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Transcript
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