Lesson 1Pre-test checks for warnings and risk levels (BP limits, unstable chest pain, recent heart attack)Reviews pre-test checks to spot warnings and level risks, including blood pressure limits, unstable chest pain, recent heart attack, and other conditions that may need delaying or changing the test.
Reviewing medical history and diagnosesIdentifying absolute warningsRelative warnings and precautionsBlood pressure and rhythm screening checksRisk category assignment and test planningLesson 2Post-exercise recovery monitoring: ECG and vitals timeline, observation time, discharge criteriaCovers structured post-exercise watch, including ECG and vital sign monitoring timeline, criteria for longer recovery, and safe discharge after treadmill test, stressing spotting delayed heart issues or irregular beats.
Immediate post-exercise ECG recording sequenceBlood pressure and heart rate recovery scheduleMonitoring for delayed heart issues or irregular beatsObservation time and recording pointsClinical criteria for safe discharge homeLesson 3Technician actions for bad events: heart changes, ongoing irregular beats, low BP, faintingCovers technician duties when bad events happen, including spotting and quick handling of heart ECG changes, ongoing irregular beats, low BP, fainting, and working with emergency teams.
Immediate actions for heart ST changesHandling ongoing fast irregular beatsResponse to low BP and near-faintingHandling fainting and patient falls safelyActivating emergency and code protocolsLesson 4ECG monitoring during stages: ST changes, irregular beats, and rate responses to watchDetails ECG changes to watch in each treadmill stage, including ST segment shifts, T-wave changes, irregular beats, and heart rate responses, stressing early spotting of heart lack of blood and abnormal rate or recovery patterns.
Expected heart rate and rhythm responsesST segment drop and rise patternsT-wave and U-wave exercise changesSpotting ventricle and atrial irregular beatsRate incompetence and recovery patternsLesson 5Blood pressure monitoring schedule and method during exercise phasesExplains correct blood pressure measurement during exercise, including cuff choice, timing in each stage, method to reduce movement errors, and understanding normal and abnormal pressure responses.
Choosing cuff size and arm positionTiming BP readings in each stageListening method on a moving patientNormal systolic and diastolic responsesSpotting low and high pressure trendsLesson 6Electrode setup for continuous monitoring and best lead choice for heart lack of blood detectionExplains correct skin prep, electrode placement, and lead choice to best detect heart lack of blood during treadmill test, stressing minimizing errors and ensuring continuous, high-quality ECG monitoring all stages.
Skin preparation and error reduction stepsStandard limb and chest electrode positionsModified chest lead placement for stress testingSelecting monitoring leads for ST segment analysisWire handling and movement error controlLesson 7Informed agreement and patient briefing: test goals, stopping rules, and expected feelingsOutlines getting informed agreement and briefing patients on test purpose, procedure, expected feelings, and stopping rules, ensuring understanding, cooperation, and less worry before treadmill stress test.
Explaining test goals and clinical reasonsDescribing treadmill procedure step by stepDiscussing expected feelings during exerciseReviewing absolute and relative stop rulesAddressing patient questions and worriesLesson 8Criteria for quick escalation: absolute and relative reasons to stop the testDefines absolute and relative reasons to stop treadmill test, including ECG changes, blood pressure issues, severe symptoms, and equipment problems, and when to escalate to urgent medical check.
Absolute reasons to stop immediatelyRelative reasons needing judgmentECG-based triggers for stoppingBlood pressure and symptom limitsPost-stop medical escalation stepsLesson 9Standard treadmill protocols (e.g., Bruce) and stage timing/parametersReviews common treadmill protocols like Bruce and modified Bruce, including stage times, speed and slope changes, and choosing based on patient fitness, age, and clinical reason for stress test.
Bruce protocol stages, speed, and slopeModified Bruce and low-level protocolsRamp and custom treadmill protocolsChoosing protocol for patient conditionAdjusting or stopping stages safelyLesson 10Symptom and effort monitoring: breathing trouble, chest pain, dizziness, tiredness—use of Borg/RPE scaleExplains systematic monitoring of symptoms and effort using structured questions and Borg or RPE scale, linking patient-reported effort with ECG and blood flow responses in each treadmill stage.
Using Borg and RPE scales correctlyAssessing chest pain and heart pain symptomsMonitoring breathing trouble, dizziness, and tirednessLinking symptoms with ECG changesCommunicating with patients during stagesLesson 11Baseline measurements: resting ECG, blood pressure, symptom list, functional capacity estimateDescribes baseline checks before exercise, including resting ECG, blood pressure, symptom review, medications, and functional capacity estimate, to spot pre-existing issues and guide protocol and safety.
Resting 12-lead ECG recording and reviewBaseline blood pressure and heart rate recordingSymptom history and current issue checklistMedication review and timing before testingEstimating functional capacity and METsLesson 12Documentation for stress test: baseline findings, stage-by-stage data, reasons for stoppingDefines essential recording for treadmill tests, including baseline data, stage-by-stage ECG, vitals, symptoms, workload, and stopping reasons, ensuring clear communication and legal completeness.
Recording baseline ECG and vital signsStage-by-stage speed, slope, and METs logSymptom, irregular beat, and BP event notesDocumenting stopping reason and timingSummarizing key findings for the report
