Everyday Excellence: Enhance Diagnostic Confidence with Advanced ECG & Chest X-Ray Interpretation

Credit

Handouts/Brochure

Speaker

Paul Langlois, APN, PhD, CCRN, CCNS Related seminars and products

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Paul Langlois, APN, PhD, CCRN, CCNS, is a critical care clinical specialist in the surgical, medical, neurologic, burn, CCU, and trauma ICUs of Cook County Hospital, Chicago. Drawing on over 40 years of experience assessing and managing patients with life-threatening diseases, Dr. Langlois provides advanced-level training to nurses, physician assistants, nurse practitioners, respiratory therapists, and physicians.

Dr. Langlois is committed to providing the highest quality of care to patients through advanced education. His presentations are evidence-based, timely, and provide participants with numerous case studies to facilitate critical thinking. As a bedside clinical nurse specialist, he has developed several institution-wide protocols for the multidisciplinary assessment and management of infectious disease and multi-system organ failure patients.

His presentations are enthusiastically delivered and offer highly practical tips that help make the most challenging concepts easy to understand. Linking knowledge to clinical practice is the goal of every educational program.  

 

Speaker Disclosures:
Financial: Dr. Paul Langlois has employment relationship with Cook County Hospital and Emergency Care Consultants. He receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Paul Langlois is a member of the American Nurses Association, the American Association of Critical Care Nurses, and the Society of Critical Care Medicine.

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Objectives

1. Identify the anatomic location of a myocardial infarction using a 12 lead ECG 
2. Differentiate the following conduction conditions on a 12 lead ECG: left- and right-bundle branch block as well as bifascicular block 
3. Distinguish ECG changes from the following conditions: Brugada syndrome, Wellen’s syndrome, pericarditis and long-QT syndrome 
4. Identify normal anatomic structures on a chest x-ray 
5. Contrast the following traumatic conditions: pneumothorax, hemothorax and rib fractures on a chest x-ray
6. Differentiate between the following conditions on a chest x-ray: pneumonia, pleural effusion, aortic aneurysm, empyema and tuberculosis

Outline

ECG Electrode Placement

• 12 lead, right sided, and posterior wall ECG

Initial 12 lead Interpretation

• Rate, rhythm, intervals
• Wave morphology
• Axis

Heart Blocks

• Left and right bundle branch blocks
• Incomplete heart blocks
• Bifascicular blocks
• Complete heart block

Axis Deviation and The Significance

• Left and right axis deviation

Myocardial Ischemia and Infarction

• Anterior wall
• Lateral wall
• Inferior wall
• Posterior wall
• Case studies

Ventricular Hypertrophy

• Left ventricle
• Right ventricle

Electrolyte Disturbances in 12 Lead Interpretation

• Potassium
• Calcium
• Magnesium
• Case studies

Clinical Conditions

• Brugada syndrome
• Wellen’s syndrome
• Long QT syndrome
• Pericarditis
• Pulmonary embolism
• Case studies

Chest X-ray Imaging

• X-ray vs CT vs MRI vs pulmonary angiography vs ultrasound
• Posterior-anterior vs anterior-posterior view
• Lateral view
• Decubitus view

Systematic Approach to Chest X-ray Interpretation

• Image quality
• Normal chest x-ray (landmarks, variations from normal, incidental findings

Step-by-Step Assessment of Chest X-ray

• Medical devices present (tubes, lines, pacemakers, VADs)
• Airway (trachea alignment, carina)
• Breathing (assess lung fields for density, lung markings)
• Cardiac assessment (cardiac silhouette, enlargement, mediastinal conditions)
• Diaphragm (diaphragm position, costophrenic angles)
• Everything else (ribs, clavicle, unusual densities)

Associated Physical Assessment with Chest X-ray

• Compare left and right lung fields
• Clinical context
• Pre- and post-operative assessment
• Follow-up imaging (CT, MRI, pulmonary angiography)

Evaluating Pulmonary Conditions on X-ray

• Chest trauma (pneumothorax, hemothorax, rib fractures)
• Pneumonia
• Pleural effusion
• Pulmonary edema
• Chronic obstructive pulmonary disease
• Tuberculosis
• Aortic aneurysm
• Foreign bodies
• Diaphragmatic hernia
• Sarcoidosis
• Empyema
• Case studies

Target Audience

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