STUDENT COURSE INFORMATION
FANSHAWE COLLEGE OF APPLIED ARTS AND TECHNOLOGY
HEALTH SCIENCES
JANUARY 2010
RESP-3005 -- DIAGNOSTIC PROCEDURES 2
Duration: 60 total course hours
Credit Units: 4.00
*NOTE: The hours may vary.
This course is a prerequisite for:
RESP-5001
CLINICAL THEORY I
RESP-5002
CLINICAL PRACTICUM I
RESP-5008
CLINICAL THEORY 1
RESP-5009
CLINICAL PRACTICUM 1
RESP-5014
CLINICAL THEORY 1
Prerequisite(s) for this course:
RESP-3001
RESP-3003
DIAGNOSTIC PROCEDURES 1
THERAPEUTIC MODALITIES
Co-requisite(s) for this course:
NO COURSES
Course Description:
A continuation of course RESP3001, this course provides an in-depth study of the basis and rationale
behind other diagnostic tests and treatments of cardiopulmonary and associated disorders. Emphasis is
placed on pulmonary function testing and cardio pulmonary diagnostics.
Vocational Learning Outcomes:
Upon successful completion of this course, the student will be able to:
1. Acquire and interpret pulmonary function tests results
2. Perform and interpret physiological calculations used in the assessment of cardiopulmonary status
3. Describe diagnostic equipment used in the evaluation of cardiopulmonary and
hemodynamic status
4. Describe equipment used for monitoring cardiopulmonary and hemodynamic status
Essential Employability Skills Learning Outcomes:
Essential Employability Skills Learning Outcomes
1.
Communicate clearly, concisely and correctly in the written,
spoken and visual form that fulfills the purpose and meets the
needs of the audience.
2.
Respond to written, spoken or visual messages in a manner
that ensures effective communication.
3.
Execute mathematical operations accurately.
4.
Apply a systematic approach to solving problems.
5.
Use a variety of thinking skills to anticipate and solve
problems.
6.
Locate, select, organize and document information using
appropriate technology and information systems.
7.
Analyze, evaluate and apply relevant information from a
variety of sources.
8.
Show respect for the diverse opinions, values, belief systems
and contributions of others.
9.
Interact with others in groups or teams in ways that contribute
to effective working relationships and the achievement of
goals.
Taught Reinforced
Assessed
or
evaluated
10. Manage the use of time and other resources to complete
projects.
11. Take responsibility for one's own actions, decisions and
consequences.
Detailed Content:
Section One - PULMONARY FUNCTION
Unit I - Pulmonary Function Equipment
Upon completion of this unit the student will:
1. Describe the working principle, the measuring capacity, accuracy, methods of sterilization and
methods of quality control for:
a. flow sensing devices (pneumotachs)
i.
vane spirometer
ii.
heated wire spirometer
iii.
thermistor bead spirometer
iv.
differential pressure transducer
v.
vortex (ultrasonic flow transducer)
b. b.volume collecting devices (spirometers)
i.
wedge spirometer
ii.
dry rolling seal spirometer
iii.
water-seal spirometer
c. c.gas analyzers
i.
thermal conductivity
ii.
infra-red absorption
iii.
emission spectroscopy
iv.
gas chromatography
v.
mass spectrometry
vi.
zirconium fuel cells
2. Describe the operating principle of the X-Y recorder
3. Describe the operating principles of body plethysmography
Unit II - Lung Volumes and Capacities
Upon completion of this unit the student will:
1.
Define and calculate normal adult values for all lung volumes and capacities
2.
Assess any deviation from normal values
3.
Describe the methods of performing and calculating the following:
a.
minute volume (Vm)
b.
respiratory rate (RR or f)
c.
tidal volume (Vt)
d.
expiratory reserve volume (ERV)
e.
inspiratory capacity (IC)
f.
inspiratory reserve volume (IRV)
g.
slow vital capacity (SVC)
h.
functional reserve capacity (FRC)
i.
residual volume (RV)
j.
total lung capacity (TLC)
k.
k.oxygen uptake
4.
