Lesson 1Pre-test screening for contraindications and risk stratification (BP thresholds, unstable angina, recent MI)Reviews pre-test screening to find contraindications and sort risk, including blood pressure limits, unstable angina, recent heart attack, and other conditions dat may need to delay or change testing.
Reviewing medical history and diagnosesFinding absolute contraindicationsRelative contraindications and precautionsBlood pressure and rhythm screeningAssigning risk category and planning testLesson 2Post-exercise recovery monitoring: ECG and vitals timeline, observation duration, criteria for dischargeCovers structured watching after exercise, including ECG and vital signs timeline, criteria for longer recovery, and safe discharge after treadmill test, stressing finding delayed lack of blood or irregular beats.
Right after exercise ECG recording orderBlood pressure and heart rate recovery scheduleWatching for delayed lack of blood or irregular beatsHow long to watch and writing pointsClinical rules for safe going homeLesson 3Operator actions for adverse events: ischemic changes, sustained arrhythmia, hypotension, syncopeCovers what operator does when bad events happen, including spotting and quick handling of lack of blood ECG changes, lasting irregular beats, low blood pressure, fainting, and working with emergency teams.
Quick actions for lack of blood ST changesHandling lasting fast irregular beatsResponse to low blood pressure and near-faintingHandling fainting and patient falls safeStarting emergency and code rulesLesson 4ECG monitoring during stages: what ST changes, arrhythmias, and rate responses to watch forDetails 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 lack of blood and abnormal rate or recovery patterns.
Expected heart rate and rhythm responsesST segment down and up patternsT-wave and U-wave exercise changesSpotting ventricle and atrium irregular beatsRate incompetence and recovery patternsLesson 5Blood pressure monitoring schedule and technique during exercise phasesExplains right blood pressure measuring during exercise, including cuff choice, timing in each stage, way to cut motion artifact, and understanding normal and abnormal pressure responses.
Choosing cuff size and arm positionTiming BP readings in each stageListening method on moving patientNormal systolic and diastolic responsesSpotting low and high pressure trendsLesson 6Electrode setup for continuous monitoring and optimal lead selection for ischemia detectionExplains right skin prep, electrode placing, and lead choice to best spot lack of blood during treadmill test, stressing cutting artifact and ensuring continuous, good ECG watching all stages.
Skin prep and artifact cut stepsStandard limb and chest electrode positionsChanged chest lead place for stress testChoosing monitoring leads for ST analysisCable handling and motion artifact controlLesson 7Informed consent and patient briefing: test goals, stopping criteria, and expected sensationsOutlines getting informed consent and briefing patients on test purpose, procedure, expected feelings, and stopping rules, making sure dem understand, cooperate, and worry less before treadmill stress test.
Explaining test goals and clinical reasonsDescribing treadmill procedure step by stepDiscussing expected feelings during exerciseReviewing absolute and relative stop rulesAnswering patient questions and worriesLesson 8Criteria for immediate escalation: absolute and relative indications to stop the testDefines absolute and relative reasons to stop treadmill test, including ECG changes, blood pressure problems, severe symptoms, and equipment issues, and when to quick go to urgent medical check.
Absolute reasons to stop right awayRelative reasons needing judgmentECG triggers for stoppingBlood pressure and symptom limitsSteps after stopping for medical escalationLesson 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 personal treadmill protocolsChoosing protocol for patient conditionAdjusting or stopping stages safeLesson 10Symptom and exertion monitoring: dyspnea, chest pain, dizziness, fatigue—use of Borg/RPE scaleExplains systematic watching of symptoms and effort using 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 rightAssessing chest pain and angina symptomsWatching breathing trouble, dizziness, and tirednessLinking symptoms with ECG changesTalking with patients during stagesLesson 11Baseline measurements: resting ECG, blood pressure, symptom inventory, functional capacity estimateDescribes baseline checks before exercise, including resting ECG, blood pressure, symptom review, medications, and ability estimate, to find existing problems and guide protocol and test safety.
Resting 12-lead ECG taking and reviewBaseline blood pressure and heart rate recordingSymptom history and current problem listMedication review and timing before testEstimating ability and METsLesson 12Documentation items for stress test: baseline findings, stage-by-stage data, reasons for terminationDefines key writing for treadmill tests, including baseline data, stage-by-stage ECG, vitals, symptoms, workload, and stop reasons, for clear talk and legal full records.
Recording baseline ECG and vital signsStage-by-stage speed, slope, and METs logSymptom, irregular beat, and BP event notesWriting stop reason and timingSummarizing key findings for report
