Full Course Description

2-Day: Cardiac Diagnostics and Interventions Course

Nurse practitioners, nurses, physician assistants and even physicians have told me that they are apprehensive to prescribe, administer or send a patient for a cardiac intervention or diagnostic test due to a lack of confidence and up-to-date knowledge. I understand the challenge…as there is a lot to understand when making these critical patient decisions.

I’m Dr. Paul Langlois, APN, PhD, CCRN, CCNS, a critical care clinical specialist in the surgical, medical, neurologic, burn, CCU and trauma ICUs of Cook County Hospital, Chicago. Throughout my career I have assisted countless healthcare providers overcome fears associated with ordering and interpreting cardiac tests. If a test or intervention were ordered inadvertently, we may not get the information we need to make informed decisions or worse….we could cause potentially dire patient consequences.

During this comprehensive training event, you can expect to learn:

  • Red flags that intensive cardiac testing is required
  • Radiology options as an assessment AND intervention
  • Implications of overlooked genetic cardiac tests
  • Lifesaving cardiac therapeutics – including the PROMeNADe study
  • Up to date guidelines for cardiac interventions
  • The impact of common medications on cardiac testing

But that’s not all! I will be sharing some of my unforgettable, real-world case studies after each major section to reinforce your learning. Together we will evaluate laboratory data, ECG results, ECHO cardiograms, physical assessment findings and clinical pearls to interpret the diagnostic interventions. The only thing that is missing during this event is the antiseptic smell of the hospital…

Dr. Paul Langlois, APN, PhD, CCRN, CCNS

Program Information

Objectives

  1. Distinguish the need for invasive and noninvasive cardiac interventions and diagnostic tests.
  2. Determine how SARS-CoV-2 affects the heart both acute and chronically.
  3. Investigate medications which impact every cardiac intervention.
  4. Practice patient preparation and aftercare of cardiac interventions and diagnostics.
  5. Analyze cardiac laboratory parameters for the cardiac patient.
  6. Evaluate genetic diagnostics which are either directly or indirectly linked to cardiac conditions.
  7. Interpret normal and abnormal echocardiographic results.
  8. Appraise common medications which affect echocardiographic findings.
  9. Analyze the need for CT, MRI, PET scan and angiography.
  10. Formulate a monitoring plan for your patient who received an intra-aortic balloon pump or ventricular assist device.
  11. Differentiate the types of extracorporeal membrane oxygenation.
  12. Distinguish the need for a permanent pacemaker and implantable cardiac defibrillator cardioverter.
  13. Evaluate the patient selection criteria for transcatheter aortic valve replacement and open-heart surgery.

Outline

Electrocardiogram and Electrophysiology

  • What you must know when looking at a 12-lead ECG
  • When medications do not work – now what?
  • Six red flags which indicate greater testing is required
Laboratory Blood and Urine Tests
  • Troponins
  • B-type natriuretic peptide
  • D-dimer
  • Electrolytes
  • Thyroid function
  • Lipid panel
  • Arterial blood gas interpretation
  • Urine for catecholamines and protein
Genetic Testing for Cardiac Conditions – Often Overlooked
  • Inherited cardiac genetic tests for arrhythmias, pulmonary hypertension, familial hypercholesterolemia & more
  • Risk stratification of the cardiac condition for potential parents
  • What are the therapeutic options based on genetic test?
Echocardiography is THE Test You Must Know
  • When to order an ECHO – what does this really tell the practitioner?
  • Five steps to ECHO cardiogram interpretation
  • The ECHO colors tell you so much
  • What do ECHO bubble studies inform us about the heart
Radiology: An Assessment and Intervention for the Cardiac Patient
  • Chest radiograph – what do you need to look for in your cardiac patient?
  • Computerized tomography
  • Magnet resonance imaging of the heart
  • Cardiac angiography – it is more than just vessels
  • Positron emission tomography – what will this test tell you?
Interventional Cardiology
  • Cardiac catheterization –clarity of blood flow
  • Balloon angioplasty and stent placement – difference in the type of stents?
  • Cardioversion and ablation – patient selection criteria is vital
  • MAZE procedure
  • Cardiac stress testing – the dos and don’ts
  • Mechanical thrombectomy – patient assessment pre- and post-procedure
  • Valvular treatments: transcatheter aortic valve replacement, balloon valvuloplasty and open-heart surgery
Life-Saving Cardiac Therapeutics
  • Intra-aortic balloon pump considerations
  • Ventricular assist device - not just for the ICU patient anymore
  • Extracorporeal membrane oxygenation – selecting between the three types
  • Impella Heart Pump: indications, contraindications and monitoring
  • Pacemaker and implantable cardiac defibrillator cardioverter; some ICD are MRI compatible (PROMeNADe study)