Identify the purpose of performing an FRC test
5.
Describe the following test methods employed in determining FRC:
a.
helium dilution
b.
nitrogen washout
c.
body plethysmography
d.
single breath nitrogen washout
Unit III - Spirometry and Pulmonary Mechanics
Upon completion of this unit the student will:
1.
Describe the methods of performing and calculating the following tests:
a.
forced vital capacity (FVC)
b.
forced expiratory volume timed (FEVt)
c.
forced expiratory flow 25% - 75% (FEF 25% - 75%)
d.
forced expiratory flow 200 - 1200 (FEF 200 - 1200 )
e.
peak expiratory flowrate (PEFR)
f.
maximum voluntary ventilation (MVV)
2.
Discuss the advantages of performing flow-volume tests
3.
Describe the significance and method of determining:
a.
lung compliance (CL)
b.
airway resistance (RAW)
c.
airway conductance (GAW)
Unit IV - Diffusion Testing
Upon the completion of this unit the student will:
1.
State the purpose of Carbon Monoxide Diffusion tests (DL CO)
2.
Explain the single breath diffusion (DL COsb) technique
3.
Describe the significance of the results obtained from a diffusion test
Unit V - Classification of Lung Disorders
Upon completion of this unit the student will:
1.
Describe
Obstructive Lung Disease
2.
Describe
Restrictive Lung Disease
3.
Describe
Mixed Pattern
as it relates to pulmonary function testing
as it relates to pulmonary function testing
of lung disease as it relates to pulmonary function testing
Unit VI - Specialized Testing Regimens
Upon completion of this unit the student will:
1.
State the purpose of bronchodilator therapy with respect to pulmonary function testing
2.
Assess the results obtained from pre and post bronchodilator therapy
3.
Describe bronchial provocation testing (Challenge Testing)
4.
Assess the results obtained from bronchial provocation testing
5.
State the significance of closing volume and closing capacity (CV, CC)
6.
Describe pulmonary exercise testing
Section Two - PHYSIOLOGICAL CALCULATIONS
Unit I - The Alveolar Air Equation
Upon completion of this unit the student will,
1.
State the purpose of the alveolar air equation
2.
Describe the IDEAL alveolar air equation
3.
Describe the CLINICAL alveolar air equation
4. Given the barometric pressure (PB), the water vapour pressure (PH2 O), the FIO2 , and the PaCO 2 ,
solve problems involving the alveolar air equation
Unit II - A-aDO 2 Gradient
Upon completion of this unit the student will,
1.
State what the acronym A-aDO2 represents
2.
State the purpose of the A-aDO2 equation
3. Given the barometric pressure (PB), the water vapour pressure (PH2O), the FIO2, the PaCO2 , and
PaO2 , solve problems involving the A-aDO 2 equation
Unit III - Arterial-Mixed Venous Oxygen Content
Upon completion of this unit the student will,
1.
State what the acronym C(a-v)O2 represents
2.
State the clinical significance of the C(a-v)O2
3. Given the hemoglobin (Hb), the oxygen saturation of mixed venous blood (SvO 2), and the partial
pressure of oxygen in mixed venous blood (PvO 2 ), solve problems involving the C(a-v)O 2
4.
Define the oxygen extraction ratio
Unit IV - Hemodynamic Calculations
Upon completion of this unit the student will,
1.
Calculate and describe systemic and vascular resistance index
Unit V - The Fick Equation
Upon completion of this unit the student will,
1.
Define the Fick equation
2.
Solve problems involving the Fick equation
Unit VI - Ventilation-Perfusion Matching
Upon completion of this unit the student will,
1.
Define transpulmonary pressure
2.
Describe the ventilation and blood perfusion to the different zones of the lungs
3.
