imPULSE™ Chest Pain Competency Course Information
imPULSE is a cutting-edge Chest Pain Competency Training Program. The need for quality trained medical personnel in the area of chest pain competency continues to grow. This training is comprehensive, organized and easy to navigate. Content progresses from Basic ECG at Level 1 through Advanced and Special Situations at Level 6. In addition there is a Reference Library filled with over 100 realistic ECG examples and tips to help learning. Your staff and facility will benefit from such top-notch training. Click below for a courseware demonstration.
Level I Basic ECG provides an auditory, visual and virtual learning experience of cardiac anatomy and physiology, coronary structures and vessels, the conduction pathway, waveform basics, the QRS, normal waveform intervals, and methods of calculating heart rate.
At the completion of Level I Basic ECG, the learner will:
- Identify heart anatomy, muscle, chambers and vessels.
- Describe heart physiology, including conduction pathways.
- Differentiate waveform basics and their relationship to anatomy and physiology.
- Demonstrate paper basics and heart rate determination.
Level II How to Obtain an ECG The goal of this level is to prepare staff to be capable, confident and competent when monitoring or obtaining 12 Lead, Posterior (15 Lead) and Right Sided (18 Lead) ECGs. This level covers anatomical landmarks, selecting and preparing the sites for electrode placement, addresses 3,5,12,15, and 18 leads electrode placement for monitoring, difficult situations, how to fine tune and trouble shoot when obtaining an ECG.
At the completion of Level II How to Obtain an ECG, the learner will:
- Define what an ECG represents.
- Identify anatomical landmarks.
- Select and appropriately prepare electrode skin sites.
- List electrodes correctly for 3,5,12, 15 (Posterior) and 18 (Right sided) lead placement.
- Explain the procedure for obtaining an ECG.
- Distinguishes paper basics in relation to time and voltage.
- Solve fine tuning issues such as calibration and paper speed.
- Identify and troubleshoot problems caused from difficult situations, interference, capture, and human error.
Level III Heart Rhythms provides clear and simple methods of rhythm recognition in sinus, atrial, junctional, and ventricular rhythms, including blocks and paced rhythms. We build from the impulse origination and conduction of the rhythm in the heart muscle to the electrical “photograph” it makes on a rolling ECG, providing a new and interactive learning perspective. Floating calipers and rhythm rule tips enhance studies along with understanding how to measure and view or “triage” each rhythm.
At the completion of Level III Heart Rhythms, the learner will:
- Identify origination and conduction of sinus, atrial, junctional and ventricular rhythms.
- Define the normal rates, appearance and nuances of each rhythm.
- Summarize how to view an ECG and rules to assist with interpretation.
- Explain the reason for and how to measure intervals.
- Categorizes which rhythms are safe, which must be watched cautiously and which are volatile and potentially lethal.
- Relate how all rhythms fit into five basic rhythm disturbances.
Level IV 12 Lead ECGs Find out that looking at the 12 lead ECG doesn’t have to be Greek! Integrate basics with heart anatomy as it correlates to make understanding the 12 lead layout and normal lead waveforms simple and straightforward. In all leads, we zoom in on ischemia and injury in ST segments address issues relating to changes. Reciprocal changes, R wave progression, Q wave characteristics, axis, old verses new MI, BBB and more are presented.
At the completion of Level IV 12 Lead ECGs the learner will:
- Explain normal 12 Lead layout.
- Summarize Lateral, Inferior, Septal, Anterior and Posterior leads in relation to cardiac anatomy.
- Evaluate each lead as it appears normal, ischemic, and in injury.
- List locations of myocardial infarction and their reciprocal changes.
- Identify ST, Q, R, T wave changes.
- Distinguish BBB with MI.
Level V Acute Coronary Syndrome The goal of Level V, ACS, is to raise awareness of the standards of care for patients with Acute Coronary Syndrome (ACS). This requires an understanding of pathophysiology, risk factors, symptom presentation, triage process and treatments indicated. The importance of subtle waveform changes in the 12 lead ECG, waveform progression, ST segment monitoring, determination of old vs. new MI, cardiac biomarkers, and fibrinolytics are addressed. It is critical for emergency professionals to be experts in early recognition and diagnosis of ACS, which will ultimately lead to timely intervention and positive outcomes when adhering to AHA/ACC Guidelines.
At the completion of Level V ACS, the learner will:
- Describe the pathophysiology of ACS.
- Identify the evolutionary changes in ischemia and injury.
- List risk factors, modifiable and non modifiable.
- Identify signs and symptoms indicative of ACS in triage.
- Relate current guidelines from AHA/ACC for risk stratification and treatment of ACS.
- Distinguish the importance of timely 12 lead ECG testing and indications for doing a right sided ECG.
- Explain the importance of subtle waveform changes in ST segments, Q waves, and T waves.
- Differentiate old MI vs. acute MI.
- Identify cardiac biomarkers, treatment options and other pathway considerations
- Describe other conditions (differential diagnosis) presenting with chest discomfort along with their related ECGs.
- Explain the importance of prevention, screening, collaboration, education and competency in ACS.
Level VI Advanced and Special Situations
imPULSE Level VI presents many advanced and serious situations encountered in clinical practice such as Osborne waves in hypothermia and the effects of illegal drug use such as cocaine and ecstasy. Our goal is to provide a clear, concise, brief and focused over view of each situation, the signs and symptoms to be aware of, ECG changes, keys to identification, nuances and more. Study 12 lead ECGs depicting structural abnormalities, conduction defects, muscle injury and electrolyte abnormalities. Being able to make a difference in the lives of others, we must be keenly aware of the many serious and advanced situations which may imitate other conditions and complicate appropriate treatment. You will study 58 pages of rich text prior to testing.
At the completion of Level VI Advanced and Special Situations, the learner will:
- Identify nomenclature for different combinations of the QRS waveform.
- Explain waveform changes and key elements related to a quick look at special situations.
- Define conditions affecting electrical conduction and their abnormal ECGs
- Distinguish cardiac structural changes and their affect on the 12 lead ECG.
- List the 4 types of cardiomyopathy and what makes each different.
- Relate various conditions affecting the heart and in response to abnormal levels of prescribed or illegal drugs.
- Distinguish which serious conditions may follow cardiac injury and key elements about them.
- List pacemaker types related to function and lead placement.
- Differentiate findings and ECG waveform changes seen in electrolyte imbalance.
- Define other physical conditions or injuries which may affect the heart and reflect on the ECG.
Level VII Reference Library Filled with over 100 12-Lead ECGs, complete with unique measuring tools to practice and learn with, current guidelines, tips, links, and ACS news of interest.
Learning format:
Web based, self paced, presented and reinforced with animated visual, auditory, textual and innovative interactive-learn by doing approach.