Target Audience

  • Nurse Practitioners
  • Physician Assistants
  • Clinical Nurse Specialists
  • Nurses
  • Interventional Cardiac Technologists
  • Stress Test Technicians
  • Exercise Physiologists
  • Physicians

Copyright : 12/05/2022

Atrial Fibrillation and Cardiovascular Implantable Electronic Devices: Latest Research, Treatments & Conundrums

Atrial fibrillation is the most common type of cardiac arrhythmia and the leading cardiac cause of stroke and often we see these unstable patients in a critical care setting. Various treatments for atrial fibrillation include anticoagulation, rate control medication, rhythm control medication, cardioversion, ablation, and other interventional cardiac procedures. This session describes the evaluation, diagnosis, and management of atrial fibrillation and highlights the new treatment directions. Several devices for stabilizing cardiac rhythms will be discussed as well as an overview of the patient who presents with ICD shock.

Program Information

Objectives

  1. Summarize arrythmia management options for atrial fibrillation.
  2. Discuss nursing interventions for atrial fibrillation.
  3. Review emerging/new device technology.
  4. Learn about care of the patient who presents with ICD shock.

Outline

  • Management of atrial fibrillation
    • Rhythm control vs rate control
    • Stroke prevention (DOAC, warfarin & left atrial appendage closure device)
    • Risk for tachyarrhythmia induced heart failure
    • Pharmacological treatment
    • Non-pharmacological treatment
    • Trials
    • Guidelines
    • Patient education
  • Convergent procedure overview
    • CV surgery part
    • Electrophysiology part
  • Cardiovascular implantable electronic devices
    • Implantable cardiac monitors
    • Cardiac resynchronization therapy
    • Shocks
      • Emergency department presentation
      • Phantom
      • Appropriate vs inappropriate
    • MRI conditional vs nonconditional
    • Infections
    • End of life care/deactivation
    • Patient education

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Physician Assistants

Copyright : 11/08/2022

Cardiac Output Manipulations for Hemodynamic Stability

A common reason for transfer to intensive care is that a patients’ status has become unstable. In this session, view Cyndi Zarbano as you learn the how’s and why’s of keeping our patients hemodynamically stable.  When training CCU/ICU nurses, Cyndi often shares “if you can learn to understand how and why we manipulate the cardiac output mathematical equation, you will improve your critical thinking skills – and patient care outcomes!” Cyndi has been a national seminar speaker for 15 years earning a reputation for being engaging using humor, stories, and nursing experiences to help attendee’s “get it”! Her career has included flight nursing, prior military background leaving service as a Lieutenant Commander, and nearly 30 years in various intensive care roles.

Program Information

Objectives

  1. Determine cardiac output manipulations for hemodynamic stability.
  2. Analyze the three components of stroke volume and determine how we can manipulate it.
  3. Differentiate the six vasopressors and how we select which is the right one for each patient situation.
  4. Choose pharmacological agents to optimally stabilize patients in crisis.

Outline

  • Cardiac Output (CO) = Heart Rate (HR) x Stroke Volume (SV)
  • Normal and abnormal values for multiple cardiac findings
  • Breaking down the equation to manipulate each component
    • Heart Rate – too fast or too slow
    • Stroke Volume
      • Preload – “dry or over-tanked up”
      • Afterload – manipulating the pressure the heart pushes against to move blood forward
      • Contractility – too much or too little squeeze
  • How the initiation of drugs and fluid options can manipulate the equation
  • Swan Ganz catheters, FloTrak or Vigileo monitors can drive interventions
  • The role of Intra-Aortic Balloon Pumps or Impella’s
  • Understand the rationale behind medication selection

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Physician Assistants

Copyright : 11/09/2022

Prescribing Heart Failure Medications: The Latest Updates for Life-Saving Clinical Decisions

Heart Failure is a complex clinical syndrome. The heart failure diagnosis alone can scare even the most adept and proficient providers.  It is not uncommon to feel as though we don’t want to change the medications for fear of causing harm.

