CPR Renewal
Online Training
New NRP Class
S.T.A.B.L.E. Program
January 28, 2010
Course Overview
When newborn infants become ill and require specialized care, each member of the healthcare team-nurses, physicians, therapists and assistants-must know what to do in a timely and effective manner. It is not uncommon for an infant to be properly resuscitated in the delivery room, but to receive less than optimal care post-resuscitation, resulting in an unfortunate outcome. First introduced in 1996 in the US and Canada, S.T.A.B.L.E. is a neonatal education program focusing exclusively on the post-resuscitation/pre-transport stabilization care of sick infants. This early transitional care affects not only the infant’s immediate health, but the long-term outcome as well. Education in stabilization beyond resuscitation is critical to the mission of reducing infant mortality and morbidity.
S.T.A.B.L.E. stands for the 6 assessment parameters covered in the program: Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support for the family. The design of this program is for all Healthcare Providers whose practice setting involves exposure to newborns, other than NICU providers.
Some of the Objectives Include:
• Recognize infants at increased risk for becoming hypoglycemic and
hyperglycemic.
• Identify candidates for placement of an umbilical catheter.
• List 3 ways healthcare providers can support parents of sick infants.
• Recognize infants at increased risk of becoming hypothermic, and list 3
necessary precautions to observe when re-warming hypothermic infants.
• Describe how to provide assistance during endotracheal intubation.
• List 2 signs and symptoms of a pneumothorax.
• Describe indications for, and safe administration of, dopamine.
• Identify the initial, appropriate IV fluid therapy for sick neonates.
• Discuss the relationship of thrombocytopenia to possible sepsis.
• List 3 laboratory tests indicated for evaluation of infection
Who Should Attend:
All Labor and Delivery, Postpartum and Newborn Nurses functioning in a “Women’s Services” unit other than NICU.
Allied health professionals may attend as appropriate based on the level of team involvement with sick newborns.
The course fee is $150 for Provider 6.7 Contact Hours and includes the course textbook from Nursing Unlimited’s library.
Please remember to include $5.00 for shipping and handling.
| West Broward Plantation General Hospital Plantation, FL Monday 9:30am – 6:30pm March 1 Register now |
Advanced Telemetry for Nurses
September 23, 2009
Course Overview
The purpose of this course is to provide healthcare professionals with a detailed approach to cardiac dysrhythmia interpretation, as well as cardiovascular anatomy and physiology, electrophysiology and treatments of dysrhythmia, in accordance with the American Association of Critical Care Nurses and the American Heart Association’s ACLS guidelines. Course includes detailed, in-depth review of clinical diagnosis and treatment of the cardiac patient.
Some of the Objectives Include:
- Describe the general anatomical structures of the heart.
- Identify the heart’s electrical properties.
- Describe the right- versus the left-sided mechanical functions of the heart.
- Explain proper electrode placement for EKG monitoring.
- Identify the components of the normal EKG complex.
- Utilize the 5-step method for EKG interpretation.
- Identify the criteria for arrhythmias, clinical significance and treatment modalities.
- Identify the assessment sequence and techniques for pulmonary, cardiac and vascular diseases.
- Describe different types of vascular diseases and their complications.
- Outline diagnosis and treatment of acute coronary syndrome (ACS).
- Perform a 12 lead and right-sided EKG.
- Identify frequently used telemetry cardiac drugs, mechanism of action, side effects, adverse effects and nursing considerations.
Who Should Attend:
- Anyone who wishes to work in:
• Critical care
• Stepdown units
• Special Procedures
- RNs who would like to expand their marketability
The course fee is $300 for 29.4 Contact Hours. A comprehensive course workbook will be provided on the first day of class.
| North Dade Nursing Unlimited Headquarters 18405 NW 2nd Ave Miami Gardens, Fl Monday – Friday July 5 – 9 Register now |
South Dade Kendall Regional Medical Center Medical Office Building II 11750 SW 40 St Room 758 Miami, FLMonday – Friday 9:00am – 5:00pm February 15 – 19 Register now |
| West Broward Plantation General Hospital Medical Office Building II 4101 N.W. 3rd Court, Suite #7 Plantation, FL Monday – Friday March 8 – 12 Register now |
North Broward Keiser University 1500 N.W. 49th Street (Please go to the front desk for classroom assignment) Ft. Lauderdale, FL Monday – Friday April 26 – April 30 Register now |
| Boca Raton West Boca Medical Center 21644 State Road 7 Education Center North Boca Raton, FLMonday – Friday 9:00am – 5:00pm June 14 – 18 Register now |
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Pandemic Influenza – 1 Contact Hour
May 11, 2009
What Is Pandemic Influenza?
An influenza pandemic is an influenza epidemic that spreads on a worldwide scale, infecting a large proportion of the human population. In contrast to regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in recent history. Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans. Often, these new strains result from the spread of an existing flu virus to humans from other animal species. History teaches that the influenza virus mutates to cause a worldwide epidemic about twice a century, on average. But scientists have yet to figure out what causes these viral mutations, when they will occur and what makes certain viruses more lethal than others.
Seasonal Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae, which affects birds and mammals. The name influenza comes from the Italian, meaning “influence”. The most common
symptoms of the disease are chills, fever, pharyngitis, muscle pains, severe headache, coughing, weakness and general discomfort. In more serious cases, influenza causes pneumonia, which can be fatal, particularly for the young and the elderly. In children the immune responses are still developing, while the elderly immune function tends to be weaker due to the aging process. Influenza, although often confused with the common cold, is a much more severe disease and is caused by a different type of virus.