Describe four possible V/Q ratio possibilities
a.
Normal
b.
Deadspace
c.
Shunt
d.
silent
Unit VII - Deadspace VD
Upon completion of this unit the student will,
1.
Define dead space
2.
Define anatomic dead space
3.
Define alveolar dead space
a.
True
b.
Relative
4.
Define physiologic dead space
5.
Describe Bohr's Deadspace equation
6.
Describe the Clinical Deadspace equation
Unit VIII - VD/VT Ratio
Upon completion of this unit the student will,
1.
State what the acronyms VD/VT represent
2.
State the normal range for the VD/VT ratio during spontaneous and mechanical ventilation
3.
Given the PaCO2 and PECO2, solve problems involving the VD/VT ratio
Unit IX - Intrapulmonary Shunting
Upon completion of this unit the student will,
1.
Describe the physiological effect of shunting
2.
Describe the two general mechanisms
a.
anatomical shunt
b.
capillary shunt
3.
Describe the two classifications of capillary shunt
a.
true / absolute
b.
relative
4.
Define the physiologic shunt Q SP
5.
Define the true shunt QS
Unit X - QS/QT Ratio
Upon completion of this unit the student will,
1.
State what the acronym QS/QT represents
2.
Describe the Classic Shunt Equation
3.
Solve problems involving the QS/QT ratio
4.
Describe the clinical significance of the shunt evaluation
5.
Describe the techniques of accomplishing shunt measurements
Section Three - BRONCHOSCOPIC PROCEDURES
Unit I - Bronchoscopy
Upon completion of this unit the student will,
1.
Define the term
bronchoscopy
2. Discuss the indications, contraindications, hazards and precautions associated with a bronchoscopic
procedure
3.
Identify characteristics of different types of bronchoscopes:
a.
flexible (fibreoptic)
b.
rigid
4.
Describe major patient monitoring concerns during a bronchoscopic procedure
Section Four - CARDIAC DIAGNOSTICS
Unit One - 12 LEAD ECG CONFIGURATION
Upon completion of this section the student will,
1.
2.
Describe common electrode placement for monitoring 12 lead ECGs
Explain what is meant by
look at the heart
limb
leads and
chest/vector
leads and how the various leads
3.
Describe, under normal conditions, what the vectors of the heart are
4.
What is meant by the term biphasic
5.
State what is meant by the term
6.
Discuss how to determine the main vector of the heart
7.
Discuss right and left bundle branch blocks with respect to:
a.
Causes
b.
12 lead interpretation
c.
Significance
d.
Treatment
8.
Discuss different types of myocardial infarction with respect to:
a.
Causes
b.
12 lead interpretation
c.
Significance
d.
treatment
hexaxial reference
as it pertains to the heart
Unit Two - CARDIAC STRESS TESTING (Exercise Tolerance Testing)
Upon completion of this section the student will,
1.
State the purpose and diagnostic value of a cardiac exercise stress test
2.
Describe the most common types of cardiac stress tests performed
3.
Name the steps taken to ensure patient safety when performing a stress test
4.
State the name, purpose and position of all leads used
5.
Describe what is meant by "ST deflection" (depression and elevation)
6.
State the meaning of a "positive stress test" and reasons for stopping a stress test
Unit Three - HOLTER MONITORING
Upon completion of this section the student will,
1.
Describe the basic principles of Holter monitoring
2.
Lists the advantages and disadvantages of Holter monitoring
3.
List indications and contraindications for Holter monitoring
4.
Explain the therapist and patient roles in Holter monitoring
Unit Four
ADVANCED CARDIAC LIFE SUPPORT (ACLS)
Upon completion of this section the student will,
1.
Discuss the various steps of the Pulseless Arrest Algorithm
2.
Explain what is meant by Pulseless Electrical Activity (PEA)
3.
Describe the following drugs as they relate to ACLS protocols:
a.
Epinephrine
b.
Lidocaine
c.
