%) of clinical externship hours. A student may have the opportunity to make up absences; however, this is only available at the discretion and approval of a lead instructor and can only be completed outside of scheduled classroom hours, if available. In the event that the student will be absent from his or her clinical externship, the student must call the assigned site and ICHS in advance. All absences must be justified in writing (i.e. doctor’s excuse). Students are not excused from attending the clinical externship except for grave emergencies or serious illness, and the student must call the assigned site and ICHS in advance. Additionally, these hours must be made up within a student’s scheduled dates for the course, the term, the semester or the scheduled clinical rotation. Instructors, in their discretion, may base a percentage of the grade on attendance. Termination may occur for any of the following attendance situations: 1. Eight (8) consecutive absences per semester. 2. Absence in excess of 20 percent (20%) of available course hours. 3. Absence in excess of 20 percent (20%) of externship hours. Tardiness for didactic or clinical education will not be tolerated. Anytime beyond the scheduled reporting time will be considered late or tardy. When attending clinical externship, if a student is to be late, he or she must notify the clinical instructor at the facility and the program clinical coordinator. If a student must miss class, he or she must contact the program director or instructor at least 30 minutes prior to the class beginning. For didactic education, four episodes of tardiness or leaving ICHS early per semester will result in an absence. If a student is more than 15 minutes late, he or she must obtain the instructor’s permission to attend the class. Four late arrivals will result in the equivalent “consequence” as one unexcused absence. Any student who has been excessively tardy in arriving to class or absent will receive a written advisement and guidance report by a faculty member. A student, who has more than one unexcused absence during clinical externship, may be removed from the site. DISTANCE EDUCATION ATTENDANCE POLICY Students must log into their online course prior to the third day of the course as dictated by the drop/ad policy of ICHS. Failure to log in by the end of the third day will result in the student being dropped from the course. Attendance in online courses is defined as active participation in the course. Active participation is defined as completion of all expectations outlined in the online course as contained in the lesson plan, syllabi and other course related documents within the course. These expectations may include but are not limited to participation in discussion forums, submission of completed assignments, and completion of quizzes and exams. VETERAN'S ATTENDACE POLICY Excused absences will be granted for extenuating circumstances only. Excused absences must be substantiated by entries in students' files. Early departures, class cuts, tardies, etc., for any portion of a class period will be counted as absence. Students exceeding 3 unexcused absences in a 7 day period for non-degree programs and 5 unexcused absences in a semester for degree granting programs will be terminated from their VA benefits for unsatisfactory attendance. The student's attendance record will be retained in the veteran's file for USDVA and SAA audit purposes. Course Description Basic EKG is a thoroughly updated course design to provide the student with a great understanding of basic anatomic and electrocardiographic concepts. Different types of arrhythmias, such as Atrial, Junctional and Ventricular will be covered. Atrioventricular Blocks, as well as Axis, Hypertrophy, Infarction, and Pacemakers among other miscellaneous Pathologies will also be covered. A detail explanation of Equipment operation, artifacts, and quality assurance will be covered in detail. The defining characteristics, physiologic mechanisms, signs and symptoms, physiologic consequences, and interventions of each type of pathology are explained and discussed in a classroom and lab atmosphere. After completion of this course the student will be ready to sit for the certification in Electrocardiography offered by Cardiovascular Credentialing International. Upon successful completion of this course, the student will be able to: 1. Define the key terms associated with electrocardiographs. 