Standard

Rev.03/17/03

EMS 133 - Cardiology II

(To Review Previous Version of this Standard and Guide, Click Here)

Course Description

This course expounds on the objectives in Cardiology I emphasizing advanced patient assessment and management of the cardiac patient. Topics will include advanced cardiovascular assessment, pharmacological intervention, electrical intervention, and emergency resuscitative treatment utilizing the American Heart Association’s Advanced Cardiac Life Support (ACLS) Providers course. This course provides instruction on topics in Division 5 (Medical), Section 2 (Cardiology) of the USDOT/NHTSA Paramedic National Standard Curriculum.

Competency Areas	Hours
Assessment of the Cardiac patient	Class	4
Emergency Resuscitative Equipment	D. Lab	2
Assessment and Management of Cardiovascular Emergencies	P. Lab/O.B.I.	0
	Credit	5

Prerequisite:	EMS 126, EMS 127, EMS 128, EMS 129
Corequisite:	ENG 101, SCT 100, EMS 132, EMS 200

Course Guide

Competency	After completing this section, the student will:	Hours
		Class	D.Lab	P.Lab/ O.B.I.
ASSESSMENT OF THE CARDIAC PATIENT		5	3	0
History and physical exam	Identify and describe the details of physical exam specific to the cardiovascular system.
	Define pulse deficit, pulsus paradoxus and pulsus alternans.
	Identify the normal characteristics of the point of maximal impulse (PMI).
	Identify and define the heart sounds.
	Relate heart sounds to hemodynamic events in the cardiac cycle.
	Describe the differences between normal and abnormal heart sounds.
	Identify and describe the components of the focused history as it relates to the patient with cardiovascular compromise.
	Based on field impressions, identify the need for rapid intervention for the patient in cardiovascular compromise.
	Identify what is meant by the OPQRST of chest pain assessment.
	Value the sense of urgency for initial assessment and intervention in the patient with cardiac compromise.
	Perform, document and communicate a cardiovascular assessment.
	Demonstrate how to evaluate major peripheral arterial pulses.
The 12-Lead ECG	Describe the abnormalities originating within the bundle branch system.
	Recognize the pitfalls in the differentiation of wide QRS complex tachycardias.
	Describe the phenomena of reentry, aberration and accessory pathways.
	Identify the ECG changes characteristically produced by electrolyte imbalances and specify the clinical implications.
	Identify patient situations where ECG rhythm analysis is indicated.
	Recognize the ECG changes that may reflect evidence of myocardial ischemia and injury.
	Recognize the ECG limitations in reflecting evidence of myocardial ischemia and injury.
	Correlate abnormal ECG findings with clinical interpretation.
	Describe the incidence, morbidity and mortality associated with myocardial conduction defects.
	Defend patient situations where ECG rhythm analysis is indicated.
EMERGENCY RESUSCITATIVE TREATMENT		11	1	0
Electrical therapeutic interventions	Identify the clinical indications for transcutaneous and permanent artificial pacing.
	Describe the components and the functions of a transcutaneous pacing system.
	Explain what each setting and indicator on a transcutaneous pacing system represents and how the settings may be adjusted.
	Describe the techniques of applying a transcutaneous pacing system.
	Describe the characteristics of an implanted pacemaking system.
	Describe artifacts that may cause confusion when evaluating the ECG of a patient with a pacemaker.
	List the possible complications of pacing.
	List the causes and implications of pacemaker failure.
	Identify additional hazards that interfere with artificial pacemaker function.
	Recognize the complications of artificial pacemakers as evidenced on ECG.
Pharmacologic therapeutic interventions	Describe the most commonly used cardiac drugs in terms of therapeutic effect and dosages, routes of administration, side effects and toxic effects.
ASSESSMENT AND MANAGEMENT OF CARDIOVASCULAR EMERGENCIES		24	24	0
Angina	Describe the epidemiology, morbidity and mortality, and pathophysiology of angina pectoris.
	List and describe the parameters to be evaluated in a patient with angina pectoris.
	Identify what is meant by the OPQRST of chest pain assessment.
	List other clinical conditions that may mimic signs and symptoms of coronary artery disease and angina pectoris.
	Identify the ECG findings in patients with angina pectoris.
	Identify the paramedic responsibilities associated with management of the patient with angina pectoris.
	Based on the pathophysiology and clinical evaluation of the patient with chest pain, list the anticipated clinical problems according to their life-threatening potential.
Myocardial infarction	Describe the epidemiology, morbidity and mortality of myocardial infarction.
	List the mechanisms by which an MI may be produced by traumatic and non-traumatic events.
	Identify the primary hemodynamic changes produced in myocardial infarction.
	List and describe the assessment parameters to be evaluated in a patient with a suspected myocardial infarction.
	Identify the anticipated clinical presentation of a patient with a suspected acute myocardial infarction.
	Differentiate the characteristics of the pain/discomfort occurring in angina pectoris and acute myocardial infarction.
	Identify the ECG changes characteristically seen during evolution of an acute myocardial infarction.