CVT2843L - Cardiovascular V Practicum

Academic Dean’s Contact Information

LAKELAND DEAN’S OFFICE: LLC 2255              PHONE: (863) 297-1024
WINTER HAVEN DEAN’S OFFICE: WSC 101      PHONE: (863) 297-1020

Polk State College Mission and Program Outcomes

Polk State College, a quality-driven institution serving Polk County and beyond, transforms students’ lives through the power of teaching and lifelong learning by providing access to affordable associate and baccalaureate degree programs, career certificates, and workforce employment programs, delivered through various modalities and innovative technologies by diverse, qualified faculty and staff. In line with this purpose, Polk State’s Associate in Science and baccalaureate degree programs develop competence in various career-related skills. This course focuses on the development of competencies related to the following program outcomes:

Upon successful completion of the program, the graduate is able to:

1. Demonstrate the use of information and skills necessary for employment within a cardiac catheterization laboratory, including assisting physicians during diagnostic and interventional cardiac and peripheral procedures.
2. Apply the cognitive and psychomotor domains needed to assist physicians by mastering competencies related to patient care and technical procedures.
3. Demonstrate the use of information and skills acquired during Advanced Cardiac Life Support (ACLS) Certification.
4. Demonstrate high standards for professional judgment, ethical behavior, and critical thinking as necessary to the role of an entry-level invasive cardiovascular technologist.

1. Demonstrate the use of appropriate technical procedural skills when assisting a cardiologist during diagnostic and interventional cardiac and peripheral procedures.
2. Demonstrate effective oral and written communication.
3. Demonstrate critical-thinking skills as applicable to the Advanced Cardiac Life Support (ACLS) Certification, as well as within the different patient-care scenarios addressed within the cardiac catherization laboratory. 
4. Demonstrate appropriate use of information and skills with regard to patient communication.
5. Demonstrate appropriate use of information and skills with regard to pre- and post-catheterization patient care in holding areas.
6. Demonstrate the appropriate use of information and skills within the scrub position during diagnostic and interventional cardiac and vascular procedures.
7. Demonstrate the use of information and skills while in circulating position during diagnostic and interventional cardiac and vascular procedures.
8. ​Demonstrate skill in manipulating imaging equipment including appropriate use of radiation safety procedures.
9. Continue to develop skills and abilities related to hemodynamic monitoring and waveform recognition.

      A. Determine baseline vital signs
             1. Temperature
             2. Heart rate
             3. Blood pressure
             4. Respiration rate
             5. Pulse oximetry

II. Assess and prepare the access site:

          A. Shave or clip generous area around the access site
          B. Evaluate and grade distal pulses
                1. Manual pulse palpation
                2. Mini Doppler device usage
                3. Modified Allen’s Test for arm access
                4. Pulse sites marked with a marker
          C. Assess any non-healing ulcers or unusual markings

III. Determine that all pre-procedural tests have been completed and entered into the patient chart:

          A. 12-Lead EKG
          B. Chest x-ray
          C. Lab work
          D. CHEM-7
          E. Hematology reports
          F. Coagulation factors
          G. History and physical completed

IV. Explain diagnostic procedures to the patient and answer any questions:

          A. Explain the type of procedure
          B. Discuss the risks and possible complications
          C. List the benefits of the procedure
          D. Explain any potential methods of intervention
          E. Answer any other patient and family questions

V. Effectively pull supplies needed for specific procedures:

         A. Sheaths
         B. Wires
         C. Catheters
         D. Other needed items

VI. Perform a proper 3-minute sterile scrub: 

         A. Dress correctly with hat, mask, shoe covers, eye protection, and lead apron.
         B. Perform proper sterile scrub technique from finger tips to elbows
         C. Perform proper hand-drying, gown-donning, and closed-gloving procedures

VII. Set up the sterile tray efficiently:

         A. Open sterile supplies and hand-off items to scrub personnel properly
         B. Take sterile supplies from the circulator correctly
         C. Arrange supplies and mark syringes correctly
         D. Flush sheaths and catheters with sterile saline correctly so that no bubbles are present
         E. Prepare the 3-port manifold properly
         F. Tighten connections appropriately
         G. Flush saline through the system
         H. Produce an absolutely bubble-less system

VIII. Perform sterile preparation and setup of the patient properly:

        A. Provide for patient modesty
        B. Perform correct patient preparation technique
        C. Use circular motion, moving inside to outside
        D. Prepare a generous area to prevent cross contamination
        E. Place sterile sheet properly over the access site and the patient
        F. Set up the procedural equipment on the sterile field effectively
        G. Maintain the sterile field properly

