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WHAT IS A PATIENT CARE TECH? HOW CAN I TRAIN MY STUDENTS TO BE ONE? CONTACT INFO Please feel free to contact me with questions/comments/suggestions! Lynne Clarke, RN, Ed.D. Health Science Department Chair A.R. Johnson Health Science and Engineering Magnet School Augusta, GA Wlclarke.weebly.com [email protected] PCT SKILLS – COMMON TO CNA Bedmaking Bathing Transfers Catheter Care ADL’s Oxygen Feeding tube care I & O ROM Skin care CPR TED hose Vital signs PPE Consent Infection Control Plan of Care HIPAA Post mortem care Report abnormal findings Emotional support Assess pain/edema Admission/Discharge/Transfer Assist with prosthetic/orthotic devices Beginning and ending procedures PCT SKILLS 12 Lead EKG Basic Arrhythmia recognition Holter monitor Emergency response Stress testing Monitor patient during blood transfusion Phlebotomy Point of care testing Specimen collection Remove peripheral IV’s Aseptic/Sterile dressing change Ostomy Care Oxygen administration Splints Handheld nebulizer Assist patient to take prescribed meds EKG SKILLS – DYSRHYTHMIA RECOGNITION Teach basic cardiac anatomy Teach basics – waves, complexes, intervals, etc. Teach EKG paper measurements Teach steps to interpret Tell the story Correlate the story to the heart’s conduction system Use technology resources to show relationship between mechanical and electrical activity • Go over each type of dysrhythmia – correlation to the story. Give out hallmark chart • Use sample 6 – second strips to have teams work to identify. • • • • • • • BASIC CARDIAC ANATOMY • Resources • • • • Anatomy and Physiology Coloring Books nhlbi.nih.gov Anatomy OpenHeart info app for iPad Dissect pig hearts WAVES, COMPLEXES, INTERVALS, ETC. EKG PAPER WAVES, COMPLEXES, INTERVALS, ETC. RATE CALCULATION METHODS Calculating Rates Method 1 – R to R Methods Method 1 – R to R Method Can only be used for regular rhythms. Can only be used for regular rhythms. Method 2- 1500 method Count number of small squares between r waves and divide that number into 1500 Most accurate method but can only be used for regular rhythms. Method 3 – 6 Second Method Count the number of complete complexes in a 6 second strip and multiply by 10. Can be used for irregular rhythms. STEPS TO INTERPRET • • • • • Rate: fast or slow Rhythm: regular or irregular or regularly irregular P-wave: regular, upright, round QRS Complex: less than 0.12 sec., constant PR interval: within 0.12 – 0.20 sec., constant ESCAPE VS. “TAKE-OVER” • Escape – when the “level” above fails to generate an impulse • “Take- over”- when the level below generates an impulse before the top level has a chance THE STORY – SCHOOL SYSTEM Education System Board of Education Building Principal Teachers Students THE STORY CORRELATION Education System Intrinsic rate Cardiac Conduction System Board of Education 60-100 Sinoatrial node (SA node) Building Principal 40-60 Atrioventricular node (Av node) Teachers 20-40 Bundle of His Students 20-40 Perkinje fibers CORRELATION EXAMPLES • 1st Degree Heart Block Building Principals take a long time to pass on information to the teachers and students • 3rd Degree Heart Block Building Principals refuse to pass on any information to the teachers and students • PVC’s • One or two students are “acting a fool” • Ventricular Fibrillation • All of the students are “acting a fool” (police might use taser) ELECTRICAL AND MECHANICAL CORRELATION • Resources • HeartCharts App for iPad • You Tube: Cardiac dysrhythmia heartbeat dances TYPES OF DYSRHYTHMIAS – CORRELATE TO THE STORY • Give out hallmark chart • Encourage students to add their own notes to the chart ID THE STRIP GAME • Form teams • Give out copies of six-second strips • Allow students to use hallmark charts to attempt to identify strip • Keep score and give “prizes” • Encourage students to keep strips to use as study examples • High tech – put every strip into Power Point and use notability • Low tech – use large post-it note paper on white board EXAMPLE EXAMPLE EKG SKILLS • Must know lead placement, patient preparation, patient education for the following: • • • • 12 Lead Telemetry Monitoring Stress testing Holter monitoring EMERGENCY ACTIONS • Recognize lethal dysrhythmias • Asystole, ventricular tachycardia, ventricular fibrillation • Call 911, CPR, AED • Mock code resource – • Mind-forge Education Service – Electrocardiogram Module • You can use this software to make an inexpensive rhythm generator on your laptop • Available from www.speakcomputers.com for about $20.00 OTHER RESOURCES • Lifeinthefastlane.com • Great EKG resources • Vhlab.umn.edu • Wlclarke.weebly.com • Live Binder • http://www.livebinder.com/play/play?id=1493572 • Access Code ARJHSPCT PHLEBOTOMY • • • • Preanalytical errors Venipuncture sites Order of the Draw Tube additives PRE-ANALYTICAL ERRORS • 70% of ALL medical care is based on clinical laboratory tests! • Pre-analytical tests occur BEFORE the specimen ever reaches the lab • Errors can result in patient treatment mistakes! • www.labresultsforlife.org VENIPUNCTURE SITES ORDER OF DRAW TUBE ADDITIVES PHLEBOTOMY EQUIPMENT Hint: Remove syringes. Cap off one of the tubes. Connect a Normal Saline 250cc or 500cc with IV tubing to the other tube – tint with the “blood” that comes with trainer. Students will get a flashback. PHLEBOTOMY PRACTICE • Obtain a laboratory requisition form from your local lab. You can make multiple copies or laminate several for reuse. • Make ID bracelets using generic male and female names and birthdays. • Have student acting as “patient” strap on Venatech trainer and ID bracelet. Complete a requisition and give it to the student “phlebotomist”. • This creates a more realistic practice situation than using one of the large, expensive practice arms. CARDIO CHEK RESOURCES • www.wlclarke.weebly.com • http://library.med.utah.edu/WebPath/TUTORIAL/PH LEB/PHLEB.html • Center for Phlebotomy Education, Inc. • www.phlebotomy.com • $699 for 3 videos • Basic Venipuncture • Preventing Pre-Analytical Errors • Skin Puncture And Newborn Screening