Most people who get the flu recover completely in one to two weeks, but some people develop serious and potentially life-threatening medical complications, such as pneumonia. In an average year, influenza kills an estimated 250,000 to 500,000 people worldwide, with about 36,000 deaths in the United States and many more hospitalizations. Flu-related complications can occur at any age; however, the elderly and those with chronic health problems are much more likely to develop serious complications. By contrast, pandemic flus often strike young, healthy people the hardest.
Modes of Transmission
Influenza can be highly contagious, particularly among persons without pre-existing antibodies against influenza, such as young children during the inter-pandemic phase and anyone during a pandemic. Roughly 50% of all infections are, however, asymptomatic. Asymptomatic infection is especially common in children. The influenza virus is transmitted in most cases by droplets through the coughing and sneezing of infected persons, but it can be transmitted by direct contact as well.
Direct Contact
Direct-contact transmission involves skin-to-skin contact and physical transfer of microorganisms to a susceptible host from an infected or colonized person, such as occurs when healthcare personnel turn patients, bathe patients, or perform 
other patient-care activities that require physical contact. Direct-contact transmission can also occur between two patients (e.g., by hand contact), with one serving as the source of infectious microorganisms and the other as a susceptible host. Indirect-contact transmission involves contact of a susceptible host with a contaminated intermediate object, usually inanimate, in the patient’s environment (such as needles or countertops).
Droplet
Droplet transmission occurs when contagious droplets produced by the infected host are propelled a short distance through coughing or sneezing and can come into contact with another person’s conjunctiva, mouth or nasal mucosa. Influenza can be transmitted by large droplets, which generally travel 3 to 6 feet. Since these droplets are generally greater than 10 micrometers and do not stay suspended in the air, this mode of transmission is not affected by special air handling or control of room pressures. Large droplets appear to be the primary route of nosocomial transmission.
Airborne (Droplet Nuclei)
Droplet nuclei (airborne) transmission entails the production of infectious droplet nuclei, generally 5 micrometers or less in diameter. In contrast with larger droplets, these droplets can remain suspended in the air and be disseminated by air currents in a room or through a facility, to be inhaled by a susceptible host. Small droplet nuclei and aerosols can remain suspended in the air for prolonged periods and travel significant distances. Small particles appear to be more infectious, with both the degree of infectivity and the severity of illness directly related to particle size. Aerosols smaller than 10 microns have been shown to cause more severe disease and require a smaller inoculum than large intranasal droplets. Preventing the spread of droplet nuclei requires the use of special air handling and ventilation procedures.
There is no evidence that influenza transmission can occur across long distances (e.g., through ventilation systems) or through prolonged residence in air, as seen with airborne diseases such as tuberculosis. Organisms transmitted in this manner must be capable of sustaining infectivity, despite desiccation and environmental variation that generally limit survival in the airborne state. However, transmission may occur at shorter distances through inhalation of small-particle aerosols (droplet nuclei), particularly in shared air spaces with poor air circulation. An experimental study involving human volunteers found that illness could be induced with substantially lower virus titers when influenza virus was administered as a small droplet aerosol rather than as nasal droplets, suggesting that infection is most efficiently induced when virus is deposited in the lower rather than the upper respiratory tract.
Evidence supporting the relative contribution of each route of transmission for influenza is limited; however, droplet transmission is thought to be the predominant form of spread in a setting with an appropriate number of air exchanges and standard ventilation. In the absence of appropriate ventilation and air exchange, airborne transmission may play a greater role, such as in a crowded space where air exchange is limited.
Pandemic Influenza – References
May 11, 2009
REFERENCES AND RESOURCES
Bloomberg News article, Scientists Move Closer to Understanding Flu Virus Evolution (August 2006).
Brundage. J.F. and G.D. Shanks, “Death from Bacterial Pneumonia during 1918-19 Influenza Pandemic”, Emerging Infectious Diseases (August 2008).
Fidler, David, “Progress and Problems with Global Health
Governance”, Global Public Health (2007).
Kawaoka, Y (ed.), Influenza Virology: Current Topics. Caister Academic Press (2006).
Lemon, Stanley M. (ed.), The Threat of Pandemic Influenza: Are We Ready? National Academies Press, p. 66 (2005).
Markel, Howard, MD, et al, “Nonpharmaceutical Interventions Implemented by US Cities during the 1918-1919 Influenza Pandemic”, JAMA. 2007; 298:644-654.
Morens, D.M., et al, Predominant Role of Bacterial Pneumonia as A Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness. The Journal of Infectious Diseases DOI: 10.1086/591708 (2008).
Nicholls, H., “Pandemic Influenza: the Inside Story”. PLoS Biol. 4 (2): e50 (February 2006).
Price-Smith, Andrew, Contagion and Chaos, Cambridge, MA: MIT Press (2009).
Roos, Robert and Lisa Schnirring, “HHS Ties Pandemic Mitigation Advice to Severity”, University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP) (February 2007).
Taubenberger, J. and D. Morens, “1918 Influenza: the Mother of All Pandemics”, Emerging Infectious Diseases, 12 (1): 15–22 (2006).
www.cdc.gov/ncidod/diseases/flu/fluvirus.htm
www.clinicaltrials.gov
www.hhs.gov/nvpo/pandemicplan/index.html
www.nih.gov
Pandemic Influenza – Purpose
May 11, 2009
PURPOSE
To educate healthcare professionals about the causes, risks and means of containment of pandemic influenza.
