inside this issue - indian hills community college | indian hills … · 2018-12-06 · cna &...

July - December 2012

Indian Hills Community College

News Update and Course Catalog

Inside this Issue:RHEP Staff Offices Have Moved

RHEP Partners with OFD and Cargill Meat for Equipment Purchase

On-line Registration Available for Some RHEP Classes

IHCC Aspen Finalist Again

RESTC Education Center Completed

Programs Receive Accreditation

Con. Ed. Article:Fibromyalgia

For more newsletter articles, go to page 19.

RHEP Staff Have Moved

www.indianhills.edu/RHEP

What’s on the Cover?This newsletter cover features some of the beautiful flowers that grow on the main Ottumwa cam-pus each spring.

The offices for the staff for the Rural Health Education Partnership have moved to the Rosenman Video Conference Training Center (VCTC). The VCTC is located adjacent to the Rural Health Education Center and both buildings share the same parking lot. Even though the Rural Health Education Center was just built in 2007, the Health Occupations division has quickly outgrown the facility. When Promise Jobs and Iowa Workforce Development recently moved to IHCC’s North Campus and vacated space in the VCTC it created an opportunity to expand space for Health Occupations. Offices for all RHEP staff including Lori Reeves, Sandy Berto Diana Harness and Scott Johnson have moved. Additional Health Occupations staff located in the VCTC will include Cindy Hewitt (EMS), Gina Buttikofer (Early Childhood), Annie Morriss (OTA), and all Health Informatics staff including Diana Johnston, Lissa Jarr and Carol Yochum. The Massage Therapy Oasis remains in the VCTC but has moved to a new location which provides more privacy for massage clients. The previous Massage Therapy Oasis is being remodeled to create a lab and classroom for the Occupational Therapy Programs as well as an additional classroom which will hold many RHEP sponsored classes. Additional remodeling on the first floor has provided a new classroom/lab for the Early Childhood program as well. Video Conference Training Center (VCTC)

RHEP Partners with Ottumwa Fire Dept. and Cargill Meat for Equipment Purchase

A large group of new and nearly new confined space and ropes rescue equipment had recently become available for sale. Ottum-wa Fire Department’s Southeast Iowa Response Group (SIRG)had interest in purchasing the equipment for rescue use and Indi-an Hills’ Rural Emergency Service Training Center (RESTC)had already been looking for and pricing similar equipment for train-ing. Although the value of the equipment was nearly $30,000 and the cost was just $8,000 neither OFD or IHCC’s RESTC could af-ford the price. By combining available funds with a generous do-nation for Cargill Meat Solutions, the equipment was purchased and will be used jointly by the SIRG and IHCC’s RESTC. OFD will maintain the equipment and have it available when needed for actual rescues and when not in use, the equipment will be available for use by IHCC for training. The partnership created

a win-win situation for both entities and emergency providers in the region and allowed both to have equipment avail-able that otherwise neither would have been able to obtain.

Vicki Ellis Changes Positions If you have ever registered for a RHEP class, you have probably talked to or emailed Vicki Ellis. Vicki has been the administrative As-sistant for RHEP for several years now. Vicki has accepted the new position of Program Assistant for the Health Occupa-tions Division. In this role Vicki will be responsible for tracking physicals & im-munizations for all health students, clini-cal contracts, as well as a wide variety of other duties. Her office is located on the upper level of the RHEC.

Course Catalog Index

Newsletter . . . . . . . . . . . . . . . . . . . . Pages 2, 23 - 24

General Information . . . . . . . . . . . . .

Acute Care, Emergency and . . . . . Page 4 - 7Specialty Certification Classes

General Classes, Conferences . . . . Page 7 - 8and Workshops

Mandatory Reporter. . . . . . . . . . . . . Page 8-9

Senior Lunch & Learns . . . . . . . . . . Page 9

Fire Fighter Courses . . . . . . . . . . . . Page 10- 11

EMS Courses & Transition . . . . . . . Page 11 - 12

CNA & Short Term/Certificate . . . . . Page 14 - 15Programs

CPR & First Aid . . . . . . . . . . . . . . . . Page 16 - 17

Continuing Education Article . . . . . . Page 18 - 22

Page 31-800-726-2585, ext. 5281

General Information

Continuing Education:

CEH’s and contact hours for RHEP sponsored programs will be awarded based on actual presence and 100% attendance for the disciplines indicated in the course listing. Certificates will be awarded for proof of continuing education or contact hours. A fee of $5 will be charged for duplicate certificates.

Pre-registration: Pre-registration is required for some classes and suggested for all as some classes may be cancelled if there is insufficient en-rollment. To pre-register for any of the classes in this catalog, call 1-800-726-2585, ext. 5281 or 641-683-5281 or email [email protected]. To pre-register on-line for a “12/YR” or “13/YR” class: 1) go to the Indian Hills website: www.indianhills.edu 2) Select “Web Advisor” under “quick Links” on the left of the page 3) Click on “Continuing Education” in the gold box on the right 4) Click on “Register and Pay for a Continuation Education Class” 5) Type in the course number if known, or use one of the other listed criteria to search for a class 6) Click on the class to learn more about it (or) 7) Check the class to begin the registration processPayment via credit card is required at the time of pre-registraion when registering on-line.

Payment: Participants paying for courses themselves are expected to pay for the course at the time of pre-registration. Payment may be

Indian Hills Community College provides equal educational and employment opportunities and does not illegally discriminate on the basis of age, race, creed, color, sex, sexual orientation, gender identity, marital status, national origin, religion or disability in its educational programs, activities or its employment and personnel policies. Inquiries or grievances related to this policy may be directed to Bonnie Campbell, Dean of Human Resources/Equity Coordinator, IHCC, 525 Grandview, Ottumwa, IA 52501

Services for Students with Disabilities: Individuals with disabilities who require accommodations or special services should contact the IHCC SUCCESS Center for assistance. Services are available to students who may need classroom accommodations, interpreters, and/or special-ized equipment. All student requests are dealt with in a confidential manner. Students should contact the Ottumwa SUCCESS Center by calling (800) 726-2585, ext. 5238. Centerville stu-dents should contact the Centerville Success Center at (800) 670-3641, ext. 2232. All students may contact the Dean of Academic Services at (800) 726-2585, ext. 5218.

made via credit card over the phone or by mailing payment: RHEP, 655 Indian Hills Dr., Bldg #21, Ottumwa, IA 52501. When sending payment please include the course number, partici-pant’s name and social security number or student ID with the payment. If a third party or employer is paying for the course this may be prepaid to the college or indicated on the registra-tion form. The third party or employer will then be invoiced for the course costs. RHEP “Partner Pricing” discounts will be re-flected in the invoice.

Partner Pricing:RHEP partners are eligible for a 15% discount on tuition of a course when the partner agency pays the participant tuition. Classes with a tuition fee of less than $40.00 are not eligible for partner pricing.

Courses held at the partner’s location are not eligible for partner pricing and mileage costs will apply.

Non-Residents: Non-residents of Iowa are required to pay 1½ times the course tuition for continuing education courses when college credit is being awarded. Participants must have lived in Iowa 90 days and provide proof of residency to the IHCC Business Office to receive in-state tuition rates.

Refund Policy: No refunds will be issued for cancellation made three days or less prior to an event. Individuals who pre-register for an event and do not cancel their registration or attend the class will be charged the course tuition.

Course Cancellations: If a course is cancelled due to insufficient enrollment, attempts will be made to contact the registrant using the contact informa-tion provided when the participant registered for the course. If the class has been cancelled due to insufficient enrollment, the participant will receive a 100% refund of any course fees pre-paid.

Course cancellations/postponements due to weather conditions will be announced on local radio and television stations and will also be posted on the IHCC web-site.Course Fliers: For complete information on each course go to thewww.indianhills.edu/RHEP website and click on “Current Course Information.” Choose your professional area and locate the specific course listing. The course flier may be viewed on screen or printed for your convenience.

Acute Care, Emergency and Specialty Certification Classes

All classes within these sections requirepre-registration.

If there is not sufficient enrollment, the course will be canceled. If there is sufficient enrollment, participants will receive a letter approximately one week before the course outlining course re-quirements. Most courses require that the student obtain and read the course textbook prior to class. Books may be obtained from any source, but are available in the IHCC bookstore. Con-tact RHEP staff for current edition information if needed.

ACLS Prep Course

This class is designed to prepare the participant with minimal or no previous ACLS knowledge to successfully complete an ACLS course. The course will include an ECG dysrhythmia re-view, emergency drug pharmacology, ACLS science, electrical therapy, treatment algorithms, and an introduction to the ACLS team concept. Completion of the ACLS Prep course prior to ACLS is HIGHLY recommended.

When: Monday, July 16, 2012 8:00 a.m. - 5:00 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 8.0 Contact hours for nursing or respiratory

therapy, 8.0 CEH’s for EMS (FE) Tuition: $71.00Course No.: 13/YR*REL*4503*700

When: Wednesday, September 5, 2012 8:00 a.m. - 5:00 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 8.0 Contact hours for nursing or respiratory


When: Monday, November 5, 2012 8:00 a.m. - 5:00 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 8.0 Contact hours for nursing or respiratory


Advanced Cardiac Life Support (ACLS) Initial

This course is designed to provide the student with ad-vanced emergency cardiovascular knowledge and skills. Treat-ment protocols will be based on the current American Heart Association guidelines. Prerequisites: PS or EMT-P student or certification, RN licensure, eighth-term nursing student or Re-spiratory Therapist. Completion of the ACLS Prep course prior to this class is HIGHLY recommended for individuals who have not taken ACLS before. Students are required to obtain a cur-

rent ACLS book for this course and are encouraged to obtain an ECC handbook. Books are available in the IHCC bookstore. The online pre-test is required for admission to this course.