IX. Assess the patient during femoral sheath removal and hemostasis:

        A. Blood coagulation (hemostasis)
               1. Vascular spasm
               2. Formation of platelet plug
               3. The clotting mechanism
               4. Clot retraction

        B. Hemostasis
               1. Minimum 15-minute (5-5-5) hold time (i.e., depending on size of the sheath and the medications on the board)
               2. Five-minute occlusive pulse (i.e., distal pulses diminished or absent)
               3. Five-minutes of moderate pressure (i.e., distal pulses assessed at least by Doppler device)
               4. Ten minutes of light pressure

        C. Possible complications
                1. Hematoma
                2. Vasovagal response
                3. Pseudoaneurysm
                4. Retroperitoneal bleed
                5. Frank bleeding
                6. Arterial occlusion
        D. Mechanical hemostasis
                1. Femo-Stop external compression system
                2. C-clamp occlusion
                3. Patches
                4. Angio-Seal Vascular Closure Device
                5. Perclose Pro-Glide Suture-Mediated Closure System
                6. VasoSeal Elite ES Device
                7. Duett Pro Sealing Device   

X. Monitor physiologic and hemodynamic activity:

1. ECG performance and assessment
      1. 12-Lead EKG
      2. Patient preparation
      3. Patient setup
      4. Rhythm recognition
      5. Recognition of arterial pressure waveforms with normal and abnormal values
                a. AO (Aorta)
                b. LV (Left Ventricle)
                c. Pressure pullbacks (LV-AO)
                d. Venous pressure waveforms with normal and abnormal values
                e. RA (Right Atrium)
                f. RV (Right Ventricle)
                g. PA (Pulmonary Artery)
                h. PCWP (Pulmonary Capillary Wedge Pressure)
                i. Pressure pullbacks (PCW-RA)

XI. Perform scrub role for diagnostic and interventional procedures:

1. LHC-Left Heart Catheterization
2. RHC-Right Heart Catheterization
3. CHC - Complete Heart Catheterization
4. IVUS-Intravascular Ultrasound
5. Abdominal aortagram
      1. Bi-lateral femoral run-off
      2. Renal angiogram
6. Cardiac Intervention
      1. Percutaneous Transluminal Coronary Angioplasty (PTCA)
      2. Thrombectomy
              a. Mechanical
              b. Manual
      3. Atherectomy
              a. Rotational
              b. Directional
              c. Elliptical
       4. Brachytherapy
       5. Pacemakers
       6. Implantable Cardiac Defibrillator (ICD)
7. Peripheral Intervention
       1. Percutaneous Transluminal Angioplasty (PTA)
       2. Atherectomy
       3. Thrombectomy
       4. Cryoplasty

XII. Position patient for angiographic views and anatomical structure imaging and access:

1. AP versus PA positioning
2. RAO, LAO, cranial, and caudal positioning
3. Panning the table
4. Cardiac Catheterization images “around the world”
5. Patient positioning for anatomical structures or angiographic views
       1. AP
       2. LAO caudal (Spider view)
       3. AP-caudal
       4. RAO-caudal
       5. RAO-cranial
       6. AP-cranial
       7. LAO-cranial
       8. Abdominal aorta with run-off

XIII. Demonstrate skills in manipulating imaging equipment:

1. Radiation control and protection
       1. Time, distance, and shielding
       2. Collimation
       3. Magnification modes
       4. Normal versus pulsed fluoroscopy
       5. Inverse-Square Law
       6. ALARA (As-Low-As-Reasonably-Achievable)
                  a. mAs and kVp
                  b. Ancillary staff education

Textbook and Other Requirements

Textbook information is provided in the course syllabus, at the campus bookstore, on the campus bookstore website (www.polk.bncollege.com), or via the “Shop Textbooks” button on the PASSPORT schedule of classes.

College-Level Communication and Computation Skills

State Rule 6A-10.030 does not apply to this course.

Student Help

The professor is available for help during posted hours, and the student is encouraged to seek assistance whenever it is needed. To further the educational process, the Learning Resources Centers, comprised of the campus Teaching/Learning and Computing Centers (TLCCs), JD Alexander (JDA) Student Success Center, and campus libraries, are available for student use. Each resource provides qualified staff and up-to-date equipment and facilities to promote academic success. The TLCCs and JDA Student Success Center provide tutoring services, computing resources, and other instructional support. The library provides information resources, individual and group study space, research assistance, information literacy instruction, and computing resources. Each facility provides free wireless access to the Internet. The Polk State College Library, Student Success Center, and TLCC hours of operation and tutoring schedules are posted at each facility and on the College’s website.