2. Describe the cardiac cycle and the conduction systems that controls the cardiac cycle. 3. Describe the electrocardiogram. 4. Maintain equipment for safety and accuracy; identify and eliminate artifacts and mechanical problems. 5. Identify the basic equipment and supplies required for electrocardiography. 6. Demonstrate proper lead placement. 7. Describe and demonstrate the step-by-step procedure for obtaining an EKG and use documentation skills to identify electrocardiographs. 8. Calculate rate and identify rhythms. 9. Definition of Axis 10. Hypertrophy 11. Describe Ischemia, Acute Injury, Old Myocardial Infarction and Walls affected 12. Heart Blocks, ST-T Wave Abnormalities 13. Electrolytes Imbalance, Changes in Cardiac Rhythm due to Medications 14. Pacemaker Rhythms and Malfunction Topical Outline and Schedule DATE WEEK 1 Describe the Course SPECIFIC OBJECTIVES Distribute and Discuss Syllabus Discuss The Library and other Resources At the end of this class, the student will be able to: 1- Understand the anatomy of the heart 2- Understand the cardiac cycle 3- Understand the conduction system of the heart 4- Understand the autonomic nervous system 5- Describe the roll of an electro-cardiographer 6- Discuss the history of EKG TOPIC (S) Anatomy of the Heart LEARNING Power Point Presentation ACTIVITIES Discussion: Anatomy of the Heart, Principles of Circulation, The Cardiac Cycle. Video presentation on the Electrical Conduction of the Heart OUTSIDE Homework: Practice Quiz page 11, Label Heart Diagram page 12 WORK & Read: Chapter 1 EKG Plain and Simple ASSIGNED Key Terms READINGS DATE WEEK 2 At the end of this class, the student will be able to: SPECIFIC 1- Understand Einthoven’s triangle OBJECTIVES 2- Understand cell depolarization and repolarization 3- Understand cellular ion exchange 4- Understand waves, intervals, segments 5- Understand graph paper (vertical and horizontal) time and amplitude 6- Precordial leads and limb leads 7- Leads placement TOPIC (S) Basic Principles of Electrophysiology LEARNING Power Point Presentation ACTIVITIES Video: Ion Adventure (Dale Dubin) Practice Lead Placement Projection of normal and abnormal EKG strips Homework: Practice Quiz page 31 and 42 OUTSIDE WORK & Read: Chapters 2-3 EKG Plain and Simple ASSIGNED Key Terms READINGS Study for Quiz # 1 DATE WEEK 3 At the end of this class, the student will be able to: SPECIFIC 1- Understand how to operate the EKG machine OBJECTIVES 2- Understand how to input patient information 3- Understand possible artifacts and pitfalls 4- Understand how to replace EKG paper 5- Record a twelve lead EKG and rhythm strips 6- Understand the importance of proper lead placement TOPIC (S) The EKG Machine Power Point Presentation LEARNING Introduction to the EKG Machine and it’s functions ACTIVITIES Students will practice loading paper, information input, adjusting Amplitude and Speed, Filter, Lead Placement. Quiz # 1 OUTSIDE Homework: Presentation of Einthoven’s Triangle, (limb, augmented, and WORK & precordial leads) ASSIGNED Read: Chapter 4 EKG Plain and Simple READINGS Key Terms DATE WEEK 4 At the end of this class, the student will be able to: SPECIFIC 1- Learn how to calculate heart rate OBJECTIVES 2- Understand the differences between a regular and irregular rhythm 3- Understand normal sinus rhythm 4- Understand sinus tachycardia and bradycardia 5- Understand sinus arrhythmia 6- Understand sinus arrest and block TOPIC (S) Calculating Heart Rate, Sinus Rhythms LEARNING Power Point Presentation ACTIVITIES Discuss the different ways to calculate Heart Rate Discuss all Sinus Rhythms Practice and identify Rhythm Strips Homework: Practice Rhythm Strips (ECG Workout book) Pages 34-84 OUTSIDE WORK & Read: Chapters 5,6,7 EKG Plain and Simple ASSIGNED Practice Quiz page 88 READINGS Study for Quiz # 2 DATE WEEK 5 At the end of the class, the student will be able to: SPECIFIC 1- Understand wandering atrial pacemaker OBJECTIVES 2- Understand premature atrial contractions 3- Understand non-conductive pac’s 4- Understand paroxysmal atrial tachycardia 5- Understand atrial flutter 6- Understand atrial