Kingwood College Respiratory Care Therapist Program

Credit: 3 credit hours with 2 hours lecture /4 hours lab

Prerequisites: Departmental Approval

Course Description per WECM:

“Advanced concepts of acute care, monitoring, and management as applied to the neonatal and pediatric patient.”

Learning Outcomes: Compare normal and abnormal neonatal and pediatric anatomy and physiology; and select, adjust, check and modify equipment necessary to manage the high risk neonatal or pediatric patient. The student must become certified in Neonatal CPR. Upon satisfactory completion of this course the student will:
       1.     Describe fetal development.
       2.     Describe the transition from fetal circulation to adult circulation.
       3.      Identify pathologic states in the neonatal population,
       4.      Identify pathologic states in the pediatric population.
       5.     Utilize various assessment and therapeutics in this patient population.
       6.     Stabilize and prepare for transport a simulated compromised patient in the laboratory setting.

7. Be able to document ability to resuscitate a newborn, by obtaining Neonatal Resuscitation Program certification.*

* NRP Certification Failure to obtain NRP certification will result in an incomplete “I” for the class until certification is obtained.

SCANS: The Secretary’s commission on Achieving Necessary Skills (SCANS) has identified (1) reading, (2) writing, (3) mathematics, (4) speaking and listening, (5) thinking skills, (6) personal qualities, (7) workplace competencies, and (8) basic use of computers as competencies required to enter employment.

SCANS Performance Objectives:
1. The student will demonstrate a working knowledge of Scans competency 1 [reading] Performance will be satisfactory if the student successfully:
          a. Understands assigned pages in the textbooks for this course
          b. Understands the scenario format of the unit exam questions
          c. Understands the assigned handouts for this course

2. The student will demonstrate a working knowledge of Scans competency 2 [writing]. Performance will be satisfactory if the student successfully:
a. composes a three-page research paper on an assigned subject

3. The student will demonstrate a working knowledge of Scans competency 3 [mathematics.] Performance will be satisfactory if the student successfully:
a. Calculates the required formulae used in neonatal & pediatric ventilation
b. Calculates the required formulae used in neonatal & pediatric assessment

4. The student will demonstrate a working knowledge of Scans competency 4 [speaking and listening]. Performance will be satisfactory if the student successfully:
a. Works with other students in small groups to complete lab assignments
b. Understands all oral instructions given in the lab portion of the course

c. Works with other students in small groups to complete case studies

5. The student will demonstrate a working knowledge of Scans competency 5 [thinking skills]. Performance will be satisfactory if the student successfully:
          a. Analyzes and answers the homework questions
          b. Analyzes the test questions in the scenario portion of the test
          c. Completes the lab stations

6. The student will demonstrate a working knowledge of Scans competency 6 [personal qualities]. Performance will be satisfactory if the student successfully:
          a. Interacts with faculty and peers within the classroom and lab social system
          b. Monitors and suggests improvements to the experimental model
          c. Exhibits personal self-esteem by demonstrating leadership responsibilities in the lab setting.

7. The student will demonstrate a working knowledge of Scans competency 7 [work place competencies]. Performance will be satisfactory if the student successfully:
          a. Displays in the lab setting the social skills needed to interact with the neonatal and pediatric staff
          b. Displays in the lab setting, the social skills needed to interact with the neonatal and pediatric patient population
          c. Performs all performance evaluations in the lab setting in timely

d. Completes the NRP Certification within the accepted time frame.

8. The student will demonstrate a working knowledge of Scans competency 8 [computers]. Performance will be satisfactory if the student successfully:
a. successfully uses the computer prompts on the various mechanical ventilators
b. uses the word processor to complete the research paper

c. accesses the lecture notes and additional internet reading assignments

Attendance:

Students are expected to attend all class, lab, and clinical sessions unless they are officially excused. An official absence is granted when such absence is caused by official participation in a college activity, and the instructor is informed in advance. All other absences are unofficial. Absences caused by unavoidable conditions, such as illness, should be reported to the instructor by the start of class (281.312.1605.) Please, be aware that any call-ins will none-the-less count as an absence or tardy.

