COURSE SYLLABUS
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1. |
TITLE OF COURSE: |
CRITICAL CARE I |
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PREFIX/NUMBER: |
RCA 230 |
CREDIT HOURS: |
2 |
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2. |
PREREQUISITE: |
RCA 153 or consent of instructor |
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3. |
FACULTY: |
Delia Ann Lechtenberg MA, RRT
Pueblo Community College |
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RESOURCES NEEDED: |
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TEXT: |
Clinical Application of Mechanical Ventilation, 3rd ed. by David W. Chang
Workbook to Accompany Clinical Application of Mechanical Ventilation, by David W. Chang
Egan’s Fundamentals of Respiratory Care, 9th ed., by Wilkins, Stoller & Scanlan
Egan’s Fundamentals of Respiratory Workbook, 9th ed., by Wehrman
Basic Clinical Lab Competencies for Respiratory Care, 4th ed., by Gary C. White |
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SUPPLIES: |
Scientific Calculator, Three ring binder |
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COURSE DESCRIPTION: |
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The course is focused on the care of critically ill patients. Topics include advanced pulmonary physiology and pathophysiology, assessment and monitoring of acute and chronic respiratory failure, mechanical ventilation, and emergency respiratory care. The laboratory portion of the class will include an opportunity for the student to develop skills essential for the assessment and treatment of the critically ill. |
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EVALUATION PROCEDURES: |
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a. |
Module Exams (2) - 20% Exams will be given at the end of each Module. Each exam will be given via either D2L or an in-class paper exam This will be at the instructor’s discretion. For the most part I plan on using D2L Each exam may contain a mixture of multiple choice, essay, short answer, matching and true/false questions. All module exams must be passed with a 77% or greater. Any student who does not pass the module exams with a 77% or higher will be given one opportunity to retest with a different exam, the 2nd grade the highest that can be achieved is 77%. If the student fails a module exam a 2nd time, he or she will receive a failing grade for the class and will not be allowed to continue in the course, and subsequently not be allowed to continue on to the RCA 281 clinical internship. A re-test will be a proctored exam available in the learning center, and the re-test must be taken with 48 hours of first exam. No self assessment will be given for 2nd exam. |
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b. |
Reading quizzes-20% - Reading will be assigned weekly. A pre-test over the reading will be given at the beginning of each class, and then a post-test will be given at the end of lecture. The average of both of these exams will be the grade given for the quizzes. The average grade of the pre and post quizzes must equal no less than 80% or higher. Each student will only be allowed to fail one(1) reading exam. (average between pre and post) Failing more than 1 will result in failing this class. The pre-test will always be given exactly at 8:30, and will be given 10 minutes to complete the quiz. Any one late to class will not be given the opportunity to take the pre-test, and their grade will only be averaged from the post test. |
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c. |
Final Examination (1) 20%- The Final exam must be successfully master at 77% or higher. Failure to do so will result in failing the class. |
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d. |
Lab -20%. –Students will be broken into small labs. After each lab the student will be required to complete an assignment and/or take a quiz over what they had learned. All lab assignments are to be kept in the portfolio, and must be designated as “Lab”. . |
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e. |
Workbook/ Portfolio/ Assignments-20% All workbook assignments will correspond to the readings in the textbook. Homework will be assigned by the instructor. Workbook and homework assignments will be due as indicated by instructor. A portfolio will be required in this class. The portfolio is to contain the following:
1. Terminology of Key terms found at the beginning of each chapter in Egans and Chang. However, you do not need to duplicate terms. These are to be type written and alphabetized. Student will be graded on completeness and neatness., and is worth 50 points.
2. Homework, case studies/ critical thinking question, lab assignments required by the instructor
3. Quizzes or other projects done in class
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Your final course grade will be determined on a percentage basis outlined above. |
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Grading Scale |
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Raw Score Range |
Letter Grade |
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100 |
to |
94 |
A |
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93 |
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85 |
B |
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84 |
to |
77 |
C |
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76 |
to |
69 |
D |
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68 |
to |
0 |
F |
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SPECIAL REMARKS |
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Attendance: Since this class only meets for 11 sessions, absenteeism will not be looked upon favorably. Two absences will result in missing 20% and the student will be dropped as per the absence policy in the PCC handbook and Respiratory Care Handbook. Absolutely No EXCUSED absence will be given for vacations, work or personal situations. |
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Tardy policy: If a student does not notify the instructor prior to the beginning of the class that he/she will be tardy, the student will be unexcused. Two (2) tardies will equal one (1) unexcused absence. Students are expected to discuss with the instructor the reason for the tardiness. |
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Missed Assignments/Missed Exams: Students will not be allowed to make up assignments or exams.