Amiodarone
d.
Atropine
4.
Describe how a defibrillator works.
5.
Explain the differences between a manual and automated external defibrillator (AED).
6.
Discuss the steps needed to use a manual or AED with respect to a cardiac arrest situation.
Unit Five - ECHOCARDIOGRAPHY
Upon completion of this section the student will,
1.
Explain the elementary principles of ultrasound
2.
Explain the basic principles of:
a.
pulse echo imaging
b.
Doppler effect
3.
Recognize the basic cardiac structures in an echocardiogram
Section Five - CAPNOGRAPHY
Upon completion of this unit the student will,
1.
State the principle of operation of an end tidal CO 2 monitor
2.
Describe the difference between side stream and main stream sampling
3.
State the clinical applications of capnography
4.
Describe the origin of the CO 2 waveform
5.
Interpret CO 2 waveforms and trends
Section Seven - OXIMETRY TESTING
Upon completion of this unit the student will,
1.
Describe the oxyhemoglobin curve
2.
Describe oxygen transport vs. oxygen content
3.
Describe functional vs. dysfunctional haemoglobin
4.
State the indications for pulse oximetry
5.
Discuss the principle of operation of an oximeter
6.
Describe the technical errors / complications of pulse oximetry
7.
Describe the general application of oximetry
Section Eight - TRANSCUTANEOUS MONITORING
Upon completion of this unit the student will,
1.
State indications and advantages for transcutaneous monitoring
2.
Describe the types of electrode used
3.
State the sensor temperature, location and duration of application for:
a.
Adults
b.
infants
4.
State factors affecting accuracy
5.
State contraindications to transcutaneous monitoring
Section Nine - SLEEP DISORDERED BREATHING
Unit I - Sleep Studies
Upon completion of this unit the student will,
1.
Describe the stages of sleep
2.
List the indications for cardiorespiratory monitoring
3.
Define and describe common sleep disorders
4.
Describe the categories of Sleep Disordered Breathing (SDB)
5.
Describe the signs, symptoms and diagnostic procedures for the evaluation of SDB
6.
Discuss the significance of recordings obtained during sleep studies:
a.
Apnea
b.
Airflow
c.
oxygen saturation
d.
chest wall movement
e.
abdominal wall movement
f.
CO2 measurement
g.
ABG monitoring
h.
limb movement
i.
electro-ocular-gram (EOG)
j.
electro-encephalo-gram (EEG)
k.
electro-cardio-gram (ECG)
7.
Discuss interpretation of sleep study results
8.
Describe the application of CPAP and BiPAP® for the treatment of SDB
Teaching/Learning Methodology:
Lectures, handouts, related textbooks, audio-visual presentations, reading assignments, class discussions
Required Learning Resources:
Clinical Blood Gases, 2nd Edition, Malley, Publisher: Saunders
Manual of Pulmonary Function Testing , 8th Edition, Ruppel, Publisher: Mosby
Egan's Fundamental of Respiratory Care , 9th Edition
Clinical Assessment in Respiratory Care , 6th Edition, Wilkins, Publisher: Mosby
Mosby's Respiratory Care Equipment , 7th Edition, Cairo, Publisher: Mosby
Access to Fanshawe Online
Method Of Evaluation:
The final mark/grade for this course will be determined as follows:
Method
Mini Tests
Test #1
Test #2
Final Test
TOTAL
Percentage
10%
30%
30%
30%
100%
NOTE: Test and assignment due dates, etc. will be provided by the professor at the beginning of the
course.
Consult the Program Division Policy for additional information on course evaluation and progression.