Absences: will impact the final average with the first absence counting one [1] point, the second absence two [2] points, the third absence five [5] points, and each absence following a ten [10] point reduction.

Each tardy of less than 30 minutes will result in the deduction of 0.33% from the final grade average for this course. A “tardy” is inclusive of leaving class within thirty minutes before dismissal, as well as, taking leave during class or labs for longer than a reasonable amount of time. The instructor will be the arbitrator of what is ‘reasonable.”

Tardies of 30 minutes or more will be considered a half-day absence. These will be deducted as 0.5% from the final grade average for this course. Leaving a class/lab early or for extended periods will be calculated as a tardy or absence, depending on the amount of time missed. Students are to notify the instructor prior to walking out of class early.

Students shall not schedule conference times with other faculty or councilors during class time, and any class time missed due to ‘appointments’ with councilors or other faculty will not be treated any differently from other types of tardy or absences.

Leave of Absence is NOT given in this program. Withdrawal is required. Student may not drop this class without consultation with the instructor.

Academic Integrity (from NHMCCD Catalogue):

NHMCCD is committed to a high standard of academic integrity in the academic community. In becoming a part of the academic community, students are responsible for honesty and independent effort. Failure to uphold these standards includes, but is not limited to, the following: plagiarizing written work or projects, cheating on exams or assignments, collusion on an exam or project, and misrepresentation of credentials or prerequisites when registering for a course. Cheating includes looking at or copying from another student’s exam, orally communicating or receiving answers during an exam, having another person take an exam or complete a project or assignment, using unauthorized notes, texts, or other materials for an exam, and obtaining or distributing an unauthorized copy of an exam or any part of an exam.

Plagiarism means passing off as one’s own the ideas or writings of another (that is, without giving proper credit by documenting sources). Plagiarism includes submitting a paper, report or project that someone else has prepared, in whole or in part. Collusion is inappropriately collaborating on assignments designed to be completed individually. These definitions are not exhaustive.

When there is clear evidence of cheating, plagiarism, collusion, or misrepresentation, a faculty member will take disciplinary action including but not limited to: requiring the student to retake or resubmit an exam or assignment, assigning a grade of zero or “F” for an exam or assignment, or assigning a grade of “F” for the course. Additional sanctions including being withdrawn from the course/program or being expelled from school may be imposed on a student who violates the standards of academic integrity.

Unit Exams: Please, note that due to the nature of this course exams may be comprehensive and might include information from earlier courses. Each unit exams will consist of 30-50 multiple and multiple-multiple choice questions. Many of these questions may be linked to case studies. These exams will start promptly within the first 5 minutes of class.

Unit 2 which is the written portion of the NRP Certification will be a series of small exams that will be averaged together before averaged into the unit exam grades. The student will need to buy 10 scantron forms that have 15 questions for these exams. All NRP exams will be done in classroom.

Students who are scheduled to do their written tests in the testing center in the SFA building shall present at the testing center before or at the time the test starts. Exams in the testing center will not be allowed to continue past the usual time of the class that day. The student will return to the classroom as soon as he/she finishes so that he/she can participate in the rest of the day’s activities. It is the student’s responsibility to learn the testing center’s schedule for evenings.

Students who complete the exam in the classroom may exit the classroom but must move away from the doors until everyone has completed the test. No one leaving the classroom before completing the test shall speak to any student who has completed the exam.

Cell Phones & Pagers:

All cell phones and pagers must be turned off during class time. No cell phone speakers are to be worn in the ears during lectures or exams. If an emergency situation exists and only with instructor’s approval, cell phones may be placed in “vibrate” mode. However, leaving the classroom to answer an emergency call MUST be an infrequent occurrence.

Remediation: All students will be required to remediate any exam not passed with a 75%. This remediation will consist of extra homework assignments & at least one meeting with the instructor. This remediation will not change the grade. Remediation must be turned in prior to Finals Week. Single quizzes don’t need to be remediated, but consistently low quiz grades may be reason for remediation.