When: Monday & Tuesday, July, 23-24 2012 Mon. 8:00 a.m. - 4:30 p.m. (hour for lunch on your

own) Tue. 8:00 a.m. - 11:30 a.m.Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 11.0 Contact hours for nursing or respiratory

therapy, 11 CEH’s for EMS (FE) Tuition: $142.00Other Fee: $6.00 (Card)Course No.: 12/CU*EMS*810*700

When: Wednesday & Thursday, Sept. 12-13, 2012 Wed. 8:00 a.m. - 4:30 p.m. (hour for lunch on your

own) Thur. 8:00 a.m. - 11:30 a.m.Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 11.0 Contact hours for nursing or respiratory

therapy, 11 CEH’s for EMS (FE) Tuition: $142.00Other Fee: $6.00 (Card)Course No.: 12/CF*EMS*810*700

When: Monday & Tuesday, November 12-13, 2012 Mon. 8:00 a.m. - 4:30 p.m. (hour for lunch on your

own) Tue. 8:00 a.m. - 11:30 a.m.Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 11.0 Contact hours for nursing or respiratory

therapy, 11 CEH’s for EMS (FE) Tuition: $142.00Other Fee: $6.00 (Card)Course No.: 12/CF*EMS*810*701


With a minimum enrollment dependent upon the course, RHEP can bring most of the courses in this section to your facility. RHEP will take care of all paperwork, pro-vide the necessary equipment and instructors. Contact Lori Reeves for more information, 641-683-5337 or [email protected].

The American Heart Association strongly promotes knowledge and proficiency in BLS, ACLS and PALS, and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsor-ship by the American Heart Association, and any fees charged for such a course do not represent income to the Association.

Dates at a Glance:

ACLS Prep........6/16, 9/5, 11/5ACLS.................7/23-24, 9/12-13, 11/12-13 ACLS Update...7/3, 9/18, 11/20 PALS.................8/13-14, 10/10-11, 12/11-12PALS Update ....8/6, 10/3, 12/5 AMLS................9/28-29 AMLS Instr........9/29 PHTLS..............10/12-13 PHTLS Instr......10/13 TNCC................11/15-16

Acute Care, Emergency and Speciality Certification Classes

ACLS Update (Renewal)

This course, based on the 2010 AHA science changes, is de-signed for individuals with current ACLS course completion. Participants must bring a copy of their card or proof of last course completion to the class. Students are required to obtain a current ACLS book for this course and are recommended to obtain an ECC handbook. Books are available in the IHCC bookstore. Completion of the online pre-test is required for admission to this course.

Individuals whose ACLS is not more than 6 months expired may take this course but must complete all testing without remedia-tion. If testing (hands-on and written) is not passed the first time no re-testing will not be allowed and the individuals must take the full provider course.

When: Tuesday, July 10, 2012 8:00 a.m. - 4:00 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 7.0 Contact hours for nursing or respiratory

therapy, 7.0 CEH’s for EMS (FE) Tuition: $71.00Other Fee: $6.00 (Card)Course No.: 13/YR*REL*4504*700

When: Tuesday, September 18, 2012 8:00 a.m. - 4:00 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 7.0 Contact hours for nursing or respiratory


When: Tuesday, November 20, 2012 8:00 a.m. - 4:00 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 7.0 Contact hours for nursing or respiratory


Pediatric Advanced Life Support (PALS) Initial

This course, based on the 2010 AHA science changes, is de-signed to provide the student with the knowledge and skills nec-essary to care for newborn and pediatric patients in emergency medical situations. This course is based on current American Heart Association guidelines. Prerequisite: Current EMT-P or PS certification, RN licensure, Respiratory Therapist, Paramed-ic or PS student, seventh - term nursing student. Students are required to obtain a current PALS book for this course and it’s recommended that they obtain an ECC handbook. Books are available in the IHCC bookstore. Completion of the pre-test is required for admission to this course.

When: Monday & Tuesday, August 13-14, 2012

8:00 a.m. - 4:30 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 15.0 Contact hours for nursing or respiratory

therapy, 16.0 CEH’s for EMS (FE) Tuition: $142.00Other Fee: $6.00 (Card)Course No.: 12/CF*EMS*815*700

When: Wednesday & Thursday October 10-11, 2012 8:00 a.m. - 4:30 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 15.0 Contact hours for nursing or respiratory

therapy, 16.0 CEH’s for EMS (FE) Tuition: $142.00Other Fee: $6.00 (Card)Course No.: 12/CF*EMS*815*701

When: Tuesday & Wed., December 11-12, 2012 8:00 a.m. - 4:30 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 15.0 Contact hours for nursing or respiratory

therapy, 16.0 CEH’s for EMS (FE) Tuition: $142.00Other Fee: $6.00 (Card)Course No.: 12/CW*EMS*815*700

1-800-726-2585, ext. 5281

Participants must pre-register for allof these courses:

641-683-5281 or 1-800-726-2585, ext. 5281

Check your course location! Many of RHEP’s classes will now be held in

the VCTC, Room 125

PALS Update (Renewal)

This course, based on the 2010 AHA science changes, is de-signed for individuals with current course completion of all PALS provider class. Students are required to obtain the current PALS book for this course and it is recommended that they obtain an ECC handbook. Books are available in the IHCC bookstore. Completion of the pre-test is required for admission to this course.

Individuals whose PALS is not more than 6 months expired may take this course but must complete all testing without remedia-tion. If testing (hands on and written) is not passed the first time no re-testing will be allowed and the individuals must take the full provider course.

When: Monday, August 6, 2012 8:00 a.m. - 4:30 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 7.5 Contact hours for nursing or respiratory


When: Wednesday, October 3, 2012 8:00 a.m. - 4:30 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 7.5 Contact hours for nursing or respiratory

Acute Care..., Cont.situations. The course is based on the current National Association of Emergency Medical Technician’s (NAEMT’s) Prehospital Trauma Life Support (PHTLS) 7th edition curriculum. Students are required to obtain a current PHTLS book for this course. Books are available in the IHCC bookstore or available through multiple on-line sources. Prerequisite: Licensure as an EMS provider or nurse.

When: Friday & Saturday, October 12-13, 2012 8:00 a.m. - 5:00 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, RHECRoom: 108Credit: 16.0 Contact hours for nursing, 16.0 CEH’s for

EMS (FE) Tuition: $144.00 (plus student must obtain a current 7th

edition PHTLS text book)Other Fee: $15.00 (Card)Course No.: 12/CF*EMS*820*700

PHTLS Instructor

This course is for current PHTLS providers who wish to become a PHTLS instructor. A letter of recommendation from a current PHTLS course coordinator or instructor is required. Instructor candidates must be monitored teaching prior to issuance of an instructor card.

When: Saturday, October 13, 2012 5:00 p.m. - 10:00 p.m. Where: IHCC Ottumwa Campus, Rural Health Educ. Ctr.Room: 118Credit: 5.0 Contact Hours for nursing, 5.0 CEH’s for EMS

(OE)Tuition: $25.00Other Fee: $10.00 (Card) Course No.: 13/YR*REL*4755*701

Trauma Nurse Core Course (TNCC)

This class is intended for RNs who work in an emergency room setting (at least 6 months of ER experience is recommended). Other healthcare professionals may audit the course. The course covers the care of the trauma patient in the ER setting.

When: Thursday & Friday November 15-16, 2012 8:00 a.m. - 5:00 p.m. (hour for lunch on your own)

Where: IHCC Ottumwa Campus, RHECRoom: 108Credit: 16.0 Contact hours for nursing, 16.0 CEH’s for

EMS (FE) Tuition: $142.00 Book: $65.00Other Fee: $65.00 (ENA Surcharge)Course No.: 13/YR*REL*4260*700



When: Wednesday, December 5, 2012 8:00 a.m. - 4:30 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 7.5 Contact hours for nursing or respiratory


Advanced Medical Life Support (AMLS)

This course will address the most common medical complaints and offers a “think outside of the box” method of assessing and managing a patient in medical crisis. This course emphasizes using the scene size-up, history and physical exam to system-atically rule out and rule in possibilities and probabilities of their medical problem. This course offers the opportunity to be in an assessment-based approach and progress to a diagnosis-based approach to develop a specific treatment plan for a specific medical condition: resulting in a differential diagnosis. Students are required to obtain a current AMLS book for this course. Books are available at the IHCC Book Store.

When: Friday - Saturday, September 28-29, 2012 8:00 a.m. - 5:00 p.m. (hour for lunch on your own)Where: IHCC Ottumwa Campus, RHECRoom: 111Credit: 16.0 Contact Hours for nursing or respiratory

therapy, 16.0 CEH’s for EMS (FE) Tuition: $142.00 (plus student must obtain a current AMLS

text book)Other Fee: $15.00 (Card) Course No.: 12/CF*EMS*825*700

AMLS Instructor

This course is for current AMLS providers who wish to become an AMLS instructor. A letter of recommendation from a current AMLS course coordinator or instructor is required. Instructor candidates must be monitored teaching prior to issuance of an instructor card.

When: Saturday, September 29, 2012 5:00 p.m. - 10 p.m.Where: IHCC Ottumwa Campus, RHEC.Room: 108Credit: 5.0 Contact Hours for nursing, 5.0 CEH’s for EMS

(OE)Tuition: $25.00Other Fee: $10.00 (Card), Instructor Books will available for purchase on

site. Course No.: 13/YR*REL*4755*700

Prehospital Trauma Life Support (PHTLS)

This course is designed to provide the student with the knowledge and skills necessary to care for patients in emergency trauma www.indianhills.edu/RHEP

1-800-726-2585, ext. 5281

Management of Patients Across the Continuum (CCRN - Critical Care Nursing)The CCRN Series is tentatively being offered again for Fall 2012. Hopes had been to have an alternate delivery system in place for fall classes but this looks unlikely at this time. A minimum of 5 students is required to hold these classes. For this reason please preregister by August 13, 2012 for this series. If the minimum number of students register for the series then individual classes will be available for continuing education by others.

