Description:

This course provides the didactic preparation that will be needed to supplement the clinical experiences of Polysomnography Clinical II. Students will refine knowledge and skills related to patient and equipment preparation, monitoring and documentation and therapeutic interventions associated with polysomnographic procedures. 6 hrs. integrated lecture lab/wk.

Supplies: Refer to the instructor's course syllabus for details about any supplies that may be required.

Textbook(s): For information see - http://bookstore.jccc.net

Course Fees: NONE

Course Objectives:

Upon successful completion of this course the student should be able to:

1. Describe and demonstrate implementation of protocols for monitoring and scoring polysomnographic studies.
2. Discern common errors and take appropriate corrective measures.
3. Compare and contrast the indications, criteria, methods, techniques, and troubleshooting related to sleep studies.
4. Describe and demonstrate appropriate patient care and therapeutic interventions based on clinical scenarios.
5. Demonstrate the ability to set-up, administer, titrate, and troubleshoot therapeutic interventions.

Content Outline & Competencies:

I. Protocols for Monitoring and Scoring
   A. Differentiate between hypopnea and apnea.
   B. Describe the general characteristics of UARS, primary snoring,
Cheyne-Stokes, and periodic breathing
   C. Categorize abnormal respiratory events according to the definitions
and sub-classifications of apnea, hypopnea, hypoventilation, periodic
breathing, Cheyne-Stokes respiration and UARS
   D. Describe the methods and techniques for scoring cardiac-related and
respiratory-related events
   E. Distinguish between central, mixed, and obstructive apnea.
   F. Differentiate between normal and abnormal oxyhemoglobin saturation
using oximetry data.
   G. Differentiate artifact from arousals and abnormal results on
cardiac-related and respiratory-related tracings and in identifying
epileptiform or seizure activity.
   H. Discuss common errors in evaluating respiratory and cardiac events
on a PSG study.
   I. Devise a plan to troubleshoot causes of artifact and common
equipment problems
   J. Describe and differentiate characteristics of the various complexes,
spindles, waves, and activity associated with sleep study activity.
   K. Explain various types of adult and pediatric procedures for advanced
PSG monitoring including bilevel PAP, NIPPV, Pes, pH, parasomnia and
seizure investigation
   L. Apply professionally accepted guidelines to differentiate between
sleep stages, wake and sleep sub-classifications, arousals and in the use
of scoring criteria 
   M. Integrate new information such as age-specific EEG characteristics,
EEG arousals, and alpha-intrusion to customize the sleep scoring rules to
each clinical scenario
   N. Integrate sleep staging data, events-related data, and arousal data
to calculate indices for report generation
   O. Calculate sleep onset, percent sleep stages, total recording time,
total movement time, REM onset, and arousals using sleep/wake data
   P. Identify common errors in performing calculations on sleep/wake
data
   Q. Verify the accuracy of a computer generated report by manually
calculating latencies, percentages, and indices
   R. Explain the components of a polysomnographic report
   S. Demonstrate the ability to prepare a sleep report for interpretation
by the physician.
   T. Differentiate between the pathophysiologic disorders based on their
associated clinical and polygraphic signs and symptoms

II. Arousals and Periodic Limb Movement
   A. Differentiate between artifact, movement-related, RERAs, respiratory
and spontaneous arousals
   B. Describe the methods and techniques for monitoring and scoring
periodic limb movement  and non-PLM related events
   C. Apply professionally accepted criteria to classify limb movements
associated with arousals
   D. Apply professionally accepted scoring criteria for arousals and
sleep/wake data

III. Pediatric/Infant Sleep Studies
   A. Discuss normal developmental aspects of infant and children sleep
   B. Discuss methods used to interpret pediatric/infant sleep studies
   C. Describe the criteria used to score pediatric/infant sleep studies
   D. Identify the types of sleep studies that can be performed on a
pediatric/infant
   E. Discuss the major challenges and limitations associated with
performing a sleep study on a pediatric/infant
   F. Describe the most commonly encountered sleep disorders in infants
and children
   G. Discuss the most common types of therapies and interventions used to
treat infants and children with sleep disorders

IV. Multiple Sleep Latency Testing/Maintenance of Wakefulness Testing
   A. Describe the indications for performing a MSLT/MWT
   B. Describe the procedure for preparing a patient for a MSLT or MWT
   C. Describe the similarities and differences between the MSLT and MWT
   D. Describe the procedure for performing MSLT or MWT
   E. Describe the criteria for terminating, evaluating, and scoring
MSLT/MWT 
   F. Identify common errors in evaluating sleep/wake MSLT/MWT data
   G. Compare MSLT/MWT results to established norms and determine clinical
significance of analysis results
   H. Apply professionally accepted scoring guidelines to MSLT/MWT

V. Therapeutic Interventions
   A. Describe the types of surgical, non-surgical and behavioral
treatment modalities commonly used to treat sleep disorders.
   B. Recommend intervention and titration of O2 and/or PAP therapy based
on written protocols when given a clinical scenario
   C. Describe the indications for administering and titrating oxygen and
PAP levels using established clinical protocols
   D. Demonstrate the ability to set-up, administer, and titrate oxygen
and PAP levels based on clinical protocols
   E. Describe the artifacts commonly seen during the therapeutic phase of
the study
   F. Determine and take appropriate corrective action to assure proper
signal display during the therapeutic phase of the study
   G. Differentiate between lethal and non-lethal ECG dysrhythmias
   H. Initiate emergency procedures, such as CPR and airway management,
based on a clinical scenario
   I. Assess individual patient care needs with regard to age, cognitive
needs, emotional needs, level of cooperation, disease processes, and risk
of infection

Methods of Evaluation of Competencies:

Evaluation of student mastery of course competencies will be accomplished using the following methods:

Written examinations	70-90% of total grade
Assignments		10-30% of total grade
Lab Competencies 	Satisfactory on Satisfactory/ Needing Improvement
evaluation by the instructor
Grading Scale:

A  =   92-100%  	
B  =   83-91%  	
C  =   75-82%*	
D  =   67-74%	
F  =    0 - 66%

*minimum required to continue in program

Caveats:

1. Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
2. A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.
3. Students will need basic word processing and Internet skills for the completion of some papers, exercises and projects.

Disabilities:

If you are a student with a disability, and if you will be requesting accommodations, it is your responsibility to contact Access Services. Access Services will recommend any appropriate accommodations to your professor and his/her director. The professor and director will identify for you which accommodations will be arranged.

JCCC provides a range of services to allow persons with disabilities to participate in educational programs and activities. If you desire support services, contact the office of Access Services for Students With Disabilities (913) 469-8500, ext. 3521 or TDD (913) 469-3885. The Access Services office is located in the Success Center on the second floor of the Student Center.