H O W C A N I T R A I N M Y S T U D E N T S T O B E O N E ?

WHAT IS A PATIENT CARE TECH?

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 SchoolAugusta, GA

Wlclarke.weebly.comwlclarke58@gmail.com

PCT SKILLS – COMMON TO CNA

Bedmaking Bathing TransfersCatheter Care ADL’s OxygenFeeding tube care I & O ROMSkin care CPR TED hoseVital signs PPE ConsentInfection Control Plan of Care HIPAAPost mortem care Report abnormal findingsEmotional support Assess pain/edemaAdmission/Discharge/TransferAssist with prosthetic/orthotic devicesBeginning and ending procedures

PCT SKILLS

12 Lead EKG Basic Arrhythmia recognition Holter monitor Emergency responseStress testingMonitor patient during blood transfusion

Phlebotomy Point of care testingSpecimen collection Remove peripheral IV’s

Aseptic/Sterile dressing change SplintsOstomy Care

Oxygen administration 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

Method 1 – R to R Method Can only be used for regular rhythms.

Calculating Rates Method 1 – R to R Methods 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 BlockBuilding 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/

PHLEB/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