EMT 251 - Advanced Cardiac Care Refresher

1. Identify pathophysiological principles of the cardiovascular system.
2. Describe the assessment findings to formulate a field impression and implement the treatment plan for the patient with cardiovascular disease/injury based on 3-lead and 12-lead cardiac monitoring and interpretation.
3. Define cardiovascular anatomy and physiology.
4. Identify cardiovascular pathologies and management, and adjunctive diagnostics.

1. Identify and explain the importance for each component to the chain of survival, with special focus involving the first 10 minutes of a witnessed cardiopulmonary arrest.
2. Describe cardiovascular disease and injury and the importance of basic and advanced cardiac monitoring as integrated in patient assessment and management.
3. Identify and describe the anatomy and physiology of the cardiovascular system throughout the levels of body organization, including mechanical and electrophysiology.
4. Identify and explain abnormal 3-lead Electrocardial Graph (ECG) tracings as they relate to pathophysiology for rhythms originating from the atria, atrioventricular junction, and the ventricles. 
5. Differentiate abnormal 12-lead ECG tracings and axis deviations as they relate to the anatomy and pathophysiology of the cardiovascular system.
6. Discuss common pathologies and emergency management of cardiovascular diseases/injuries utilizing ECG monitoring.
7. Explain additional diagnostic assessments and tools utilized in confirming cardiovascular emergencies.
8. State the importance of proper ECG monitoring as it relates to initial and on-going patient assessment, management, and legal documentation.
9. Explain the proper systematic approaches in patient assessment, formulating a field impression and implementing a treatment plan based on the mechanisms of illness/injury for the patient with cardiovascular and pulmonary compromise utilizing basic skills.
10. State the important role of the automated external defibrillator (AED) and AED operations.
11. Differentiate between cardioversion, defibrillation, and cardiac pacing.
12. Identify and explain the names, classes, mechanisms, dosing, indications, contraindications, preparations, and administration of common drugs used in cardiovascular and pulmonary emergencies.
13. Explain the proper systematic approaches in patient assessment, formulating a field impression and implementing a treatment plan based on the mechanisms of illness and injury for the patient with cardiovascular and pulmonary compromise utilizing advanced skills.
14. Discuss current trends and changes in healthcare, and demonstrate the ability to integrate roles and responsibilities by formulating a field impression and implementing simulated patient care following guidelines, protocols, and standing orders.

1. Introduction
   1. The chain of survival
   2. Early defibrillation
2. Cardiovascular Disease and Cardiac Monitoring
   1. Incidence and types of disease and injury
   2. Importance of cardiac monitoring and interpretation
3. Cardiovascular Anatomy and Physiology
   1. The vascular system
   2. Myocardial placement, location, and positioning.
   3. Levels of body organization relating to the myocardium
   4. Myocardial circulation
   5. Electrophysiology of the heart
   6. Autonomic nervous system
4. Normal and Abnormal 3-Lead ECG Tracings as They Relate to Anatomy and Pathophysiology
   1. Systematic approach to 3-lead ECG interpretation
   2. Sinoatrial
   3. Atrial
   4. Atrioventricular junction
      1. Ventricular
      2. Excitation rhythms
   5. Heart blocks
   6. Abnormal wave characteristics and changes
5. 12-Lead Placement, Axis Determination, Axis Deviation, and Augmented Lead Placement
   1. Systematic approach to 12-lead ECG interpretation
   2. ECG tracings and axis determination
   3. ECG tracings and axis deviation
   4. Augmented lead placement and ECG tracings
6. Cardiovascular Pathologies and Management
   1. Ischemia, injury, infarction (with normal and abnormal ECG tracings)
   2. Electrolyte imbalances
   3. Hypertrophy and cardial myopathies
   4. Pericarditis
   5. Trauma
   6. Thermal
   7. Neurological impacts
   8. Blocks and hemi-blocks
   9. Emboli
   10. Artifact
   11. Age-specific variants
   12. Pharmacology
7. Adjunctive Diagnostics
   1. Physical signs and symptoms
   2. Patient medical history
   3. Comparative ECG analysis
   4. Blood gasses: metabolic panel, cultures, enzyme and drug levels, clotting factors
   5. Radiography, echocardiogram, scanning, and or catheterization
8. Special Considerations in ECG Monitoring
   1. Initial 3 and 12 lead ECG analysis
   2. Comparative ECG analysis from previous tracings
   3. ECG changes before, during, and after patient interventions             
   4. Proper patient information and documentation
9. Systematic Approach to Patient Assessment and Management Utilizing Basic Skills
   1. Opening an airway and basic adjuncts.
   2. Rescue breathing, ventilation, and oxygen therapy
   3. Cardiopulmonary resuscitation
   4. Develop and execute a patient management plan based on field impression
10. The Automated External Defibrillator (AED)
    1. Definition and importance
    2. Operations
    3. Implementation
11. Electrical Management Involving Cardiac Dysrhythmias and Arrhythmias
    1. Cardioversion
    2. Defibrillation
    3. Cardiac Pacing
12. Common Drugs Used in The Emergency Management of Cardiovascular and Pulmonary    Emergencies
    1. Names and classes
    2. Mechanisms
    3. Dosing
    4. Indications and contraindications
    5. Preparations and administration
13. Systematic Approach to Patient Assessment and Management Utilizing Advanced Skills
    1. Advanced airway management, ventilation and oxygen therapy
    2. Vascular access and medication administration
    3. Chemical and electrical cardioversion
    4. Management of cardiac dysrhythmias and arrhythmias
    5. AED and Defibrillation
    6. Transcutaneous external pacing
    7. Develop and execute a patient management plan based on field impression
14. Integration
    1. Current trends and changes
    2. Demonstration of knowledge and skills competencies