The capstone course I will take in the fall is HSA4853.

I plan to endeavor in the

supervised project track. As a paramedic/registered nurse I am eligible for this route. Also, I
work full-time in the emergency department, and part-time with a private ambulance company so
there is very limited time for an internship. Given my background I would love to focus my
projects perspective on prehospital ECG transmissions. Since the birth of emergency medical
services back in the 60s, the ability existed (National EMS Museum Foundation, 2016).
However, it seems inexcusable that with the explosion of todays technology, many agencies do
not transmit ECGs to the hospital.
To prepare for the Capstone course I plan to gather research on my original idea. My
timeline will be set a week before the project or presentation is due, to allow for time to polish
the material and practice speaking. Next, I will condense and translate the medical jargon into
something more palatable. In the initial web searches on the topic I have already encountered
worthy talking points. According to Medscape a heart attack has a 30 percent mortality rate, and
half of those patients dont live to see the ED. Furthermore, the CDC reveals one in five heart
attacks are silent, meaning without symptoms. I may want to include the subtopic of 15 lead
ECGs because they are appallingly underused. After attending a seminar by Bob Page, a renown
ECG instructor, I learned the benefits of the technique. Half of all patients with an inferior wall
myocardial infarction will have right ventricular involvement (ENA, 2013). Without the 15 lead,
there is no way of knowing if treating with nitroglycerin will reduce the hearts preload and cause
profound hypotension.
This project will help prepare me to change policies in the future, once I am armed with
the research. As a healthcare leader I can affect change, such as reaching out to our patients
before they even arrive at our ED. If half of my would-be STEMI patients are going to die in the

field, I want to try something, anything, to reduce those numbers. I like the idea of using a
mobile device to send a picture of the finished ECG to the on-call cardiologist. Its a measure
that is user friendly with limited cost. In real-time a medical order for a thrombolytic like
Tenecteplase could be received in seconds. If such policies are adopted, I can cite this Capstone
project as the source of it all.

References

Centers for Disease Control and Prevention. (2015, August 5). Heart attack. Retrieved July 10,
2016, from http://www.cdc.gov/heartdisease/heart_attack.htm
Emergency Nurses Association. (2013, September 16). Right-Sided and Posterior
Electrocardiograms (ECGs). Retrieved July 11, 2016, from https://www.ena.org/practiceresearch/Practice/Documents/RightSideECG.pdf
National EMS Museum Foundation. (2016). 1967-METRO AMBULANCE SERVICE. In The
Virtual EMS Museum. Retrieved July 10, 2016, from http://www.emsmuseum.org/virtualmuseum/amad/articles/399743-1967-Metro-Ambulance-Service-Atlanta-Georgia
Zafari, A. M. (2016, March 28). Myocardial Infarction. In Medscape. Retrieved July 12, 2016,
from http://emedicine.medscape.com/article/155919-overview