Course Number and Title: EMT 211 Cardiology
EMT 203, EMT 217
This comprehensive course that covers the pathophysiology, assessment, and management of adult patients with diseases involving the cardiovascular system. Emphasis is placed on basic and advanced cardiac monitoring, acute coronary syndromes, and peripheral vascular disease.
All students must be able to access the Internet and know how to retrieve information from the Learning Management System on the DTCC web page.
- Describe normal heart function. (CCC 2, 6, 7; PGC 2, 4)
- Describe the electrophysiology of the heart. (CCC 1, 6; PGC 1, 2, 4)
- Analyze and interpret 3-lead electrocardiograms (ECG). (CCC 2, 6; PGC 1, 2, 3)
- Analyze and interpret 12-lead electrocardiograms (ECG). (CCC 2, 6; PGC 1, 2, 3)
- Formulate a plan to manage a patient with cardiac arrhythmia. (CCC 1, 2, 6; PGC 1, 2, 3, 4, 6)
- Describe the identification and management of acute coronary syndrome (ACS). (CCC 1, 2, 6; PGC 1, 2, 3, 4, 6)
- Describe the identification and management of cardiovascular emergencies. (CCC 1, 2, 6; PGC 1, 2, 3, 4, 6)
- Formulate a plan for the management and/or prevention of cardiovascular illness. (CCC 2, 6; PGC 1, 2, 3, 4, 6)
See Core Curriculum Competencies and Program Graduate Competencies at the end of the syllabus. CCPOs are linked to every competency they develop.
Upon completion of this course, the student will:
- Describe normal heart function.
- Describe the functions of the heart integrating the principles of conduction, contraction, action potentials, the cardiac cycle, cardiac output, and autonomic nervous system innervation.
- Identify the factors that affect venous return.
- Define preload, afterload, cardiac output, ejection fraction, stroke volume, minute volume, and left ventricular end diastolic pressure.
- Identify the vessels of the cardiac circulatory system and the portions of the myocardium and conduction system that they supply.
- Identify the structure and function of the cardiac conduction system.
- Identify heart sounds, and relate them to hemodynamic events in the cardiac cycle.
- Describe the clinical significance of Starling’s law and Poiseuille’s law.
- Describe the electrophysiology of the heart.
- Define automaticity, excitability, conductivity, contractility, depolarization, repolarization, absolute refractory period, and relative refractory period.
- Compare and contrast fast action potential and slow action potential.
- Explain the role of electrolytes (sodium, potassium, calcium, chloride, and magnesium) in action potential.
- Describe the effects of neurotransmitters on myocardium.
- Explain the autonomic nervous system relationship to the cardiovascular system.
- Analyze and interpret 3-lead electrocardiograms (ECG).
- Describe the location and cardiac surfaces represented by the ECG leads.
- Identify the following pieces of an electrocardiogram: p-wave, PR-interval, QRS-complex, ST-segment, T-wave, U-wave, and QT-interval.
- Describe the relationship of each piece of the ECG to the cardiac cycle.
- Calculate a heart rate on an ECG strip.
- Differentiate and identify rhythms originating in the sinus node, the atria, atrioventricular (AV) junction and the ventricles.
- Describe the phenomena of reentry, aberration and accessory pathways.
- List the causes of Pulseless Electrical Activity (PEA).
- Compare and contrast AV blocks.
- Identify mechanical rhythms generated by an implanted pacemaker.
- Identify a malfunctioning or failed pacemaker.
- Analyze and interpret 12-lead electrocardiograms (ECG).
- Describe the location and cardiac surfaces represented by the ECG leads.
- Identify the arteries that supply the cardiac surfaces in each lead.
- Identify ischemia, infarct, reciprocal changes, imitators and axis deviation.
- Explain the evolution and localization of an acute myocardial infarction.
- Formulate a plan to manage a patient with cardiac arrhythmia.
- Identify the cardiac rhythm, and determine if the condition requires intervention.
- Identify pharmacologic, non-pharmacologic, and electrical intervention strategies that are consistent with American Heart Association Standards and Delaware Paramedic Standing Orders.
- Describe the identification and management of acute coronary syndrome (ACS).
- Describe the epidemiology and morbidity/mortality associated with ACS.
- Compare and contrast stable angina, unstable angina, progressive, and pre-infarction angina.