fibrillation TOPIC (S) Atrial Arrhythmias LEARNING Power Point Presentation ACTIVITIES Discuss Atrial Arrhythmias Practice and identify Rhythm Strips Quiz # 2 Homework: Practice Rhythm Strips (ECG Workout book) Pages 85-137 Read: Chapter 8 EKG Plain and Simple Practice Quiz page 109 Study for Mid-Term WEEK 6 At the end of this class, the student will be able to: 1- Understand junctional rhythm 2- Understand accelerated junctional rhythm 3- Understand junctional tachycardia 4- Understand first degree AV block 5- Understand second degree AV block (Type I and II) 6- Understand third degree AV block TOPIC (S) Junctional Arrhythmias and AV Blocks LEARNING Power Point Presentation ACTIVITIES Discuss Junctional Arrhythmias and AV Blocks Practice and identify Rhythm Strips Mid-Term Exam Homework: Practice Rhythm Strips (ECG Workout book) Pages 138-196 OUTSIDE WORK & Read: Chapter 9 and 11 EKG Plain and Simple ASSIGNED Practice quiz page 122, 165 READINGS Key Terms DATE WEEK 7 At the end of this class, the student will be able to: SPECIFIC 1- Understand premature ventricular contractions (unifocal, multifocal, OBJECTIVES R on T) 2- Understand idioventricular rhythm 3- Understand accelerated ventricular rhythm 4- Understand ventricular tachycardia 5- Understand ventricular fibrillation 6- Understand Torsade De Pointes 7- Understand ventricular standstill (primary and secondary) 8- Understand pulseless electrical activity 9- Right and Left Bundle Branch Blocks 10- Fascicular blocks TOPIC (S) Ventricular Arrhythmias and Bundle Branch Blocks Power Point Presentation LEARNING ACTIVITIES Discuss Ventricular Arrhythmias and Bundle Branch Blocks Practice and identify Rhythm Strips Discuss Defibrillators Homework: Practice Rhythm Strips (ECG Workout book) Pages 197-255 OUTSIDE WORK & Read: Chapter 10 EKG Plain and Simple ASSIGNED Practice Quiz page 146 READINGS Key Terms OUTSIDE WORK & ASSIGNED READINGS DATE SPECIFIC OBJECTIVES DATE WEEK 8 At the end of this class, the student will be able to: SPECIFIC 1- Understand the mean QRS vector OBJECTIVES 2- Discuss limb, augmented and precordial leads 3- Understand normal axis, left and right axis deviation 4- Infarction and hypertrophy and the effects on axis 5- Understand right and left ventricular hypertrophy 6- Understand atrial dilation 7- Understand fascicular blocks TOPIC (S) Axis and Hypertrophy LEARNING Power Point Presentation ACTIVITIES Discuss Axis and Hypertrophy Practice and identify 12 Lead EKG Criteria use to identify Axis and Hypertrophy OUTSIDE Homework: Practice 12 Lead EKG’s to determine Axis and Hypertrophy WORK & Read: Chapter 13 EKG Plain and Simple ASSIGNED Practice Quiz page 289 READINGS Study for Quiz # 3 DATE WEEK 9 At the end of this class, the student will be able to: SPECIFIC 1- Understand coronary arteries distribution OBJECTIVES 2- Understand ischemia, injury and necrosis 3- Understand ST-T wave abnormalities 4- Understand angina pectoris 5- Understand the area affected by correct identification of EKG leads 6- Understand hemiblocks in reference to infarctions 7- Understand the differences between acute and old mi TOPIC (S) Ischemia, Infarction LEARNING Power Point Presentation ACTIVITIES Discuss Acute, Old and Silent Myocardial Infarctions Practice and identify 12 Lead EKG Criteria use to identify the area affected by Ischemia, Injury and Necrosis Quiz # 3 Homework: Practice 12 Lead EKG’s to determine MI’s and location OUTSIDE WORK & Read: Chapter 14 EKG Plain and Simple ASSIGNED Practice Quiz page 332 READINGS Key Terms DATE SPECIFIC OBJECTIVES TOPIC (S) LEARNING ACTIVITIES WEEK 10 At the end of the class, the student will be able to: 1- Understand the effects of pulmonary disease on an EKG tracing 2- Understand electrolytes imbalance and the effects on the heart 3- Understand the effects of medications on the heart 4- Understand Q-T abnormalities 5- Understand hyperkalemia, hypokalemia, hypercalcemia, hypocalcemia, digitalis toxicity, quinidine effects Miscellaneous Effects Power point slides presentation Discuss the miscellaneous effects on the Heart and the EKG abnormalities associated Practice Tracings for Miscellaneous Abnormalities Homework: Practice 12 Lead EKG’s Read: Chapter 16 EKG Plain and Simple Key Terms OUTSIDE WORK & ASSIGNED READINGS