Withdrawing From a Course

A student may officially withdraw from a course during any given term, provided he or she follows the appropriate policy and procedure. Following the conclusion of the Drop Period, a student may officially withdraw from any course without receiving a grade, provided this is done before the published withdrawal deadline. The published deadline reflects approximately (but no more than) 70% of the term, based upon the course’s scheduled duration. It is the student’s responsibility to submit these withdrawal forms; failure to do so may result in a grade of F in the course. Under the Forgiveness Policy, a student is allowed only three attempts in any one course: one initial enrollment and two repeats. A student is not allowed to withdraw from a third course attempt. Limited-admission programs may have specific guidelines regarding course withdrawal that vary from this policy; these guidelines are listed in each specific program’s handbook.

If a student stops attending class, the grade earned (usually an F) is assigned and posted. Prior to withdrawing from a course, the student should consult with the Financial Aid Office to determine what impact, if any, course withdrawal may have on his or her financial-aid status. A student cannot use course withdrawal to avoid academic dishonesty penalties. A student who is engaged in processes related to academic dishonesty in a course is not eligible to withdraw from the course.

Repeating a Course

Under the Forgiveness Policy, a student is allowed only three attempts in any one college-credit course: one initial enrollment and two repeats. Under certain circumstances, a student may petition to repeat a credit course beyond the third attempt. Limited-admission programs may have specific guidelines regarding course repeats that vary from this policy; these guidelines are listed in each specific program’s handbook. The student should be aware that repeating a course may result in a higher course cost. A course cannot be repeated unless the previously earned grade is a D, F, or W (the Polk State College Catalog provides further details regarding this process). Prior to repeating a course, the student should consult with the Financial Aid Office to determine what impact, if any, repeating the course may have on his or her financial-aid status.

Academic Dishonesty

The student is responsible for his or her work. It is assumed that each student is honest and abides by this standard; however, in the event that there is an indication or suspicion of cheating or plagiarism, the situation is dealt with in accordance with the published College policy. Copies of this policy are available in the Student Services Office. More specific information regarding academic dishonesty can be found in the instructor’s Course Syllabus.

Information Technology Access/Use Policy

The information technology resources provided by Polk State College (including, but not limited to, telephones, computers, the Polk State Local Area and Wide Area Networks, and the Internet) must be used for academic purposes only. Use of these resources is a privilege, not a right. Inappropriate use can result in revocation or suspension of this privilege.

Equal Access/Opportunity

Polk State College is an equal access/equal opportunity institution committed to excellence through diversity in education and employment. The College complies with all state and federal laws granting rights to students, employees, and applicants for employment or admission to the College. Polk State College does not discriminate on the basis of race, color, national origin, ethnicity, sex, age, religion, sexual orientation, marital status, veteran status, genetic information, disability, or pregnancy in its programs, activities, or employment.

The following person has been designated to handle inquiries regarding non-discrimination policies:
Lonnie Thompson
Chief Diversity Officer
999 Avenue H NE
Winter Haven, FL 33881
Office: WAD 227
Telephone: (863) 292-3602
e-mail: lthompson@polk.edu

Equal Opportunity For Students With Disabilities

The College complies with The Americans with Disabilities Act and provides equal educational opportunity for qualified individuals. A student with a disability who requires special accommodations or auxiliary aids under The Americans with Disabilities Act (ADA) should contact the Coordinator or Director of Disability Services.

Note: Limited-admission programs may have performance restrictions that apply. Restrictions (where applicable) are outlined in each program’s student handbook.

Video and/or Audio Recording

Video and/or audio recording in a college class are strictly regulated by State and Federal law, in addition to Polk State College Policy. Improper video and/or audio recordings made in a college classroom, or the improper sharing of such recordings, exposes the recording student to serious potential legal liability. Students are strongly cautioned to make informed choices in compliance with State and Federal law, as well as College Policy, when debating whether to make audio and/or video recordings in class.

An enrolled student may record video and/or audio of a class lecture for personal educational use, including in support of disability accommodations. A lecture is defined as: a formal or methodical oral presentation, given by the instructor as part of a college course, that is intended to present information or teach enrolled students about a particular subject. A lecture may be presented live, online, or in-person by the course professor.

A lecture recording may not be shared or published without the written permission of the professor. All supportive disability accommodation-based audio and/or video lecture recording activity must receive prior written approval from the Polk State College Office of Disability Services and the course professor.