This program has been developed by the Iowa Critical Care Nursing Education committee. The program is divided into modules designed for the health-care professional who is taking care of patients in settings such as the emergency department, critical care unit, medical/surgical unit and home care. Participants may come to one or all classes depending upon their learning needs. The course will provide extensive handouts, up-to-date information and CH’s/CEH’s in a cost effective delivery system allowing usage of the best instructors from across the state.

Continuing Education has been approved for these classes for Nurses, Respiratory Therapists, Paramedics and Paramedic Specialists. Classes are worth either 3.5 or 7.0 Contact Hours or CEH’s. These classes meet criteria for Critical Care Paramedic continuing education.

All classes will be held in the Video conferencing and Teleconferencing Center (VCTC) - room CC7. The course number for all classes will be: 13/YR*REL*4013 plus the section number listed below. Site cancellations due to insufficient enrollment will be made by 3:00 p.m. on the Tuesday the week prior to the class date.

Section Date Time Mod # Course Title Cost700 Aug 28 8-4 1 Cardiac and Pulmonary Assessment $58701 Sept 4, 11, 18, 25, Oct 2 8-11:30 2 Cardiac Dysrhythmias $135702 Sept 4 12:30-4 3A Cardiac Physiology and Angina $32703 Sept 11 12:30-4 3B Myocardial Infarction $32704 Sept 18 12:30-4 4A Congestive Heart Failure $32705 Sept 25 12:30-4 4B Valve Disease & Pericarditis $32

706 Oct 2 12:30-4 10 Pacemakers $32707 Oct 9 8-11:30 5 Pulmonary Physiology $58708 Oct 9 12:30-4 17 Acid/Base Balance $58709 Oct 16 8-4 9 Respiratory Disorders $58710 Oct 23 8-4 Renal Disorders $32711 Oct 30 8-4 18 Endrocrine Disorders $32712 Nov 6 8-4 GI Disorders $58713 Nov 13 8-11:30 19 I Acute Changes on 12-lead EKG $75714 Nov 13 12:30-4 19 II Neurological Assessment $75715 Nov 20 8-4 Neurological Disorders $3271 Nov 27 8-4 Advanced 12- Lead- Day I $32

717 Dec 4 8-4 Advanced 12- Lead- Day II

Acute Care, Emergency and Specialty Certification Classes

General Classes, Conferences and Workshops

Social Work Ethics

This program will provide information and discussion of the ethical responsibilities in the social work environment. The im-protance of supervision, record keeping and commmitment to clients and employers will be discussed.

When: Friday October 5, 2012

Please check our website www.indianhills.edu/rhep for the most current listing of workshops and for more details

on those listed below. For further information on the following courses contact Lori Reeves at 641-683-5337 or Sandy Berto at 641-683-5183 and for registration call

641-683-5281.

9:00 a.m. - 12:00 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Credit: 3.0 CEH’s for Social WorkTuition: $30.00Course No.: 13/YR*REL*5025*700

Direct Care Conference- Guided Imagery

This conference is designed to give CNA’s and direct care pro-fessionals an opportunity to recharge and relax. Guided Imag-ery is based on the concept that the body and mind are con-nected. It is a program of directed thoughts and suggestions that guide the imagination toward a relaxed, focused state. Guided imagery works well for a variety of disorders and illnesses and can improve performance and concentration in a variety of types of individuals. Come learn with Mel Davis-Schiefer, MS, LMHC,


Gen. Classes, Conf. & WkshpsLMSW how to use voice tone for yourself or to assist a client or patient to relax and use the benefits of guided imagery

When: Friday October 5, 2012 9:00 a.m. - 12:00 p.m. or repeated 1:00 p.m. - 4:00 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $25.00 (includes handouts and snacks)Course No.: 13/YR*REL*4360*700- Morning Session 13/YR*REL*4360*701-Afternoon Session

Benefit Liason Training

The purpose of the Benefits Liaison is to connect Iowans who are Social Security beneficiaries with information and resources. This role has a benefit to all Iowans with disabilities, and will have the impact of improved employment outcomes for agen-cies that provide the services for them. By becoming a part of this enhanced statewide network, citizens and professionals will improve the overall health of their communities and services through including more people with disabilities in employment.

When: Friday, Sept 21, 2012 9:00 a.m. - 4:00 p.m. Where: IHCC Ottumwa Campus, VCTC Room 125Credit: 3.0 CEH’s for social workTuition: $TBDCourse No.: 13/YR*REL*4097*700

District F Nursing Leadership Conference

IHCC is partnering with the IHA District F Nurse Leaders and Educators Group to host the second biennial Nursing Leader-ship Conference. This year’s conference will include an in-triguing morning ketnote on Horizontal Violence featuring Deb McKittrick, JD, DesMoines Area Community College, as well as a motivating afternoon keynote on customer service from well known nursing presenter, Faith Roberts entitled, “It’s in Every One of Us”. Breakout sessions between the keynotes will in-clude various topics of interest to current and future nurse lead-ers.

Registrations for this conference are NOT being taken by Indian Hills but RHEP will have electronic conference brochures avail-able and can email the brochure which includes a registration form to anyone who needs one. Please contact Lori Reeves at [email protected].

When: Friday, Sept 14, 2012 8:15 a.m.- 2:30 p.m. Where: IHCC Ottumwa Campus, RHEC Room 108Credit: 5.3 Contact Hours for nursingTuition: $35.00 before 8/31/12, $45.00 after or at the doorCourse No.: 13/YR*REL*4262*700

With a minimum of eight students, Depen-dent Adult and/or Child Abuse classes may be brought to your facility. Please call four

weeks in advance of your needs. Call: 1-800-726-2585, ext. 5183

Dependent Adult/Child Abuse - Mandatory Reporter

These courses meets the Iowa Code 235.B.16(5) requirements for foster parents, social workers, nurses, nurse aids, EMS and other health care providers as mandatory reporters of adult/child abuse. Individuals may attend Dependent Adult Abuse, Child Abuse or both.

For all courses:Credit 2.0 CEH’s/CH’sTuition: $20.00 each Adult OR Child Abuse

When: Thursday, July 12, 2012 Adult: 5 - 7 p.m., Child: 7 - 9 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Course No.: 13/YR*REL*4506*700 (Dep. Adult Abuse) 13/YR*REL*4507*700 (Child Abuse)

When: Thursday, July 26, 2012 Adult: 8 - 10 a.m., Child: 10 a.m. - 12p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Course No.: 13/YR*REL*4506*801 (Dep. Adult Abuse) 13/YR*REL*4507*801 (Child Abuse)

When: Thursday, August 9, 2012 Adult: 5 - 7 p.m., Child: 7 - 9 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Course No.: 13/YR*REL*4506*701 (Dep. Adult Abuse) 13/YR*REL*4507*701 (Child Abuse)

When: Thursday, August 16, 2012 Adult: 8 - 10 a.m., Child: 10 a.m. - 12 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Course No.: 13/YR*REL*4506*802 (Dep. Adult Abuse) 13/YR*REL*4507*802 (Child Abuse)

When: Thursday, September 13, 2012 Adult: 5 - 7 p.m., Child: 7 - 9 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Course No.: 13/YR*REL*4506*702 (Dep. Adult Abuse) 13/YR*REL*4507*702 (Child Abuse)

When: Thursday, September 27, 2012 Adult: 8 - 10 a.m., Child: 10 a.m. - 12p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Course No.: 13/YR*REL*4506*803 (Dep. Adult Abuse) 13/YR*REL*4507*803 (Child Abuse)

Mandatory Reporter - Abuse

All evening Mandatory Reporter Courses will now be held in the VCTC, Room 125. Day-

time courses remain in RHEC 118.

1-800-726-2585, ext. 5281

Senior Lunch & LearnsAlthough open to anyone, this series of Lunch & Learn classes will feature subjects of interest, related to health, specifically for our senior population. Re-licensure continuing education will not be offered for these courses. All Senior Lunch & Learn classes will be held in the back of the IHCC cafeteria in the Arts and Sciences Complex. Participants are encouraged to use the Grandview entrance and park on the belt drive adjacent to the library (former chapel) for the most convenient parking and shortest walk.

“Tools & Gadgets to Live Independently” with Tracy keninger, Director, Rural Solutions/Assistive Technology, Easter Seals of Iowa

When: Friday, July 13, 2012 11:30 a.m. - 2:00 p.m. (lunch at 11:30 p.m.)Where: IHCC Ottumwa Campus, Food Service CafeteriaCost: $6.00 (includes lunch)

“Scam Alert- It Looks to Good to be True” with Jim Karp, Iow State Patrol

When: Friday, August 10, 2012 11:30 a.m. - 2:00 p.m. (lunch at 11:30 p.m.)Where: IHCC Ottumwa Campus, Food Service CafeteriaCost: $6.00 (includes lunch)

“Aging Changes in the Senses- Are You Talking to Me? What’s That Smell? with Kim Browm, ARNP

When: Friday, September 14, 2012 11:30 a.m. - 2:00 p.m. (lunch at 11:30 p.m.)Where: IHCC Ottumwa Campus, Food Service CafeteriaCost: $6.00 (includes lunch)

“Keep That Needle Sharp! Adult Immunizations” with Lynelle Diers, RN, Wapello Co. Public HealthWhen: Friday, October 12, 2012 11:30 a.m. - 2:00 p.m. (lunch at 11:30 p.m.)Where: IHCC Ottumwa Campus, Food Service CafeteriaCost: $6.00 (includes lunch)

“Singing the Blues- Down with Depression” with Dr. Kathy Murray

When: Friday, May 11, 2012 11:30 a.m. - 2:00 p.m. (lunch at 11:30 p.m.)Where: IHCC Ottumwa Campus, Food Service CafeteriaCost: $6.00 (includes lunch)

