9.00 am - Needs Analysis and Introduction to Program
This introductory session will set the scene for the two-day program. The pre-test will offer you an opportunity to self-evaluate your current level of knowledge and identify areas for special review during the day. Common terminology used in cardiac medicine will also be reviewed at this stage.
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Pre-test and electrophysiology terminology review.
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Assessing cardiac function – mechanical and electrical.
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Review of cardiac anatomy and physiology.
10.00 am - Morning Tea and Coffee
10.30 am - Introduction to Electrophysiology
The electrical activity of the heart is a fascinating yet complex aspect of human physiology. A working knowledge of cardiac electrophysiology is essential to understanding the basics of ECG s and cardiac rhythms.
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Recording and interpreting cardiac electrical activity.
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Significance of ECG waveforms and intervals.
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Practice in interpretation of normal sinus rhythm.
11.30 am - Recording a 12 Lead ECG
The role and place of ECGs in diagnosis of cardiac disease is unquestionable. Correctly recording an ECG is an important nursing skill and the correct placement and attachment of leads is crucial. This session will clearly explain nursing responsibilities and the process involved in recording a diagnostic quality ECG.
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Why are ECGs recorded and what information can they provide?
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How to prepare a person and correctly place electrodes.
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When should the filter be used and what is calibration?
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What is interference and how can it be eliminated?
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Criteria for recording a diagnostic standard ECG.
12.30 pm - Lunch Break and Networking
1.30 pm - Simplifying 12 Lead Ecg Analysis When a Patient Has Chest Pain
In this session, you will learn the basics of ECG interpretation, with specific emphasis on the patient with chest pain. How are ten attached lead wires utilised to record 12 lead views of the left ventricle, and which leads "look" at specific areas of the heart? What ECG changes are seen with common cardiac disorders – including myocardial ischaemia, injury and acute infarction – and which require urgent interventions?
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How to approach an analysis of a 12 lead ECG.
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Lead views of the heart – standard and other optional lead recordings.
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In the patient with chest pain – what ECG changes indicate myocardial ischaemia, injury or infarction?
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What changes need to be reported urgently? Why?
2.30 pm - Afternoon Tea & Coffee
3.00 pm - Recognising and Reporting ECG Changes
The final session of today will review and reflect on what has been learned. As well, there will be a discussion of the professional implications for nurses who record ECGs as part of their scope of practice.
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Practical review of 12 lead ECG changes.
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Review of professional and legal nursing responsibilities in relation to ECG recording and in recognizing and reporting ECG changes.
Summary and review of pre-test.
4.00 pm - Close of Day One of Program
9.00 am - Introduction – Needs Analysis
Nurses are expected to have a sound understanding of the normal rhythm of the heart – sinus rhythm. We will review your scope of practice in regard to recognition and management of arrhythmias. Whether you are involved in initiating cardiac monitoring, or just want to be able to interpret the rhythm strip at the bottom of the 12 lead ECG tracing, this session will assist you.
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Pre-test to identify your current knowledge level.
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Discuss role of the nurse in interpreting arrhythmias?
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Review assessment of cardiac function
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Cardiac electrophysiology.
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Identifying criteria for sinus rhythms.
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Practice rhythms for analysis.
10.00 am - Morning Tea and Coffee
10.30 am - A Simple Approach to Arrhythmia Interpretation
Interpreting abnormal heart rhythms is often considered to be difficult and primarily the role of experienced nurses working in special care areas such as CCU or ICU. This session will introduce a simple approach to arrhythmia interpretation that can be used by all nurses - regardless of their workplace. It will enable them to confidently communicate and document abnormal rhythms using appropriate and commonly accepted terminology.
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Introduction to arrhythmia terminology.
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Explore common causes and thus identify patients at risk of arrhythmias.
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Discuss the physiological effects of arrhythmias and the importance of clinical assessment to determine urgency of treatment required.
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Explore a simple approach to categorizing arrhythmias.
11.30 am - Arrhythmias with a Fast Rate – Tachyarrhythmias
Tachyarrhythmias occur commonly– both in young healthy persons and in those with acute or chronic cardiac disorders. This session will describe what happens to the heart when tachyarrhythmias occur; and will explore where they may originate; how to recognise differing rhythms and possible management options.
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Introduction to tachyarrhythmias.
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What effect may they have of cardiac output /circulation?
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Can we differentiate between life threatening and non–life threatening tachyarrhythmias?.
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Management options – drugs, manual techniques, defibrillation.
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Rhythm interpretation practice.
12.30 pm - Lunch Break and Browse the Book Display
1.30 pm - Arrhythmias with a Slow Rate - Brady-arrhythmias
Bradycardias can occur for a variety of reasons – in those with cardiac disorders and in others who are healthy. Why do some individuals have a normal slow pulse that has no effect on their cardiac output/circulation when others rapidly become symptomatic at similar rates? This session will explore the origin, causes, effects and management of brady-arrhythmias.
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Introduction to brady-arrhythmias.
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Possible causes and effects – can they be life threatening?
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Management options – drugs, manual techniques, pacing.
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Rhythm interpretation practice.
3.00 pm - Questions and Practice Scenarios
We will finish by putting your new knowledge into practice – a number of clinical scenarios will be posed where you can identify the arrhythmia, consider nursing and medical treatment indicated, and summarize nursing responsibilities.
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Group review of patient scenarios.
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An overview of life threatening cardiac arrhythmias – cardiac arrest.
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BLS / ALS guidelines and role of the ARC.
4.00 pm - Close of Program and Evaluations
Heather Schubert OAMHeather has extensive experience and qualifications in acute care nursing and education including management roles in ICU and CCU. She teaches Basic and Advanced Life Support and has an interest in assisting all nurses – regardless of their training level - to develop enhanced clinical assessment skills and to take a more active role in the management of emergencies. Heather was a founding member of the S.A. Branch of the Australian College of Critical Care Nurses (previously CACCN), is a Fellow of the Royal College of Nursing, Australia and is on the SA committee of the Australian Resuscitation Council. She has her own business as a Consultant Nurse Educator, is a Clinical Associate of the Adelaide University and has taught aspects of emergency and acute care extensively in metropolitan and rural communities throughout South Australia. She was awarded an Order of Australia in 2009 for her services to critical care nursing and education in SA.