- Differentiate the characteristics of the visceral and somatic pain.
- List differential diagnoses of chest pain.
- Explain the processes that result in an occlusion of a coronary artery.
- Describe the assessment findings of a patient with ACS.
- Describe the identification and management of cardiovascular emergencies.
- Identify and describe the components of a focused history as it relates to the patient with cardiovascular compromise.
- Describe the pathophysiology, epidemiology, precipitating causes, and assessment findings of the following cardiovascular emergencies: heart failure, cardiac tamponade, hypertensive emergencies, cardiogenic shock, cardiac arrest, vascular disorders, aortic aneurysm/dissection, thromboembolism, valvular heart disease, coronary artery disease, infectious diseases of the heart, cardiomyopathy, myocardial contusion, myocardial rupture, and congenital abnormalities.
- Explain the significance of unequal pulses or blood pressures in the extremities.
- Define pulsus paradoxus, pulse deficit, and pulsus alternans.
- Describe how to identify if pulsus paradoxus, pulsus alternans, or electrical alternans is present.
- Compare and contrast right congestive heart failure and left congestive heart failure.
- Compare and contrast forward left heart failure and backward left heart failure.
- Define and explain the clinical significance of paroxysmal nocturnal dyspnea, pulmonary edema, and dependent edema.
- Define aneurysm, claudication, and phlebitis.
- Describe the importance of inspection, palpation, and auscultation as it pertains to the assessment of the cardiovascular system.
- List components of the focused history of a patient experiencing signs and/or symptoms of cardiovascular compromise.
- Describe the characteristics of an implanted pacemaking system.
- Formulate a plan for the management and/or prevention of cardiovascular illness.
- Explain the pharmacologic and non-pharmacologic management strategies for ACS consistent with International Liaison Committee on Resuscitation (ILCOR) consensus for treatment and Delaware Paramedic Standing Orders.
- Explain the pharmacologic and non-pharmacologic management strategies for cardiovascular diseases consistent with ILCOR consensus for treatment and Delaware Paramedic Standing Orders.
- Compare and contrast the indications, complications, and procedure for using synchronized cardioversion, defibrillation, and transcutaneous pacing.
- Compare and contrast the action and effects of positive and negative inotropism, chronotropism, and dromotropism.
- Identify pharmacological agents used to manage acute and chronic cardiovascular disease and their therapeutic effects, dosages, routes of administration, side effects and toxic effects, and calculate dosages.
- Identify the characteristics of a patient eligible for fibrinolytic therapy.
- Explain the use of induced therapeutic hypothermia.
- Describe prevention strategies for cardiovascular emergencies.
Students must demonstrate proficiency on all CCPOs at a minimal 75 percent level to successfully complete the course. The grade will be determined using the Delaware Tech grading system:
Students should refer to the Student Handbook for information on the Academic Standing Policy, the Academic Integrity Policy, Student Rights and Responsibilities, and other policies relevant to their academic progress.
- Apply clear and effective communication skills.
- Use critical thinking to solve problems.
- Collaborate to achieve a common goal.
- Demonstrate professional and ethical conduct.
- Use information literacy for effective vocational and/or academic research.
- Apply quantitative reasoning and/or scientific inquiry to solve practical problems.
- Perform all psychomotor, paramedic skills in the National Emergency Medical Services Education Standards consistent with acceptable practice for an entry-level paramedic.
- Conduct complete, accurate and timely patient assessments, to include history and physical exam, and communicate findings.
- Interpret assessment findings in order to accurately identify a differential diagnosis and integrate pathophysiologic principles and legal responsibilities to formulate a treatment plan.
- Effectively perform the role of Team Leader to include: timely decision making, effective resource utilization, implementing appropriate plan of action for a given situation, adapting the plan to changing conditions and communicate.
- Assess a scene or situation in order to identify threats to operating safely.
- Apply communication and ethical decision-making skills required for an entry-level paramedic.
- Exhibit professional, affective behavior.
- Function effectively as an entry-level paramedic in the pre-hospital working environment in the roles of Team Leader and Team Member.
The College is committed to providing reasonable accommodations for students with disabilities. Students are encouraged to schedule an appointment with the campus Disabilities Support Counselor to request an accommodation needed due to a disability. A listing of campus Disabilities Support Counselors and contact information can be found at the disabilities services web page or visit the campus Advising Center.