“Music with the OHS Meistersingers” with Dennis Vasconez, Director of Music at Ottumwa High SchoolWhen: Friday, May 11, 2012 11:30 a.m. - 2:00 p.m. (lunch at 11:30 p.m.)Where: IHCC Ottumwa Campus, Food Service CafeteriaCost: $6.00 (includes lunch)

When: Thursday, October 5, 2012 Adult: 5 - 7 p.m., Child: 7 - 9 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Course No.: 13/YR*REL*4506*703 (Dep. Adult Abuse) 13/YR*REL*4507*703 (Child Abuse)

When: Thursday, October 25, 2012 Adult: 8 - 10 a.m., Child: 10 a.m. - 12 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Course No.: 13/YR*REL*4506*804 (Dep. Adult Abuse) 13/YR*REL*4507*804 (Child Abuse)

When: Thursday, November 8, 2012 Adult: 5 - 7 p.m., Child: 7 - 9 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Course No.: 13/YR*REL*4506*704 (Dep. Adult Abuse) 13/YR*REL*4507*704 (Child Abuse)

When: Thursday, November 15, 2012 Adult: 8 - 10 a.m., Child: 10 a.m. - 12 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Course No.: 13/YR*REL*4506*805(Dep. Adult Abuse) 13/YR*REL*4507*805 (Child Abuse)

When: Thursday, December 13, 2012 Adult: 5 - 7 p.m., Child: 7 - 9 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Course No.: 13/YR*REL*4506*704 (Dep. Adult Abuse) 13/YR*REL*4507*704 (Child Abuse)

When: Thursday, December 13, 2012 Adult: 8 - 10 a.m., Child: 10 a.m. - 12 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Course No.: 13/YR*REL*4506*806(Dep. Adult Abuse) 13/YR*REL*4507*806 (Child Abuse)

Mandatory Reporter - Abuse

The Senior Lunch & Learn Program has received a generous donation from the Wapello County

Area Agency on Aging Board! Please the story on the back cover (page 24) for more information.



Fire Fighter Courses and Continuing Education

Rural Emergency Services Training Center

The new Indian Hills Rural Emergency Services Training Center (RESTC) lo-cated at the North IHCC campus, is now open and available for training use. EMS, Fire Departments and Law Enforcement groups as well as private business/in-dustry that has specialized rescue teams may request use of the center. It includes the multi-story, multi-use training facility as well as the Education Center with 2 classrooms and showers.

A training calendar may be viewed at: www.indianhills.edu/rhep and scroll down to “Rural Emergency Services Training Center. Click on “RESTC Scheduling Calendar”.

Please contact Lori Reeves at 641-683-5337 or email [email protected] for more information on how to sched-ule use of the facility or for more information on upcoming open enrollment classes.

Interior Fire Attack

These classes are being funded by the Iowa Volunteer Fire Fighter Training Fund. All classes have a minimum and maxi-mum enrollment and will fill on a first-come first serve basis. We ask that departments limit sending no more than 5 mem-bers to any one class. It is EXTREMELY important that if in-dividuals pre-registered for the class cannot attend, they must notify at least 3 business days before the class. If they do not a $75 non-cancelation fee will be applied per participant who does not show. If an individual cannot attend but does not find out within the 3 day time limit, someone else may be sent in their place to avoid the $75 fee.

Each department sending individuals must complete a “Super-vising Officer’s Student Approval Documentation” form. It must be completed and returned prior to or at the beginning of class or without it, participants will not be allowed to participate in the hands on portion of the class. This form can be found on the RHEP website: www.indianhills.edu/rhep.

In this course students will gain information and practice the skills required to enter structures at both ground level and with ladders at upper levels. The basic principles of firefighter safety, fire behavior, thermal layering, flame rollover, back draft, ventilation, ladders, and fire streams will be reviewed in the classroom. Classroom will be in the RESTC Education Center and hands on skills will occur at the RESTC training facility.

Prerequisites: FF I or equivalent training to meet FF I require-ments for Safety, Fire behavior, Personal protective equip-ment, Ladders, Fire hose, appliances & streams, Overhaul, Water supply, Ventilation and Forcible entry

Requirements: Full NFPA compliant Personal Protective Equip-ment and SCBA with spare cylinder

(These classes are tentative based on availability of new fiscal year funding of the Volunteer FF Training Fund)

When: Sunday, September 30, 2012 8:00 a.m. - 3:00 p.m. (sack lunch provided)Where: IHCC North Campus, RESTCCredit: 6.0 contact hours for firefightersTuition: FREE (paid for by Iowa Volunteer FF Training

Fund)Other Fee: $7.00 (Sack lunch & bottled water for rehab) Course No.: 13/YR*REL*1054*700

When: Saturday, October 20, 2012 8:00 a.m. - 3:00 p.m. (sack lunch provided)Where: IHCC North Campus, RESTCCredit: 6.0 contact hours for firefightersTuition: FREE (paid for by Iowa Volunteer FF Training


When: Sunday, June 10, 2012 8:00 a.m. - 3:00 p.m. (sack lunch provided)Where: IHCC North Campus, RESTCCredit: 6.0 contact hours for firefightersTuition: FREE (paid for by Iowa Volunteer FF Training


Step Incline Rope Rescue

In this introductory course participants will to learn rope safety and equipment capabilities in steep incline rescue situations. Content will include the use of knots and anchor points and techniques to raise and lower victims with a main line and be-lay system and use of a stokes basket. Students will also learn to use a ropes system to safely permit stabilization and accent and decent of equipment and personnel on a steep slope.Requirements: Gloves, harness and rescue helmets.

When: Sunday, September 16, 2012 8:00 a.m. - 3:30 p.m. (sack lunch provided)Where: IHCC North Campus, RESTCCredit: 6.0 contact hours for firefightersTuition: $50Other Fee: $7.00 (Sack lunch & bottled water during training) Course No.: 13/YR*REL*1054*703

High Angle Rope Rescue

In this course participants learn basic ropes safety and equip-ment capabilities when using ropes systems in a high angle rescue. Students will learn to use a ropes system to safely permit stabilization, ascent and decent of victims, equip-ment, and personnel in a high angle rescue situation. Course personnel will also learn to use ropes to rappel and raise and lower victims and equipment off a rescue tower.Prerequisites: **Students must take the Steep Incline Rescue class on Saturday to be eligible to enroll in this class.**Requirements: Gloves, boots with ankle support and climbing helmets.

When: Saturday & Sunday, September 6-7, 2012 8:00 a.m. - 3:30 p.m. (sack lunch provided)Where: IHCC North Campus, RESTCCredit: 12.0 contact hours for firefightersTuition: $80Other Fee: $7.00 (Sack lunch & bottled water during training) Course No.: 13/YR*REL*1054*703

1-800-726-2585, ext. 5281

EMS Courses

Arrangements may be made to offer Medical Responder, EMT or AEMT classes within a community or business provided there is a minimum number of students interested. For more information on these classes or to bring an EMS certification course to your community or location, contact Cindy Hewitt at (641) 683-5122 or (800) 726-2585, ext. 5122 or email:[email protected].

EMS Instructor Update

This update is required once each recertification period for EMS instructors who wish to maintain their instructor (T) endorse-ment.

When: Tuesday, October 16, 2012 7:00 p.m. - 9:00 p.m. Where: IHCC Ottumwa Campus, VCTCRoom: CC7Credit: 2.0 CEH’s for EMS (FE) Tuition: $10.00Course No.: 12/YR*HEA*3100*776

EMS Evaluator Workshop

This workshop is required for individuals who wish to become evaluators at EMS practical examination testing period. Current evaluators are not required to attend this class more than once.

When: Tuesday, October 23, 2012 7:00 p.m. - 9:00 p.m. Where: IHCC Ottumwa Campus, VCTCRoom: CC7Credit: 2.0 CEH’s for EMS (FE) Tuition: $10.00Course No.: 12/YR*HEA*3100*777

EMS Initial Certification Courses

RHEP has EMS continuing education topics ready to bring to your location. Wether you need 1 hour filled or 8,

give us a call and we can meet your needs. We have a menu of topics for you to pick from or we can develop a topic at your request 641-683-5337 or

email [email protected].

Fire Fighter I Fire Fighter II Pumper Driver/Operation

Indian Hills can offer any of the above three classes at local fire departments through the volunteer firefighter’s training fund with no tuition charges to participants. Classes require a mini-mum of 12 students to qualify for use of the fund but participants from several departments may be grouped together to meet the minimum. Fire departments are responsible for supplying the appropriate textbook (as applicable) which may be purchased from the FSTB at a discount. Fire departments may maintain books to use on a loan out basis rather than purchasing them every time a course is conducted.

Properly qualified* instructors from your department can be utilized to teach the course(s) or Indian Hills can provide an instructor acceptable to the department. (*Instructors must be certified at the level of course they are teaching and have com-pleted Fire Instructor training and must provide proof of both.)

Arrangements may be made with the FSTB to schedule certifi-

Fire Fighter Courses and Continuing Education

Check out the RESTC Training calendar.

Go to:www.indianhills.edu/RHEP and scroll down to

“Rural Emergency Services Training Center”


cation testing at the end of the course (if desired).

For more information about these courses or to schedule a class contact Lori Reeves at (800) 726-2585, ext. 5337 or (641) 683-5337 or email [email protected].

EMS Transition Courses

FR to EMR Transition

This session will cover all objectives in the FR to EMR Training Requirements section of the FR to EMR transi-tion forms. FR’s must transition prior to their renewal date on either Sept. 30, 2013 or 2014.

When: Thursday, September 13, 2012 6:00 p.m. - 10:00 p.m.Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 4.5 Contact hours for nursing, 4.5 CEH’s for

EMS (FE) Tuition: $25.00Course No.: 13/YR*REL*4815*700

EMT-B to EMT Transition

This session will cover all objectives in the EMT-B to EMT Training Requirements section of the EMT-B to EMT tran-sition forms. EMT-B’s must transition prior to their renewal date on either March 31, 2014 or 2015.