A student must remediate all unit exams that were missed because of an absence. Under these circumstances, the best grade he/she can get is a 75%. For example, the student answers 85% of the questions correctly. His grade will only be 85% of 75%-- which is only 64%. The retake will be on the first day back from the absence. If the student knows he/she will be absent on a testing day, the student may ask to take the test early and the exam will be left in the testing center for completion during the time frame established by instructor and student. A test taken early will accumulate full credit.

Calendar and Holidays:

· August 30-Sept 1 Labor Day holiday

· September 8 official day of record

· November 7 last day to withdraw

· November 26 [4 PM]-30 Thanksgiving Holiday

· December 8-14 finals week

Policies and Procedures: Student may find the following information in the Respiratory Care Student Handbook.

        - Withdrawal policy
        - Attendance policy
        - Grading scale

The Respiratory Care Therapist Program practices a non-discriminatory admissions policy with respect to race, color, creed, sex, age, or national origin.

Course Structure: Lecture and Laboratory

Procedural exams will be averaged and account for 5% of the final grade in this course. Procedural testing will be documented in DATA ARC and will be ongoing throughout the semester. Procedurals will be repeated until perfect. Neonatal Procedures can be found in the DATAARC.

Some procedural exams may be in the format of case studies that will start off with recommendations for assessment, followed by recommendations for therapy and then re-assessment of the safety and effectiveness of the recommended therapies. Several procedures may be documented with one case study scenario.

Procedures for the NRP Certification will be averaged into the procedural portion of the grade.

· Textbook and other material:
Michael Czervinske & Sherry Barnhart Perinatal & Pediatric Respiratory Care. 2^nd edition Saunders. ISBN 0-7216-8231-6

Other reading assignments may be taken from other Respiratory care textbook from prior semesters, most likely Egan’s Fundamentals and Wilkin’s Patient Assessment textbooks. We will use the CD film series for NRP certification.

To obtain copies of lecture notes, go to the links found in the course content section. It will be the student’s responsibility to have these notes printed out prior to lecture time. It is NOT acceptable to miss class time to print out these notes.

It is the student’s responsibility to have a four-function calculator in class for lecture, exams and for homework.

NOTE: The student must obtain at least 6 each 50-question Scantron forms [form #B2] for unit exams, and 10 each type’ A’ 15-question Scantron forms for NRP Certification in unit 2.

Homework: Homework will be assigned at the start of each unit, and it will be due the day of the written unit exam and it will be turned in before the test. Homework will not be graded, but will be tracked for remediation purposes.

Paper: The student will write a three-page paper over some aspect of neonatal or pediatric respiratory care: i.e. monitoring techniques, oxygen delivery or conventional ventilation or non-conventional ventilation. The paper will discuss the indications, and hazards of the selected therapy specific to the neonatal pediatric population, and explain why and how adult modes of therapy must be altered for infants. The student will pick his/her subject and an alternative by the second week of school and notify the instructor in writing.

Possible subjects for study include but are not restricted to the following:
02 delivery devices:

nasal cannula modified for infants
specific problems with tracheotomy of infants
nasal CPAP.

Conventional mechanical ventilation:

pressure limited vs. volume ventilation
demand valves vs. bias flow or blow by ventilation
problems unique to ventilation of the patient with an uncuffed ET-tube
pressure-cycled vs. flow-cycled ventilation
The role of PSV in the newborn population
The significant of inspiratory times during mechanical ventilation of the newborn [see time constants and Paw.]

None-conventional mechanical ventilation:

High frequency ventilation vs. oscillation
inverse ratio ventilation
ECMO [partial vs. full]

Monitoring modalities:

TcPa02 vs. pulse oximetry.

Capnography

Sleep apnea monitoring and pneumogram in the newborn population

Capillary blood gases vs. arterial blood gases

Umbilical artery catheters vs. radial or femoral sites for ABG.

The paper must have at least two references other than assigned textbooks. These can be on-line references, journals or books. If an on-line reference is used, please note if it is peer-reviewed or if the article seems to be written by the industry.

The student will supply the instructor with copies of all Internet, as well as, journal articles used for reference. Please cite appropriately per APA standards. Failure to provide this critical documentation will result in an F for the paper. If the reference is a textbook, copying the title page is adequate documentation.