DATE WEEK 11 At the end of the class, the student will be able to: SPECIFIC 1- Understand the indications for pacemaker implantation OBJECTIVES 2- Understand temporary pacemakers (transcutaneous, transvenous, and epicardial pacing) 3- Understand permanent pacemakers 4- Understand ventricular defibrillators 5- Understand pacemaker firing 6- Define capture, sensing, intrinsic beat, fusion beats, pseudofusion beats 7- Understand pacemaker malfunction (failure to fire, failure to capture, sensing failure) TOPIC (S) Pacemakers LEARNING Power Point Presentation ACTIVITIES Discuss Indications for Pacemaker when the Heart’s Electrical System Malfunctions Practice and identify Pacemaker Rhythm Strips Discuss Defibrillators OUTSIDE Homework: Practice Rhythm Strips (ECG Workout book) Pages 256-283 WORK & Read: Chapter 16 EKG Plain and Simple ASSIGNED Practice Quiz page 378 READINGS Study for Final Exam DATE WEEK 12 At the end of this class, the student will be able to: SPECIFIC Have a clear understanding of the importance of Electrophysiology in the OBJECTIVES medical field. Be able to analyze and understand Rhythms, and 12 lead EKG tracings TOPIC FINAL EXAM and REVIEW LEARNING FINAL EVALUATION ACTIVITIES Integration of data: Incorporate outside data (clinical assessment, physical, lab values, compare with previous exams, provide preliminary reports to physician) OUTSIDE Student to review all criteria for EKG interpretation WORK & Read Chapters 17 and 18 ASSIGNED READINGS Instructional Methods The following strategies may be used in this class: 1. Online Lectures 2. PowerPoint Presentation 3. Online Discussion 4. Practice tests 5. Internet research 6. Student evaluation of course References and Resources ICHS Virtual Library Login to the ICHS Virtual Library at http://www.lirn.net, access code 40149 to online books, journals, and other reference resources selected to support ICHS curricula. Medline Plus http://www.nlm.nih.gov/medlineplus/ Health information from the National Library of Medicine National Institutes of Health. Easy access to Medline and Health topics, medical dictionaries, directories, drug information, videos and more. PALM BEACH COUNTY LIBRARY ONLINE RESOURCES You need a free Palm Beach County Library card to access, or register for a free “Temporary Research Access Code” at http://edb.pbclibrary.org/TRAC/ If you need help using any of the library websites, click on the “Ask a Librarian” icon and “chat” with a librarian. Consumer Health http://www.pbclibrary.org/health.htm CINAHL® with Full Text - full text articles for more than 610 nursing and allied health journals (and indexing for an additional 3000 journals) as well as health care books, nursing dissertations, selected conference proceedings, and more. http://www.pbclibrary.org/databases/ LearningExpress - (Practice Tests) Contains online learning with skill building modules, test preparation materials and practice exams; including test preparation E-books. Take practice tests for Health Careers, Radiography, Registered Medical Assistant and NCLEX-RN for Nursing. Learn techniques for job searching, resumes, interviewing and workplace skills. http://www.pbclibrary.org/databases/ Health and Wellness Resource Center http://www.pbclibrary.org/databases/ Assessment Criteria and Methods of Evaluating Students A B C F equivalent to equivalent to equivalent to equivalent to 90 – 100 80 – 89 75 – 79 74 and below 4.0 3.0 2.0 0.0 Generally, the grades “A” through “C” are considered passing grades. Grades "W" and "I" indicate that no grades were earned for the course. A "W" grade indicates that the student withdrew from the course. An "I" grade indicates that the student was passing the course, but failed to complete all the required course work. The instructor, in his/her discretion may grant an "I" grade instead of an "F", pending completion of the course work by the student within a specified time arranged by the instructor and told to the student. It is the student's responsibility to follow-up with the instructor to complete the course work. If the course work is not completed by the arranged time, the “I” grade becomes an “F". Distribution of Grade Elements Quizzes 25% Mid-Term 25% Final Exam 30% Presentations 20% Total 100% Syllabus Revised: Oct 1, 2015