RESPIRATORY CARE 316

CARDIOPULMONARY DIAGNOSTICS

CRN: 34312

KapiolaniCommunity College

Spring, 2006

Mondays, 0900 – 12000, Kauila 216

I.Instructor:Aaron K. Koseki

Office: Kauila 122A

Phone: 734-9224Health Sciences phone: 723-9270

Email:

Office hours: Mondays, 1-3

  1. Description: RESP 316 introduces students to pulmonary laboratory procedures and techniques, including the Blood Gas Laboratory, Bronchoscopic Lung examination, Pulmonary Function Laboratory, Sleep Laboratory, and Neurodiagnostic examinations. The course emphasizes testing methods and protocols, interpretation of test results and correlation to disease states and appropriate therapeutic intervention.
  1. Objectives: Upon successful completion of RESP 316, the student should be able to:
  • Define the role of cardiopulmonary diagnostics in patient care
  • Describe, evaluate, and interpret pulmonary function tests, polysomnographic tests, cardiopulmonary exercise tests
  • Describe and discuss the fundamentals of a lung bronchoscopic exam
  • Describe and discuss the fundamentals of obtaining a 12-lead ECG tracing
  • Describe and discuss arterial blood gas sampling procedures, including the care and maintenance of analyzers, co-oximeters, and blood gas electrodes
  • Discuss stepwise approach to interpreting arterial blood gases, acid-base balance; correlate gases with interventions and disease states (CHF, COPD, mechanical ventilation)
  • Explain methods to diagnose lung volumes, capacities, diffusion
  • Explain methods and protocols to diagnose sleep-related disorders
  • Explain methods and protocols to diagnose neurodiagnostic disorders
  • Explain methods and protocols for cardiopulmonary exercise testing
  1. Text: Handouts in class

Egan, Fundamentals of Respiratory Care

Egan (Wehrman), Fundamentals of Respiratory Care Study Guide

Wilkins, Clinical Assessment in Respiratory Care

White, Basic Clinical Lab Competencies for Respiratory Care

Des Jardins, Cardiopulmonary Pathophysiology

  1. Evaluation: All of the following must be completed in order to

receive a grade and credit for RESP 316.

1. three exams50 points each(150 total)

2. final exam50 points

3. presentations50 points

Total250 points

Note:

  1. unexcused absence* = deduction of 7% off final grade for each absence; per program policy, role will be called

note: late arrival—student must call and leave a message prior to class explaining reason for late arrival; three undocumented late arrivals = one (1) unexcused absence

  1. three unexcused absences = reduction of course grade to <75%
  2. all items for evaluation must be completed in order to receive a grade and credit for the course.

*excused absences are illness with physician documentation, family emergencies with documentation. Call the instructor each time before class at 734-9224.

  1. Grading: is based on a percentage of total points earned

A = 100%-92%250 - 230

B = 91% - 83%228 - 208

C = 82%-75%%205 – 188

C= <75<188

Schedule (subject to change)

JanuaryTopic Vital Signs and 12-lead ECG

9Course overview (expectations, objectives)

Vital signs Part I—post-tests (COPD clinical simulation, neonatal post-test review, PFT post-test review)

11Report to CastleMedicalCenter—inservice onperforming a 12-lead ECG, 1400 hours

12ECG—KCC lab, 0800 -1200 hours

practice: 1300-1500 hours

16Holiday-MLK Day

23Multicompetent RCP—12-lead ECG

(1/24, Mini-lab, Mechanical Ventilation: graphics,1000-1200)#

3012-lead ECG Part II (if needed); 12-lead ECG exam (#1)

(1/31, Mini-lab, Mechanical Ventilation: graphics,1000-1200)#

FebruaryTopic: Pulmonary Function Testing, Sleep

Studies, Acid-base interpretation, quality

control in the Pulmonary & ABG labs

6PFT Part I, standards, quality control, FRC (lung capacities) methods, Methacholine challenge, interpretation

(2/7, Mini-lab, Mechanical Ventilation: graphics,1000-1200)#

8Report to Castle Medical Center-inservice

on quality control, 1500 hours-1700 (tentative time)

13PFT Part II

20Holiday-President’s Day

27PFT (exam #2), Advanced Acid-base interpretation

MarchTopics: Acid-base interpretation

Sleep-related disorders, Cardiopulmonary

Pathophysiology

6Acid-base interpretation Part II

Part I Sleep-related disorders

13Part II Sleep-related disorders,

Cardiopulmonary Pathophysiology

(Group I, 3/16, Mini-lab, Mechanical Ventilation,Queen’s MedicalCenter, D. Brenessel, 1300 hours-1500hours)

20 AM @ KCC Cardiopulmonary Pathophysiology,Chest films

PM @ Physician in-service, Dr. Kruger,

Kuakini Medical Center, 1300 hours, room TBA

(Group II (3/21, Mini-lab, Mechanical Ventilation,Queen’s Medical Center, D. Brenessel, 1300 hours-1500 hours)

22Physician in-service, Dr. Kruger,

Kuakini Medical Center, 1300 hours,

Room TBA

Spring Break, March 27 through March 31

AprilTopic: Cardiopulmonary Pathophysiology, Fiberoptic bronchoscopy

3Part I Assisting in fiberoptic bronchoscopy

cardiopulmonary pathophysiology

10Part II fiberoptic bornchoscopy assisting

cardiopulmonary pathophysiology

17Exam #3

Diagnostic case studies

24Diagnostic case studies

27NRP Performance Exam, Queen’s

MedicalCenter, 0900, Tower 4

MayTopic

1Diagnostic case studies

8Final exam

Presentations:

Case studies for discussion; black out patient’s name and other identifiable markers. If you wish to make copies to share, provide one to the instructor in advance of class.

1.ECG tracing of note, e.g., artifact, cardiac tamponade, cardiac ischemia, etc., with brief discussion of circumstances— minimum one (1) tracing required

  1. PFT report of note, with brief discussion of patient history—one (1)

FVC, one (1) lung volumes, one (1) DLCO. FRC may be obtained by any method—minimum one (1) study required.

  1. Sleep Study of note, with brief discussion of patient history—minimum one (1) study required. Check with Sleep Lab instructor before copying any tracings.

NOTE:

In conjunction with RESP 312 (see RESP 312 syllabus for more details), you will be required to attend a series of mini-labs on adult mechanical ventilation, attend physician inservice lectures, and complete a neonatal resuscitation workshop:

# Mini-labs: are designed to give the student a review of the adult ventilator. Practicing ventilator/patient interface, charting, setup and EST/SST of ventilator, weaning based on ABG and patient response and understanding ventilator graphics.

Students will be assigned to small groups to work with the instructor. The first three mini-labs in January and February are on Tuesdays from 1000-1200 with Radonna Doughty; the next two in March are with Diane Brennesel at QMC—students will be divided into two groups to attend on either March 16,

Thursday, or March 21, Tuesday from approximately 1300-1500 hours (one lab required only for each group).