When: Saturday, November 10, 2012 8:00 a.m. - 3:00 p.m. (hour for lunch on your

own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 6.5 Contact hours for nursing, 6.5 CEH’s for


Iowa PS to National Paramedic Transition

This session will cover all objectives in the Iowa PS to National Paramedic Training Requirements section of the Iowa PS to National Paramedic transition forms. PS’s must transition prior to their renewal date on either March 31, 2014 or 2015.

When: Friday, December 7, 2012 8:00 a.m. - 5:00 p.m. (hour for lunch on your

own)Where: IHCC Ottumwa Campus, VCTCRoom: 125Credit: 8.5 Contact hours for nursing, 8.5 CEH’s for


Iowa EMT-I to AEMT Transition

The classes necessary to cover the Iowa EMT-I to AEMT transition objectives will be offered on Thursday evenings, 6-10:00 pm, January 17 through March 28, 2013. Skills practice will be 5-10:00 pm on April 4 with skills check-offs 6-10:00 pm April 11. (See additional information in the table above). All classes will meet in the VCTC Room 125. Individuals may attend what ever portionof the class-es they need to meet transition objectives.

This series of classes is enrollment dependent so please pre-register before IHCC leaves for winter break on De-cember 20, 2012. If there is insufficient enrollment the classes will be cancelled and the series will be offered again either fall 2013 or spring 2014. Iowa EMT-I’s must transition by March 31, 2016 or drop back to EMT certi-fication.

To pre-register call 1-800-726-2585, ext. 5281 or 641-683-5281.


These classes are in no way required as EMS providers may meet transition training requirements through previous training, previous continuing education courses or on the job training. These classes are being offered for people who have not met the training require-ments or as a convenience for individuals who wish to receive this training while earning the continuing education hours they would nor-mally need to renew their certification anyway. Please mark these dates on your calender.

EMS Transition Courses Dates Day Times CostFR to EMR September 13, 2012 Thursday 6:00 p.m. - 10:00 p.m. $25

EMT-B to EMT November 10, 2012 Saturday 8:00 a.m. - 3:00 p.m. $35

IA PS to National Paramedic December 7, 2012 Friday 8:00 a.m. - 5:00 p.m. $50

IA EMT-I to AEMT-Module RxJanuary 17, 24, 31,

February 7, 14, 2013Thursdays 6:00 p.m. - 10:00 p.m. $150

IA EMT-I to AEMT-Module 2 - Medical February 21, 28, March 7, 14, 2013 Thursdays 6:00 p.m. - 10:00 p.m. $100

IA EMT-I to AEMT-Module 3 - Trauma March 21, 2013 Thursday 6:00 p.m. - 10:00 p.m. $25

IA EMT-I to AEMT-Module 4 - Misc. Topics March 28, 2013 Thursday 6:00 p.m. - 10:00 p.m. $25

IA EMT-I to AEMT-Skills Practice April 4, 2013 Thursday 5:00 p.m. - 10:00 p.m. $75

IA EMT-I to AEMT-Skills Verification April 11, 2013 Thursday 6:00 p.m. - 10:00 p.m. $75

Specific transition requirements can be found on the EMS Bureau website by going to www.idph.state.ia.us/ems/ and clicking on the “Transition” link in the blue bar at the top of the page and then the appropriate EMS level on the left of the page.

IHCC’s FR to EMR and EMT-B to EMTTransition programs can be brought to your service or

department’s location. Call 641-683-5337 or

email [email protected] for more information or to make arrangements to

host these programs.

1-800-726-2585, ext. 5281

For more information on any of the classes listed in this brochure or information about similar classes or topics, please contact the appropriate individual below.

Continuing Education for all health-relatedprofessionsincluding EMS, Law Enforcement and all

fire trainingLori ReevesAHEC Director/RHEP Department Chair(641) 683-5337 or 1-800-726-2585, ext. 5337 [email protected]

Sandy BertoRHEP Program Assistant(641) 683-5183 or 1-800-726-2585, ext. [email protected]

Diana HarnessRHEP Program Assistant(641) 683-5205 or 1-800-726-2585, ext. 5205 [email protected]

Course RegistrationAdministrative Assistant(641) 683-5281 or 1-800-726-2585, ext. 5281

AHA Training Center - CPR, First AidDiana HarnessTraining Center Coordinator(641) 683-5205 or 1-800-726-2585, ext. 5205 [email protected]

Certified Nurse Aid, Medication Manager, Activity Coordinator, or other short-term health-related

programsScott JohnsonCoordinator, Nurse Aid and Related Programs641-683-5217 or 1-800-726-2585, ext 5217 [email protected]

Initial EMS Licensure ClassesCindy HewittEMS Program Coordinator641-683-5122 or 1-800-726-2585, ext 5122 [email protected]

For More Information

Course Listings

To see an on-line listing of all RHEP classes go to www.indianhills.edu/RHEP, scroll down to “Course Offerings” and click the appropriate profession. Click on a course to bring up the course flier with all course information.

Important Information

Check your course location! Many of RHEP’s classes will now be held in

the VCTC, Room 125

On-Line Registration

On-line Registration and payment is now available for course’s whose course number begins with “13/YR”

To register on-line for a “13/YR” class:1) Go to the Indian Hills website: www.indianhills.edu2) Select “Web Advisor” under “quick Links” on the left of the page3) Click on “Continuing Education” in the gold box on the right4) Click on “Register and Pay for a Continuation Educa-tion Class” 5) Type in the course number if known, or use one of the other listed criteria to search for a class 6) Click on the class to learn more about it (or)7) Check the class to begin the registration process Payment via credit card is required at the time of pre-registraion when registering on-line.


CNA & Short Term Programs

* Indian Hills’ fall tuition rates had not been set at the time of publication of this brochure. Tuition for the classes on these pages will be based on new fall tuition rates. The tuition listed below reflects tuition rates for the 2011-2012 academic year but are listed to give an idea of cost. 2012-2013 tuition rates will likely be $5-10/credit hour more than tuition listed below. Other fees are expected to remain the same.

Nursing Essentials I / Nurse Aide (CNA)

This course introduces the student to the scientific knowledge, technical skills, and communication techniques, as specified by OBRA, to function as an accountable member of the health care team. Theory, laboratory practice, and clinical experience will be incorporated to prepare the student to address the patient’s biopsychosocial and spiritual needs.

Prerequisites: Physical with two-step TB testing (PPD) prior to course start. Criminal background check required at time of pre-registration for course.

This 3 credit course consists of: Nursing Essentials I ($411.00*), Other Fees ($15.00), Dependant Adult/Child Abuse ($40.00), and OBRA Skills Registry Exam ($75.00) and OBRA Written Registry Exam ($45.00). Background Check ($20.00)- separate check made out to IHCC prior to class.) Nursing Essentials I is billed for a total of $606.00* for in-state students (for out-of-state students please call for the cost).

Background check ($20 charge)- students wishing to enroll in the CNA program must turn in a completed background check form (with non-refundable $20 fee) no more than 30 days prior to course start and a minimum of 1 week prior to class start. Students who have not submitted a background check form a minimum of 1 week prior to class will not be allowed to start the course. Any background check more than 30 days old is not valid for the CNA program and will need to be repeated at the $20 fee.

Physical examination with 2-step TB Testing- a completed physical examination form must be turned in on or before the first day of class. Students without completed forms will not be allowed to start the class.

Payment- Payment for the CNA class is due no later than the first day of class. Students without full payment will not be allowed to start the course. Students whose course is being paid for by a third party must bring a letter no later than the first day of class from that party indicating their agreement to pay for the class for that student.

Background check forms and physical examination forms:1. may be picked up at the Rural Health Education

Center on the IHCC campus2. are available for download at: www.indianhills.edu/

RHEP under “Certificate Programs”3. may be received via mail by calling 1-800-726-2585

ext. 5281 or 641-683-5281.

When: Monday - Thursday, July 9-25, 2012Class Time: 7:45 a.m. - 3:15 p.m. (class-first seven days)Clinical: 6:30 a.m.- 2:45 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Tuition: See paragraph above for costCourse No.: 12/CU*PNN*147*81

When: Monday - Thursday, July 30- Aug. 15, 2012Class Time: 7:45 a.m. - 3:15 p.m. (class-first seven days)Clinical: 6:30 a.m.- 2:45 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Tuition: See paragraph above for costCourse No.: 12/CU*PNN*147*82

When: Monday - Thursday, Sept. 9-26, 2012Class Time: 7:45 a.m. - 3:15 p.m. (class-first seven days)Clinical: 6:30 a.m.- 2:45 p.m.Where: IHCC Ottumwa Campus, RHEC Room 11818Tuition: See paragraph above for costCourse No.: 12/CF*PNN*147*80

When: Monday - Thursday, Oct. 8-24, 2012Class Time: 7:45 a.m. - 3:15 p.m. (class-first seven days)Clinical: 6:30 a.m.- 2:45 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Tuition: See paragraph above for costCourse No.: 12/CF*PNN*147*81

When: Monday - Thursday, Nov. 26- Dec. 12, 2012Class Time: 7:45 a.m. - 3:15 p.m. (class-first seven days)Clinical: 6:30 a.m.- 2:45 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Tuition: See paragraph above for costCourse No.: 12/CW*PNN*147*80

OBRA Registry Exams

OBRA written examinations are computerized and will be administered on an individual basis. Individuals may schedule an appointment to take the exam by calling the testing center at 641-683-5142 or 1-800-726-2585, ext. 5142. Candidates must show a photo ID to test. Examination fee: $45.00. Once testing is scheduled, indivudals must pay the testing fee in RHEP offices in the VCTC. This may be done Mon.-Thur 7:30 am-5:45pm. Test fees must be paid for before testing and a receipt provided to the testing center.