It is important to be respectful of students’ rights to privacy; with this in mind, College policy stipulates that students should not record peers during lectures, class discussions, student presentations, labs, group work, and private conversations. Recording a student without his or her consent could have legal consequences, including a possible violation of State and/or Federal law and the Polk State College Student Code of Conduct.

If a professor becomes aware of a violation of the student recording policy, he or she is able to address this through the College, including the assignment of sanctions (District Board of Trustees Rule 4.01 and Polk State Procedure 5028: Student Code of Conduct: Sanctions and Assignment of Penalties for Violations). This is in addition to other liabilities, as aforementioned.

COVID-19

Polk State College is committed to the health and safety of students, faculty, and staff. Members of the College community are expected to assume personal responsibility to keep themselves and others healthy and safe. Before coming to campus each day:

• Each student must self-screen for COVID-19 symptoms. The Centers for Disease Control and Prevention (CDC) provides a list of COVID-19 symptoms (www.cdc.gov/coronavirus).
• A student who is experiencing illness or symptoms of COVID-19 should not come to campus. The student must notify his or her professor by email within one business day of the absence and should notify a healthcare provider if symptoms worsen.
• A student must self-report if he or she becomes ill with COVID-19, has COVID-19 symptoms, or has been in contact with someone who has tested positive for COVID-19. The student must also notify the College directly through the self-reporting tool on the Polk State webpage. The student is responsible for communicating his or her status with the professor should there be a need for isolation or quarantine similar to how they would address other illnesses and unforeseen conditions.

When on campus:

• The College strongly recommends that each student, whether vaccinated or unvaccinated, wear a mask or face covering while indoors on campus. A professor may offer office hours in various formats including face-to-face meetings, video conferencing, email, or telephone. The professor may require the student to wear a mask or cloth face covering during an office meeting. Any student who does not feel comfortable complying with this requirement may use other modes of communication to connect with the professor.
• Each student is strongly encouraged to practice social distancing while on campus, keeping at least six feet of separation from others when possible and avoiding crowded hallways, stairwells, and other enclosed spaces.
• Any student who is unvaccinated (or who has health concerns) should maintain six feet of social distance in classroom and lab settings, or work with the professor to arrange for special seating arrangements or accommodations (as possible).
• A student who is currently unvaccinated is strongly encouraged to get vaccinated. The College website lists information regarding on-campus vaccination events (polk.edu/vaccine). An unvaccinated student is also encouraged to follow the CDC’s guidance regarding protection from COVID-19 infection (www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html).
• Any student who begins to feel ill or who experiences symptoms such as sneezing, coughing, or fever while on campus should immediately return home, notify his or her professor(s), and call a healthcare provider if symptoms worsen. Additionally, any student exhibiting these symptoms may be sent home by his or her professor and instructed to complete the COVID Reporting Tool.

In the interest of health and safety, an instructor has the right to ask any student who fails to comply with these requirements to leave class. If a student refuses to comply, per Polk State College Rule 4.01: Code of Student Conduct for Students and Student Organizations, the professor has the right to refer the non-compliant student to a Student Services administrator for disciplinary action and to cancel class for the day.

Guidance about how to prevent the spread of COVID-19 is available through the Centers for Disease Control and Prevention (www.cdc.gov/coronavirus). Additionally, Be the Solution: Polk State College’s Return to Campus Plan is available online and provides information about the College’s response to the public health crisis (www.polk.edu/campus-safety-security/covid-19). Each student is encouraged to direct questions about these requirements to a campus-based associate dean or a professor. The Executive Dean of Student Services, Dr. Pakowski, may be reached by email at lpakowski@polk.edu.

As a limited-admission program, the Cardiovascular Technology Program has restrictions related to attendance, academic performance, and other aspects of student behavior and expectations. A student who withdraws from (or fails) any CVT course during the first semester of the first year may return the following year with the permission of the Program Director provided there is space available. Remedial activities (as appropriate) are required to re-enroll. 

The student may reapply through the Re-Admit Application Process within one year of leaving the program; re-admission approval is subject to clinical space availability and requires the permission of the Program Director. The student must successfully demonstrate clinical skills at the appropriate level to the CVT Clinical Coordinator prior to returning to the clinical setting after an absence of one semester or more.

A student who withdraws from (or fails) the same CVT Program course two times–or who fails any two separate CVT courses–is dismissed from the program without eligibility for re-admission. 

A complete list of CVT Program policies and procedures is available through the Program Director.

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