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Bedside Cardiac Monitoring Overview

Presented by:  Cynthia L Webner

Course Description:
This 3 hours Cardiac Monitoring course provides knowledge and skills that bring bedside monitoring practice into alignment with the evidence based practice guidelines published by the American Heart Association and the Practice Alerts on ST Segment Monitoring and the Dysrhythmia Monitoring published by the American Association of Critical Care Nurses.  Research has demonstrated that nursing practice often falls short in the implementation of evidence based cardiac monitoring practice. This short course covers the 3 primary purposes for bedside cardiac monitoring: arrhythmia detection, QT interval monitoring and ST segment monitoring.  Cindy provides tips and tools that can be used to enhance the use of the monitor by the beside nurse to improve patient outcomes.   Case examples are used to demonstrate the clinical impact of cardiac monitoring utilization that is evidence based.

Course Content:

  • Cardiac Monitoring
    • History
    • Guidelines to Drive Practice
  • Principles for Monitoring
    • Gain
    • Documenting Onset and Offset of Cardiac Arrhythmias
    • Lead Placement: It Is Important
  • The Anatomy of Monitoring Leads: The Connection to the 12 Lead ECG
  • The View of Each Lead
  • The Importance of the Positive Electrode
  • Purposes of Cardiac Monitoring
    • Arrhythmia Detection
    • Ischemic Detection
    • QT Interval Monitoring
  • Arrhythmia Monitoring  
    • Gold Standard Leads for Arrhythmia Monitoring
    • Identifying Patterns of right and left bundle branch blocks.
    • Differentiating Wide Complex Tachycardia on the Bedside Monitor
      • Patterns of Right and Left Bundle Branch Block (SVT with Aberrancy)
      • Patterns of Ventricular Tachycardia
      • Differentiating SVT with Aberrancy from VT
    • Identifying Atrial Activity with the Lewis Lead
    • QT Interval Monitoring
      • High Risk Patients for Torsade’s de Pointes
      • Recommendations for Practice
      • What the Prolonged QT is Telling Us
      • Technical Issues with QT Interval Measurements
      • Warning Signs for Torsade’s de Pointes
    • Ischemia Monitoring
      • Who Should We Monitor?
      • Methods to Improve ST Segment Monitoring
      • Selecting the Most Appropriate Leads
      • The Importance of the J Point
      • ST Segment Elevation Versus Depression
      • Thresholds for ST Elevation and Depression
      • Patterns of Injury or Ischemia
      • ECG Evolution of a STEMI: Expected Changes on the Monitor
      • Reciprocal Changes: How to Utilize Them to Your Advantage
      • Right Sided Chest Leads
      • Posterior Chest Leads
    • Clinical Decision Making

Learning Objectives:
Upon completion of this course, the participant will be able to:

  • Identify the 3 primary reasons for bedside monitoring.
  • Discuss recommendations for lead selection for arrhythmia monitoring.
  • Utilize QRS morphology in lead V1 to differentiate VT from SVT with bundle branch block.
  • Recognize clinical indications for QT Interval Monitoring.
  • Describe clinical practices that may improve ST Segment Monitoring and help decrease false alarms.
  • Correlate coronary artery anatomy with lead selection on the bedside monitor.

Continuing Education:
3.0 hours of continuing education (contact hours) are offered with this program. CNEA is a provider approved by the California Board of Registered Nursing, provider number 15714.

Course Price:
Click here for course price

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