A deduction of 10% of TOTAL grade will be deducted from an assignment for every day assignments is late up to 2 days. After 2 days late assignments will not be accepted. NO EXCEPTIONS. |
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The student is expected to meet with the instructor if he/she does not understand the material. |
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Failure to pass this class with a 77% or above will result in the student being placed on a probationary status and will not be allowed to move into the Intensive Care Units in the hospital until the course is repeated (which will not be until following summer). |
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The student is expected to spend 2-3 hours per credit hour preparing for class and reading the assignments. |
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METHODS OF INSTRUCTION: |
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To be successful in this course, students are expected to participate in discussions, readings, lectures, and lab activities. The instructor may assign point values to such activities. |
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ACADEMIC INTEGRITY: |
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The very nature of higher education requires that students adhere to accepted standards of academic integrity. Therefore, Pueblo Community College has adopted a policy of academic conduct as described in the Student Handbook. Violation of academic integrity may be defined to include the following: cheating, plagiarism, falsification and fabrication, abuse of academic materials, complicity in academic dishonesty, and personal misrepresentation. Since D2L may be used for the module exams, any student or students’ caught cheating while taking these exams on D2L willl be immediately withdrawn from this program. It is the student’s responsibility to be aware of the behaviors that constitute academic dishonesty. Sanctions for violating the standards of academic integrity may include warning, probation, suspension, and/or failure of the course or assignment at the discretion of the instructor. |
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10. |
ADA NOTICE: Students who have a documented disability may be eligible to receive accommodations for this class. Please contact the Disability Resources Center at 549-3446 for further information. |
Course Outline/objectives
Module I:
I. Respiratory Failure and the Need for Ventilatory Support
a. Define acute respiratory failure.
b. Differentiate between hypoxemic respiratory failure (type I) and hypercapnic respiratory failure (type II).
c. Discuss the causes of acute respiratory failure.
d. Discuss the differences between chronic respiratory failure and acute-on chronic respiratory failure.
e. Identify the complications of respiratory failure.
f. Define pump failure
g. Define decreased ventilatory drive
h. Describe the clinical presentation of a decreased ventilatory drive
i. Explain Respiratory Muscle Fatigue or failure
j. Describe the clinical presentation of respiratory muscle fatigue
k. Define increased work of breathing and describe the clinical
l. Discuss the indication for ventilatory support.
m. Discuss the general management principles of hypoemic and hypercapnic respiratory failure
n. Discuss the indications for noninvasive ventilation.
II. Non-Invasive Positive Pressure Ventilation
a. Discuss the concept of noninvasive positive pressure ventilation (NPPV).
b. List the goals of and indications for NPPV.
c. Select patients that should be managed with NPPV.
d. List those factors that are predictive of success during NPPV.
e. Discuss patient interfaces, types of ventilators, and modes of ventilation used during NPPV.
f. Discuss the initiation and management of NPPV in the acute care setting.
g. List and discuss complications associated with NPPV and their possible solutions.
h. Discuss the appropriate approach to the initial application of NPPV.
III. Mechanical Ventilators
a. Discuss the basic design features of ventilators.
b. Classify ventilators and describe how they work.
c. Define what constitutes a mode of ventilation.
d. Classify and discuss modes of ventilation.
e. Discuss the indications for the basic modes of ventilatory support.
f. Describe the application of selected modes of ventilatory support.
Module II
IV. Physiology of Ventilatory Support
a. Discuss are the effects of mechanical ventilation on oxygenation, ventilation, and lung mechanics.
b. Discuss the effects of positive pressure ventilation on other body systems.
c. Describe and list the complications and hazards of providing mechanical ventilatory support.
d. Discuss how to minimize the adverse effects of mechanical ventilation
V. Initiating and Adjusting Ventilatory Support
a. Review the indications for mechanical ventilation.
b. Identify and assess patients who need ventilatory support.
c. Describe how to choose an appropriate ventilator to begin ventilatory support.
d. Explain how to select an appropriate mode of ventilation given a patient’s specific condition and ventilatory requirements.
e. Choose appropriate initial ventilator settings, based on patient assessment..
f. Describe how to assess a patient after initiation of ventilation.
g. Explain how to adjust the ventilator on the basis of the patient’s response.
VI. Monitoring and Management of the Patient in the Intensive Care Unit
a. Discuss the principles of monitoring the respiratory system, cardiovascular system, neurologic status, renal function, liver function, and nutritional status of patients in intensive care.
b. Discuss the risks and benefits of intensive care unit (ICU) monitoring techniques.
c. Discuss why the caregiver is the most important monitor in the ICU.
d. Describe how to evaluate measures of patient oxygenation in the ICU.
e. Define why Paco2 is the single best index of ventilation for critically ill patients.
f. Describe the approach used to evaluate changes in respiratory rate, tidal volume, minute ventilation, Paco2, and end-tidal Pco2 values for monitoring purposes.
g. Discuss monitoring techniques used in the ICU to evaluate lung and chest wall mechanics and work of breathing.
h. Discuss the importance of monitoring peak and plateau pressures in patients receiving mechanical ventilatory support.
i. Describe the approach used to interpret the results of ventilator graphics monitoring.
j. Describe the cardiovascular monitoring techniques used in the care of critically ill patients and how to interpret the results of hemodynamic monitoring.
k. Discuss the importance of neurological status monitoring in the ICU and the variables that should be monitored.
l. Discuss evaluation of renal function, liver function, and nutritional status in intensive care.
m. Describe and discuss the use of composite and global scores to measure patient status in the ICU, such as the Murray lung injury score and the APACHE severity of illness scoring system.
n. Discuss monitoring and troubleshooting of the patient-ventilator system in the ICU.