OBRA Skills Registry ExamOBRA skills examinations will be completed on the IHCC Ottumwa Campus in the Rural Health Education Center nursing lab, rooms 17-18. Examinations may be scheduled by calling 1-800-726-2585, ext 5281 or 641-683-5281

OBRA Skills Registry ExamExamination fee: $75.00. Testing fee must be paid when pre-registering for the course. No walk-ins will be allowed.

Examination Dates: (Fridays)July 6 July 27 Aug 17Sept 7 Sept 28 Oct 12Oct 26 Nov 16 Dec 14

For additional information on the following courses, please contact Scott Johnson at 641-683-5217 or 1-800-726-2585, ext. 5217 or e-mail [email protected].


Medication Manager

This course is designed to prepare individuals to safely administer non-parenteral medications in a fifteen bed or less residential facility, child care facility, or a supervised living apartment. Emphasis is placed on the safe administration of medications from a prescription bottle and observation of obvious medication reactions. Prerequisites: None.

When: Monday - Wednesday, July 30-Aug. 1, 2012

9:00 a.m. - 3:00 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $137.00* Other Fee: $10.00Course No.: 12/CU*HSC*149*82

When: Monday - Wednesday, Aug. 27-29, 2012 9:00 a.m. - 3:00 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Tuition: $137.00*Other Fee: $10.00Course No.: 12/CF*HSC*149*80

When: Monday - Wednesday, Sept. 24-26, 2012 9:00 a.m. - 3:00 p.m.

Where: IHCC Ottumwa Campus, VCTC 125Tuition: $137.00* Other Fee: $10.00Course No.: 12/CF*HSC*149*81

When: Monday - Wednesday, Oct. 29-31, 2012 9:00 a.m. - 3:00 p.m.Where: IHCC Ottumwa Campus, VCTC 125Tuition: $137.00* Other Fee: $10.00Course No.: 12/CF*HSC*149*82

When: Monday - Wednesday, Nov. 19-21, 2012 9:00 a.m. - 3:00 p.m.

Where: IHCC Ottumwa Campus, RHEC Room 118Tuition: $137.00* Other Fee: $10.00Course No.:12/CW*HSC*149*80

When: Monday - Wednesday, Dec. 17-19, 2012 9:00 a.m. - 3:00 p.m.Where: IHCC Ottumwa Campus, RHEC Room 118Tuition: $137.00* Other Fee: $10.00Course No.: 12/CW*HSC*149*81

CNA..., Cont.

Activity Coordinator

This course prepares the student to work in a variety of care facilities and centers. The course presents the necessary knowledge and skills to determine facility and resident needs through the development of activity programs. The course meets federal and state requirements. A background check is required at the time of course registration.

When: Fridays, July 27-Sept. 28, 2012 8:00 a.m. - 4:30 p.m. Where: IHCC Ottumwa Campus, RHECRoom: 118Tuition: $411.00* Other Fee: $20 Background CheckCourse No.: 12/CU*HSC*184*80

1-800-726-2585, ext. 5281

Call 1-800-726-2585 ext. 5281 or 641-683-5281 to pre-register for any of

these classes.

Direct Care Conference

Friday October 5, 2012RHEC, Room

9am-12pm or 1pm-4pm$25

“Guided Imagery”Help yourself as well as your clients by

learning to use guided imagery to relax

and reduce stress.

See page 7 for more information.



Heartsaver Pediatric First Aid

Heartsaver Pediatric First Aid course teaches rescuers to effectively recognize and treat pediatric emergencies in the critical first minutes until emergency medical services personnel arrive. The course provides a complete health and safety training solution for first aid. AHA course completion card issued on successful completion. **

When: Tuesday October 2, 2012 5:30 - 8:30 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $26.00Other Fee: $4.00 Course No.: 13/YR*HEA*2007*C01

When: Tuesday, December 4, 2012 5:30 - 8:30 p.m.Where: IHCC Ottumwa Campus, VCTC 125Tuition: $26.00Other Fee: $4.00 Course No.: 13/YR*HEA*2007*C02

The American Heart Association strongly promotes knowledge and proficiency in BLS, ACLS and PALS, and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsorship by the American Heart Association, and any fees charged for such a course do not represent income to the Association.

For further information or to schedule a class for your business/facility contact Diana Harness at: 641-683-5205 or [email protected]

Heartsaver CPR/AED: Adult/Child/Infant

Heartsaver adult, child, and infant CPR teaches lay res-cuers how to recognize and treat life-threatening emer-gencies, including cardiac arrest and choking for adult, child and infant victims. Students also learn to recognize the warning signs of heart attack and stroke in adult and breathing difficulties in children. This course teaches res-cue breathing with and without the use of barrier devices. This course will incorporate adult, child and infant CPR. AHA course completion card issued on successful com-pletion of skills evaluation.**

When: Tuesday, July 17, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, RHEC Room 109Tuition: $26.00Other Fee: $4.00Course No.: 13/YR*HEA*1010*C01

When: Tuesday, Sept. 11, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125 Tuition: $26.00Other Fee: $4.00Course No.: 13/YR*HEA*1010*C02

CPR & First Aid

When: Tuesday, October 16, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tution: $26.00Other Fee: $4.00Course No.: 13/YR*HEA*1010*C03

When: Tuesday, November, 27, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $26.00Other Fee: $4.00Course No.: 13/YR*HEA*1010*C04

BLS Healthcare Provider Renewal

This course is designed to renew healthcare providers in the skills of CPR, AED, and FBAO for victims of all ages. It is intended for participants who have completed the Healthcare Provider Initial class in the past 2 years and who provide care to patients in a wide variety of settings both in and out of hospital. AHA course completion card issued on successful completion of skills evaluation.**

When: Tuesday, July 24, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, RHEC Room 109Tuition: $36.00 Other Fee: $4.00 Course No.: 13/YR*HEA*1001*C23

When: Tuesday, August 14, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $36.00 Other Fee: $4.00 Course No.: 13/YR*HEA*1001*C24

When: Tuesday, September 25, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $36.00 Other Fee: $4.00 Course No.: 13/YR*HEA*1001*C25

When: Tuesday, October 23, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, RHEC Room 109Tuition: $36.00 Other Fee: $4.00 Course No.: 13/YR*HEA*1001*C26

When: Tuesday, November 13, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $36.00 Other Fee: $4.00 Course No.: 13/YR*HEA*1001*C27

All AHA Training Center classes will move to the VCTC, Room 125

beginning 8/1/12

1-800-726-2585, ext. 5281

When: Tuesday, December 11, 2012 5:30 - 9:30 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $36.00 Other Fee: $4.00 Course No.: 13/YR*HEA*1001*C28

BLS Healthcare Provider Instructor - Initial

This course is designed to certify participants to teach BLS according to standards set by the American Heart Association. Pre-requisite: current BLS Healthcare Pro-vider. Prospective students must also:

1) Bring completed instructor application/with recommendation of instructor potential,

2) Align with a Training Center prior to the class, 3) Have completed the American Heart Association

Core Instructor Course.An AHA instructor card will be issued upon successful completion of this course and successful course monitor-ing. Contact IHCC AHA Training Center Coordinator for more details at (641) 683-5205.

Pre-registration is required. Bring your own pocket mask.

When: August 3, 2012 8:30 a.m. - 4:00 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $ 55.00Other Fee: $ 25.00 AHA Instructor Core Course DVD (if

needed), $ 96.00 BLS Instructor Manual w/ Tool Kit OR

$33.00 BLS Instructor Manual w/o Tool Kit $ 25.00 Instructor Monitoring Fee $ 49.00 Heartsaver Instructor Manual $ 6.00 AHA Instructor Card (issued on

successful completion)Course No.: 13/YR*HEA*3500*C02

When: September 21, 2012 8:30 a.m. - 4:00 p.m.Where: IHCC Ottumwa Campus, VCTC Room 125Tuition: $ 55.00Other Fee: $ 25.00 AHA Instructor Core Course DVD (if

needed), $ 96.00 BLS Instructor Manual and Tool Kit

OR $33.00 BLS Instructor Manual w/o tool kit $ 25.00 Instructor Monitoring Fee $ 49.00 Heartsaver Instructor Manual $ 6.00 AHA Instructor Card (issued on

successful completion)Course No.: 13/YR*HEA*3500*C03

CPR & First Aid, Cont.

Infant, Child or Adult CPRPediatric or Adult First AidAED (Defibrillator) Training

Standard Precautions

Are you in need of any of these classes? With a minimum number of students, ar-

rangements can be made to bring them to your job site or office.

Call Diana Harness at 1-800-726-2585 ext. 5205 or 1-641-683-5205 or email

[email protected]

RHEP’s Vision

RHEP aspires to be recognized as an innovative and unique col-laboration of entities that provide healthcare and/or emergency ser-vices to the residents of southeast

Iowa

RHEP’s Mission

RHEP is a strategic educational resource for promoting and

supporting the health and safety of our area through educational

programs and initiatives.


Objectives:

Fibromyalgia This continuing education article is worth 1.0 contact hour for nurs-ing, or 1.0 CEH for EMS (OE) for participants who send $5 payment with the completed post-test to RHEP, and obtain a post test score of at least 80%. Submission dead-line is December 31, 2012.