Years of research and collaboration amongst the most respected experts in the heart failure field have proven that neurohormonal dysregulation is what causes the decline of patients with heart failure. When it comes to the medicinal management of heart failure, utilizing guideline directed medical therapy appropriately is misunderstood. It is not merely a pump problem but rather a brain and pump problem. The indications, patient education, up-titration, vital sign parameters, and adjuvant therapies are very specific to the pathology of the failing heart. 

Program Information

Objectives

  1. Analyze neurohormonal dysregulation as the primary trigger for worsening heart failure. 
  2. Differentiate the indications for GDMT in heart failure vs. other cardiovascular comorbidities.  
  3. Determine how to concomitantly use available resources to optimize heart failure management. 
  4. Plan how to prescribe and up-titrate heart failure medications based on clinical criteria. 
  5. Appraise the effectiveness of prescribed therapies. 

Outline

Neurohormonal Dysregulation 

  • What is really causing the failure 
  • RAAS  
  • Shutting it down 

Guideline Directed Medical Therapy (GDMT)  

  • The VIM’s:  Beta adrenergic blockers  
  • The VIM’s:  ACEi/ ARB’s 
  • The VIM’s:  Where’s ALDO? 
  • The VIM’s:  The new player:  ARNI 
  • The VIM’s: SGLT2 inhibition 

What do they each do? 

  • Critical importance of appropriate integration 
  • Tips and tricks for patient tolerance 
  • Monitoring 

The VIM’s:  Stay in the Loop with Diuretics 

  • Do HF patients ALWAYs need diuretics? 
  • Subclasses of diuretics to consider 
  • Thiazides and thiazide-like diuretics 
  • Carbonic anhydrase inhibitors 
  • Potassium-sparing diuretics 
  • Osmotic diuretics 

Non-Pharmacologic Interventions for Heart Failure Management 

  • Electrophysiology involvement 
    • ICD’s 
    • Pacemakers 
    • BiV-ICD 
  • PA pressure system 
    • Using monitoring to up-titrate GDMT 
  • Social media as patient support 
  • Support groups for patients with heart failure 

Treatment Options   

  • Referral to HF specialist 
  • Treating the cause 
  • LVAD 
  • Cardiac transplantation

Target Audience

  • Nurses
  • Nurse Practitioners
  • Pharmacists
  • Physicians
  • Physician Assistants

Copyright : 05/20/2022

Pharmacological Decisions to Optimize Cardiac Outcomes

Cardiac pharmacology can be intimidating.  Are you prescribing the latest evidenced based medications to improve outcomes in your cardiac patients?  This session discusses the optimal medical management for acute and chronic heart failure, ischemic heart disease and narrow complex arrhythmias.  You will walk away with many cardiac pharmacology clinical pearls to incorporate into your daily practice and feel confident you are prescribing the latest EBP medications.

Program Information

Objectives

  1. Evaluate strategies to up-titrate medications to obtain goal directed medical therapy for systolic heart failure patients. 
  2. Develop medication plan for hypertrophic cardiomyopathy patients. 
  3. Determine the optimal pharmacological management for ischemic heart disease patients.  
  4. Differentiate between pharmacological treatments for rate versus rhythm control in tachyarrhythmias. 
  5. Apply evidenced-based medication options for the case studies presented.  
  6. Integrate clinical pearls of cardiac pharmacology into daily practice.  

Outline

Heart Failure/Cardiomyopathy Pharmacology: Systolic vs. Diastolic vs Hypertrophic 

  • ACE Inhibitors 
  • Angiotensin Receptor Blockers 
  • Angiotensin Receptor Neprilysin Inhibitor 
  • Betablockers 
  • Diuretics 
  • Nitrates and Hydralazine 
  • Sodium Glucose Cotransporter-2 (SGLT2) Inhibitors 
  • Optimizing outcomes with titrations of medications 

Ischemic Heart Disease Pharmacology: STEMI vs. NSTEMI vs chronic angina 

  • Fibrinolytics  
  • Antiplatelets  
  • Betablockers 
  • Statins 
  • Nitrates 
  • Calcium Channel Blockers 

Narrow Complex Tachycardia Pharmacology: Atrial Fibrillation vs. Atrial Flutter vs Supraventricular Tachycardia (SVT) 

  • Rhythm vs Rate Control 
  • Antiarrhythmics 
  • Calcium Channel Blockers 
  • Betablockers 
  • Digoxin 
  • Anticoagulants 

Pharmacology Case Studies 

Target Audience

  • Nurses
  • Nurse Practitioners
  • Physicians
  • Physicians Assistants

Copyright : 02/17/2022