Papers are due at the week before final exams on the last Tuesday before final exam week. Late papers will not be accepted.
Schedule:

Unit topic- instructor

Reading assignment

Keys,

Unit 1

Week 1-2
Unit1:

Kelley

Fetal development,

Changes at birth

& Assessment of the Neonate

Czervinske

Ch 1- 5

Fetal development and changes at birth & Assessment of the Neonate

http://wwwappskc.lonestar.edu/programs/respcare/2343le1.html

Slideshow

Case studies

Key case studies unit 1

Key neo1 review

Unit 2

Kelley & Missy

Neonatal Resuscitation Program

Lessons 1-5, Lessons 6-9

NRP Film

No notes, we will watch the film and take the tests as they come.

10 written and procedural check offs.

Unit 3

Kelley

Week 3-4
Unit2:

3.1 Neonatal pathology I

3.2 Neonatal Pathology II

Missy

3.3 Pediatric Pathology & assessment of the pediatric patient,

SPAG

Czervinske

Chapter 28-31

Neonatal Pathology Part I and Part II

http://wwwappskc.lonestar.edu/programs/respcare/neo2lec.html

Slideshow

Case study I

Key case studies HMD

_________________________________________________

Ch. 33-44

Ch. 6-8

Key case study 2-2 #2

________

Go to missy’s home page for her notes

Unit 4

Kelley

General care,

monitoring and assessment of the neonatal patient,

& surfactant

Czervinske

Ch 10-11, 15-16

general care of the newborn http://wwwappskc.lonestar.edu/programs/respcare/2353gen.html

monitoring [invasive and none-invasive] http://wwwappskc.lonestar.edu/programs/respcare/2353mon.html

surfactant & other selected drugs

http://wwwappskc.lonestar.edu/programs/respcare/2353surf.html

Case study key initiation of 02

Case studies

Key to trouble shooting

Case studies in

CPR, general care

Unit 5

Kelley

5.1 airway management, n-CPAP, CPAP & ventilation of the newborn

_________________

Missy

5.2 CPAP, BIPap and ventilation of the pediatric patient including special procedures:

High Frequency Ventilation, ECMO, & Nitric Oxide [iNO]

Czervinske

Chapter 15, 18

2005 AHI CPR standards for NICU

Power point Review CPR

CPAP http://wwwappskc.lonestar.edu/programs/respcare/2353cpap.html

airwayshttp://wwwappskc.lonestar.edu/programs/respcare/2353air.html

ventilation of the Neo / pedi patients http://wwwappskc.lonestar.edu/programs/respcare/2353ve.html

Highlights of the Drager Baby log

calculations needed in the nicu//kingwood.lonestar.edu/programs/respcare/2353cal.html

Chapter 19, 21-24

Airway & CPAP Key case studies

Pressure ventilation case studies Key

Go to missy’s home page for her notes

Scheduling
Tuesday [lecture and lab] 8:10 PM to 10:00 PM

Wednesday [lab] 5 PM – 9:30 PM

Calendar and Holidays:

· August 30-Sept 1 Labor Day holiday

· September 8 official day of record

· November 7 last day to withdraw

· November 26 [4 PM]-30 Thanksgiving Holiday

· December 8-14 finals week

Grading:

Grading: All exams will be weighted equally. All Unit Tests as well as procedural tests will be weighed equally and will be averaged.

Unit exams 85%

Procedural exams 5%
Research paper 5%

Daily quizzes 5%

As stated above absences and tardies will adversely affect the final grade at this point.

The following numerical ranges correspond to letter grades within the respiratory therapist program:

A = 90 - 100

B = 80 - 89

C = 75 - 79 passing

D = 65 - 74

F = < 65

ACKNOWLEDGMENT

I have received a copy and have read the course document for RSPT 2353, Neonatal/Pediatric Cardiopulmonary Care. By signing, I indicate my understanding and willingness to comply with these regulations and requirements.

Student Signature: ________________________________________________

Date: __________________________________________________________