Continuing Education Article

Fibromyalgia (FM or FMS) is a medical dis-order characterized by chronic widespread pain and allodynia, a heightened and pain-ful response to pressure.[1] It is an example of a diagnosis of exclusion. Fibromyalgia symptoms are not restricted to pain, lead-ing to the use of the alternative term fibro-myalgia syndrome for the condition. Other symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some pa-tients[2] may also report difficulty with swallowing,[3] bowel and bladder abnor-malities,[4] numbness and tingling,[5] and cognitive dysfunction.[6] Fibromyalgia is fre-quently comorbid with psychiatric conditions such as depression and anxiety and stress-related disorders such as posttraumatic stress disorder.[7][8] Not all people with fi-bromyalgia experience all associated symp-toms.[9] Fibromyalgia is estimated to affect 2–4% of the population,[7] with a female to male incidence ratio of approximately 9:1.[10] The term “fibromyalgia” derives from new Latin, fibro-, meaning “fibrous tissues”, Greek myo-, “muscle”, and Greek algos-, “pain”; thus the term literally means “muscle and connective tissue pain”)

The brains of fibromyalgia patients show structural and behavioral differences from those of healthy individuals, but it is unclear whether the brain anomalies cause fibro-myalgia symptoms or are the product of an unknown underlying common cause. Some research suggests that these brain anoma-lies may be the result of childhood stress, or prolonged or severe stress.[8]

Historically, fibromyalgia has been consid-ered either a musculoskeletal disease or neuropsychiatric condition. Although there is as yet no cure for fibromyalgia, some treatments have been shown by controlled clinical trials to effectively reduce symp-toms, including medications, behavioral interventions, patient education, and exer-

cise.[11][12][13][14][15][16] The most re-cent approach of a diagnosis of fibromyalgia involves pain index and a measure of key symptoms and severity.[17]

Fibromyalgia has been recognized as a di-agnosable disorder by the US National Insti-tutes of Health and the American College of Rheumatology.[18][19] Fibromyalgia, a cen-tral nervous system disorder, is described as a ‘central sensitisation syndrome’ caused by neurobiological abnormalities which act to produce physiological pain and cognitive impairments as well as neuro-psychological symptomatology.[20] Despite this, some health care providers do not consider fi-bromyalgia a disease because of a lack of abnormalities on physical examination and the absence of objective diagnostic tests.[21][22]

The defining symptoms of fibromyalgia are chronic, widespread pain, fatigue, and heightened pain in response to tactile pres-sure (allodynia). Other symptoms may in-clude tingling of the skin, prolonged muscle spasms, weakness in the limbs, nerve pain, muscle twitching, palpitations,[23] functional bowel disturbances,[3] and chronic sleep disturbances.[24]

Many patients experience cognitive dys-function[6] (known as “fibrofog”), which may be characterized by impaired con-centration,[25] problems with short[7][25] and long-term memory, short-term memory consolidation,[7] impaired speed of perfor-mance,[7][25] inability to multi-task, cogni-tive overload,[7][25] and diminished atten-tion span. Fibromyalgia is often associated

with anxiety and depressive symptoms.[7]

Other symptoms often attributed to fibromy-algia that may possibly be due to a comorbid disorder include myofascial pain syndrome, also referred to as chronic myofascial pain, diffuse non-dermatomal paresthesias, functional bowel disturbances and irritable bowel syndrome, genitourinary symptoms and interstitial cystitis, dermatological dis-orders, headaches, myoclonic twitches, and symptomatic hypoglycemia. Although fibro-myalgia is classified based on the presence of chronic widespread pain, pain may also be localized in areas such as the shoulders, neck, low back, hips, or other areas. Many sufferers also experience varying degrees of myofascial pain and have high rates of comorbid temporomandibular joint disorder. 20–30% of patients with rheumatoid arthri-tis and systemic lupus erythematosus may also have fibromyalgia.[26]

The cause of fibromyalgia is currently un-known. However, several hypotheses have been developed including “central sensitiza-tion”. This theory proposes that fibromyalgia patients have a lower threshold for pain be-cause of increased sensitivity in the brain to pain signals.[20]

There is evidence that genetic factors may play a role in the development of fibromyal-gia. For example, there is a high aggrega-tion of fibromyalgia in families.[27][28] Us-ing self-report of chronic widespread pain (CWP) as a surrogate marker for fibromyal-gia, the Swedish Twin Registry reports:[29][30] Monozygotic twins with CWP have a 15% chance that their twin has CWP Di-zygotic twins with CWP have a 7% chance that their twin has CWP.

Stress may be an important precipitating factor in the development of fibromyalgia.[38] Fibromyalgia is frequently comorbid with stress-related disorders such as chron-ic fatigue syndrome, posttraumatic stress disorder, irritable bowel syndrome and de-pression.[8] A systematic review found sig-nificant association between fibromyalgia and physical and sexual abuse in both child-hood and adulthood, although the quality of studies was poor.[39]

Two studies that employed single-voxel

Upon completion the participant will be able to:

- List common symptoms of fibromyalgia- Define diagnostic criteria for finbromyalgia- Identify factors thought to contribute to development of fibromyalgia- Overview fibrimyalgia teatment options

1-800-726-2585, ext. 5281

Continuing Education Article, Cont.magnetic resonance spectroscopy (1H-MRS) reported metabolic abnormalities within the hippocampal complex in patients with fibromyalgia. As the hippocampus plays crucial roles in maintenance of cog-nitive functions, sleep regulation, and pain perception, it was suggested that metabolic dysfunction of the hippocampus may be im-plicated in the appearance of these symp-toms.[40][41]

Other authors have proposed that, because exposure to stressful conditions can alter the function of the hypothalamic-pituitary-adrenal (HPA) axis, the development of fi-bromyalgia may stem from stress-induced disruption of the HPA axis.[42]

Dopamine dysfunction (hypodopaminergia)The “dopamine hypothesis of fibromyal-gia” proposes that the central abnormal-ity responsible for symptoms associated with fibromyalgia is a disruption of normal dopamine-related neurotransmission.[43] Insufficient dopamine in a part of the body is termed hypodopaminergia. Dopamine is a catecholamine neurotransmitter with roles in pain perception and natural analgesia. There is also strong evidence for a role of dopamine in restless leg syndrome,[44] which is a condition found frequently in pa-tients with fibromyalgia.[45] Some fibromy-algia patients responded in controlled trials to pramipexole, a dopamine agonist that se-lectively stimulates dopamine D2/D3 recep-tors and is used to treat both Parkinson’s disease and restless leg syndrome.[46]

In 1975, researchers hypothesized that se-rotonin, a neurotransmitter that regulates sleep patterns, mood, concentration and pain, could be involved in the pathophysiol-ogy of fibromyalgia-associated symptoms.[24] In 1992, decreased serotonin metabo-lites in patient blood samples[47] and ce-rebrospinal fluid were reported.[48] How-ever, selective serotonin reuptake inhibitors (SSRIs) have met with limited success in alleviating the symptoms of the disorder, while drugs with activity as mixed serotonin-norepinephrine reuptake inhibitors (SNRIs) have been more successful.[49] In con-trolled trials funded by Eli Lily, Duloxetine (Cymbalta), an SNRI originally used to treat depression and painful diabetic neuropathy, was demonstrated to relieve fibromyalgia symptoms in some women, however male subjects failed to improve significantly.[50] The Food and Drug Administration regula-tors approved the drug for the treatment of fibromyalgia in June 2008.[51] However, the relevance of dysregulated serotonin me-tabolism to pathophysiology is a matter of debate.[52] Complicating the analysis, one of the more effective types of medication for the treatment of the disorder (i.e. serotonin 5-HT3 antagonists) actually blocks some of

the effects of serotonin.[53]

There is strong evidence that major depression is associated with fibromyal-gia,[60] although the na-ture of the association is debated. A comprehensive review into the relationship between fibromyalgia and major depressive disorder (MDD) found substantial similarities in neuroendo-crine abnormalities, psy-chological characteristics, physical symptoms and treatments between fibro-myalgia and MDD, but currently available find-ings do not support the assumption that MDD and fibromyalgia refer to the same underlying construct or can be seen as sub-sidiaries of one disease concept.[61] Indeed, the sensation of pain has at least two dimensions: a sensory dimension which processes the magnitude and location of the pain, and an affective-motivational di-mension which processes the unpleasant-ness. Accordingly, a study that employed functional magnetic resonance imaging to evaluate brain responses to experimental pain among fibromyalgia patients found that depressive symptoms were associated with the magnitude of clinically-induced pain re-sponse specifically in areas of the brain that participate in affective pain processing, but not in areas involved in sensory processing which indicates that the amplification of the sensory dimension of pain in fibromyalgia occurs independently of mood or emotional processes.[62]

There is no single test that can fully diagnose fibromyalgia and there is debate over what should be considered essential diagnostic criteria and whether an objective diagnosis is possible. In most cases, patients with fi-bromyalgia symptoms may also have labo-ratory test results that appear normal and many of their symptoms may mimic those of other rheumatic conditions such as arthritis or osteoporosis. In general, most doctors di-agnose patients with a process called differ-ential diagnosis, which means that doctors consider all of the possible things that might be wrong with the patient based on the pa-tient’s symptoms, gender, age, geographic location, medical history and other factors. They then narrow down the diagnosis to the most likely one. The most widely accepted set of classification criteria for research pur-

poses was elaborated in 1990 by the Multi-center Criteria Committee of the American College of Rheumatology. These criteria, which are known informally as “the ACR 1990”, define fibromyalgia according to the presence of the following criteria:

A history of widespread pain lasting more than three months—affecting all four quadrants of the body, i.e., both sides, and above and below the waist.