Grade Range
A+ 90-100
A
80-89
B+ 75-79
B
70-74
C+ 65-69
C
60-64
D+ 55-59
D
50-54
F
0-49
P
greater than 50
I
N/A
N
N/A
W
N/A
X
N/A
Comment
Distinguished
Grade Point
4.2
4.0
3.5
3.0
2.5
2.0
1.5
Marginal
1.0
Unsatisfactory
0
Pass
N/A
Incomplete
N/A
No Credit Achieved N/A
Withdrawn
N/A
Audit
N/A
CHEATING - All forms of cheating are considered an academic offence and the College has a clear
policy on cheating. Please refer to Policy 2-G-04 on Fanshawe Online or in the Student Handbook.
PLAGIARISM - Plagiarism is cheating and an appropriate penalty will be applied and a report will be
placed in the student's file in conformance with College Policy 2-G-04 on cheating. Plagiarism (the
intellectual dishonesty resulting from a student's failure to acknowledge indebtedness to sources used) is
a serious academic offence that shall result in appropriate penalties, to be determined at the discretion of
the course professor in consultation with the Divisional Chair. Plagiarism includes, but is not limited to,
submitting the same work to more than one professor for credit in different courses without prior written
permission from the professors. Penalties shall range from failure of an assignment to possible failure of
the course.
REWRITES - Students cannot make the assumption that any provision will be made by the professor to
permit a student to rewrite failed assignments or tests.
Turnitin.com
As part of Fanshawe College's commitment to fostering excellence in student assignments, this course
may require students to submit their papers to Turnitin.com. This Web service is designed to help
students understand the importance of identifying borrowed work in their essays, and how to correctly
cite research sources. Instructions for how to use Turnitin.com will be provided by the professor, and
additional information is available at www.Turnitin.com.
Additional Information:
Consult your Program Outline for information concerning the minimum passing grade needed for this
course.
Prepared By:
Paul Williams, BEd., RRT, EMCA
The following applies for course offerings consistent with the Standard Academic Calendar:
Internal/External Course Credit Application Deadline
Applications for Internal/External Course Credit are available from the Office of the Registrar. Check
college calendar for deadlines.
Course Add/Drop Deadline
You may withdraw from a course without academic penalty during the first 70% of the course duration.
Application is made through the Office of the Registrar.
Academic Assistance
The primary resource for students experiencing difficulty with course material is the course professor. In
addition, students who wish to attend study skills workshops or who require further assistance, can
contact the Learning Centre in A2019 (519 452 4265) for one-to-one tutoring from staff in math,
physics, chemistry and english, or they can contact Counselling and Student Life in F2010 (519 452
4282) for information about receiving peer tutoring.
Student Success Advisors are available to assist students with academic concerns or other problems they
may face while at Fanshawe. They can either assist you directly, or refer you to the appropriate resource
on campus to get the help you need. Contact information for your Student Success Advisor can be found
on the Web at http://www.fanshawec.ca/EN/ssa/14317/advisors.asp.
Students who have been identified as having (or who wish to be assessed for) a specific learning
disability, should contact Disability Services F2010 (519 452 4282) in Counselling and Student Life for
information about available support services.
Re-taking a Course:
Subject to meeting any pre-requisite or co-requisite requirements, a student may retake a course. The
second re-take must be approved by the Academic Manager or designate and will be granted based on
extenuating circumstances and with recommended interventions such as counselling or a learning
contract. Subsequent re-take opportunities will only be available as part of an overall success strategy
developed in consultation with the student, program co-ordinator and the Academic Manager. The best
grade achieved will be used in calculating the cumulative GPA.
Related Policies
Course Grade System - See College Policy 2-C-04
Prior Learning Assessment and Recognition - See College Policy 2-A-10
Evaluations - See College Policy 2-C-02
Academic Standing - See College Policy 2-C-05
Student Appeal of a Grade or Other Academic Decision - See College Policy 2-G-02
Academic Withdrawal and Termination - See College Policy 2-C-06
Academic Offences - See College Policy 2-G-04
Student Code of Conduct Policy - See College Policy 2-G-01
Respectful College Community Policy - See College Policy 1-B-46
Authorized By:
Date:
JANUARY 2010