Tender points—there are 18 des-ignated possible tender points (al-though a person with the disorder may feel pain in other areas as well). The patient must feel pain at 11 or more of these points for fibro-myalgia to be considered.[103]

The ACR criteria for classification of pa-tients were originally established as inclu-sion criteria for research purposes and were not intended for clinical diagnosis but have now become the de facto diagnostic criteria in the clinical setting. It should be noted that the number of tender points that may be ac-tive at any one time may vary with time and circumstance. A controversial study done by a legal team looking to prove their client’s disability based primarily on tender points and their widespread presence in non-liti-gious communities prompted the lead au-thor of the ACR criteria to now question the


Continuing Education Article, Cont.useful validity of tender points in diagnosis.[104] Since the ACR criteria were originally published, research with mechanical devic-es that exert defined pressure indicate that diagnosis of fibromyalgia cannot be done objectively by machine and require a phy-sician’s subjective estimate of how much pressure should be exerted.As with many other medically unexplained syndromes, there is no universally accepted treatment or cure for fibromyalgia, and treat-ment typically consists of symptom manage-ment. Developments in the understanding of the pathophysiology of the disorder have led to improvements in treatment, which include prescription medication, behavioral intervention, exercise, and alternative and complementary medicine. Indeed, integrat-ed treatment plans that incorporate medi-cation, patient education, aerobic exercise and cognitive-behavioral therapy have been shown to be effective in alleviating pain and other fibromyalgia-related symptoms.[11] In 2005, the American Pain Society produced comprehensive guidelines for patient evalu-ation and management.[105] More recently, the European League Against Rheumatism (EULAR) issued updated treatment guide-lines

There are three medications that have been approved by the FDA for treatment of fibro-myalgia. Pregabalin (Lyrica) was approved

in June 2007, duloxetine (Cymbalta) was approved in June 2008, and milnacipran (Salvella) was approved in January 2009.[109] Pregabalin and duloxetine have been shown to reduce pain in a substantial num-ber of patients with fibromyalgia, but there were others who didn’t benefit.[109] Place-bo-controlled trials involving a total of over 2000 patients have shown milnacipran to be significantly more effective than placebo in treating both pain and the broader syn-drome of fibromyalgia.[110][111]

A 2009 meta-analysis in the Journal of the American Medical Association concluded that antidepressants were “associated with improvements in pain, depression, fatigue, sleep disturbances, and health-related quality of life in patients with FMS.” [112] The authors also stated that the goal of antidepressants in fibromyalgia should be “possible symptom reduction”, and if used long term, their effects should be evaluated against side effects. Tricyclic antidepres-sants were the most effective against pain, fatigue, and sleep problems, but have many side effects due to interaction with adrener-gic, cholinergic or histaminergic receptors, and sodium channels. Selective serotonin reuptake inhibitors (SSRIs) and Serotonin-norepinephrine reuptake inhibitors (SNRIs) had lower side effects.

Tramadol, a centrally acting analgesic with atypical opioid and antidepressant-like ac-tivity, is moderately effective in treating fi-bromyalgia pain. Long-term effectiveness and tolerability are unknown.[113] Tramadol combined with paracetamol provides fast, lasting relief that is more effective than ei-ther drug alone. This combination therapy has demonstrated efficacy, safety and tol-erability for up to two years without the de-velopment of tolerance, in the treatment of chronic pain. It is as effective as codeine plus paracetamol but produces less sleepi-

ness and constipation, and it is free of the toxic effects associated with non-steroidal anti-in-flammatories.[114]

The anti-seizure drugs gabapentin (Neuron-tin)[115] and pregabalin (Lyrica) have been test-ed. Gabapentin is ap-proved for use in treat-ment of neuropathic pain but not fibromyalgia. Pregabalin, originally la-beled for the treatment of nerve pain suffered by diabetics, has been cleared by the US Food and Drug Administration for treatment of fibromy-

algia.[116] A randomized controlled trial of pregabalin 450 mg/day found that 6 patients is the number needed to treat for one pa-tient to have a 50% reduction in pain.[117] A Cochrane Database analysis of pregabalin use in chronic pain concluded that “A minor-ity of patients will have substantial benefit with pregabalin, and more will have moder-ate benefit. Many will have no or trivial ben-efit, or will discontinue because of adverse events.”[118] A meta-analysis of four trial of pregabalin in fibromyalgia found that for pa-tients who did respond to pregabalin, there

was a reduction in time off work >1 day per week.[119]

Dopamine agonists (e.g. pramipexole (Mi-rapex) and ropinirole (ReQuip)) resulted in some improvement in a minority of pa-tients,[46] but numerous side effects, includ-ing the onset of impulse control disorders like compulsive gambling and shopping, have led to concern about this approach.[120]

Cyclobenzaprine is a muscle relaxant medication used to relieve skeletal muscle spasms and associated pain in acute mus-culoskeletal conditions. It is the most well-studied drug for this application,[121] and it also has been used off-label for fibromyalgia treatment.[122]

Tizanidine is a muscle relaxant centrally act-ing α-2 adrenergic agonist. It is used to treat the spasms, cramping, and tightness of muscles caused by medical problems such as multiple sclerosis, spastic diplegia, back pain, or certain other injuries to the spine or central nervous system. It is also prescribed off-label for some symptoms of fibromyal-gia.[123] [124]

According to a 2004 review of fibromyalgia treatment studies, opioids (other than tra-madol) have not had randomized controlled trials, and “should be considered only after all other medicinal and nonmedicinal thera-pies have been exhausted.[113]” Despite a lack of clinical trials and the potential for addiction and abuse, opioids are widely used by fibromyalgia patients. An analysis of insurance claims by 52,000 fibromyalgia patients showed that 40% had received opioids in any given year (predominantly short-acting agents).[125] As of 2011, there is no evidence that opioids are of any ben-efit in fibromyalgia, and are not recom-mended as they can worsen mood, such as depression in fibromyalgia, have abuse and dependence potential as well as other side effects such as constipation and they may even with long-term use worsen pain in some people. Additionally opioids are not recommended as there are other treatments for which an evidence base of effectiveness and efficacy exists. Despite there being no evidence of benefit, people are still com-monly prescribed opioids for fibromyalgia.[20]

Investigational medications include can-nabinoids. Although not legal in all states, medical marijuana has provided relief from fibriomyalgia symptoms in some patient. Synthesis of specific chemials in cannabis my prove beneficial in treating fibromyalgia.

Exercise improves fitness and sleep and may reduce pain and fatigue in some peo-

1-800-726-2585, ext. 5281

Continuing Education Article, Cont.ple with fibromyalgia.[129][130] In particular, there is strong evidence that cardiovascular exercise is effective for some patients.[113] Long-term aquatic-based exercise has been proven beneficial as it combines cardiovas-cular exercise with resistance training.[131] However, due to the cold sensitivities of people with fibromyalgia syndrome, aquatic therapy must take place in a warm pool. Not only that, but the air temperature outside of the pool must also be heated to prevent fi-bromyalgia patients from getting chills and aches when out of the water. This involves a specialised pool facility, which makes this therapy more expensive and less acces-sible than regular swimming exercise.

Tai chi was studied in a small, single blinded randomized controlled trial, resulting in a relative benefit ratio of 2.0 on the Fibromy-algia Impact Questionnaire and a relative benefit increase of 100.0%. In populations similar to those in this study which had a rate of benefit as measured by the Fibromy-algia Impact Questionnaire of 40% without treatment, the number needed to treat is 2. [132]

In the majority of the literature on therapy options for fibromyalgia, an overwhelming amount of studies echo the same senti-ment: that the optimal intervention for fibro-myalgia would include a treatment pack-age, consisting of appropriate medications in combination with non-pharmacological treatments including physical exercise and cognitive behaviour therapy.[133][134][135][136][137][138][139][140][141][142][143] Unfortunately, although the majority of fibro-myalgia treatment reviews recommend this multi-treatment approach, very few actually study the interactive benefits of combining the therapy options, with many stating that ‘more research needs to be done.’ By add-ing parts of each of the three therapy op-tions (drug therapy, exercise, and cognitive-behavioural therapy), fibromyalgia patients and clinicians have the ability to create in-dividualised treatment packages that suit the patient’s particular needs. Because not everyone with fibromyalgia experiences the same co-morbidities and secondary symp-toms, it’s important to have treatment op-tions that are adaptive and personalized, not a ‘one size fits all’ treatment.

Patients with fibromyalgia have higher health care costs and utilization. A study of almost 20,000 Humana members enrolled in Medicare Advantage and commercial plans compared costs and medical utiliza-tions and found that persons with fibro-myalgia used twice as much pain-related medication as those without fibromyalgia. Furthermore, the use of medications and medical necessities increased markedly across many measures once diagnosis was

made.[144]

Although in itself neither degenerative nor fatal, the chronic pain of fibromyalgia is pervasive and persistent. Most fibromyal-gia patients report that their symptoms do not improve over time. An evaluation of 332 consecutive new fibromyalgia patients found that disease-related factors such as pain and psychological factors such as work status, helplessness, education, and coping ability had an independent and significant relationship to FM symptom severity and function.[145]

Fibromyalgia is seen in about 2% of the general population[146] and affects more females than males, with a ratio of 9:1 by ACR criteria.[147] It is most commonly di-agnosed in individuals between the ages of 20 and 50, though onset can occur in child-hood.

Fibromyalgia continues to be a disputed diagnosis. Many members of the medical community do not consider fibromyalgia a disease because of a lack of abnormalities on physical examination, and the absence of objective diagnostic tests.[21][22]

Several controversial issues exist with re-gard to fibromyalgia that range from ques-tions regarding the validity of the disorder as a clinical entity, to issues regarding primary pathophysiology and the potential existence of fibromyalgia subtypes.

According to Frederick Wolfe, lead author of the 1990 paper that first defined the ACR fibromyalgia classification criteria,”the large majority of physicians, sociologists, and medical historians”[21] are skeptical about the validity of fibromyalgia as a clinical entity.[159] Some call fibromyalgia a “non-disease”[22] and “an over-inclusive and ulti-mately meaningless label.”[160] Wolfe now questions the validity of fibromyalgia as a disease. He considers fibromyalgia a physi-cal response to stress, depression, and eco-nomic and social anxiety,[161] and believes the associated symptoms are a normal part of everyday life. In 2009, he wrote, “the ten-dency to respond with distress to physical and mental stressors is part of the human condition.”[162] Wolfe notes that, “oppo-nents of the fibromyalgia concept argue that, as it is a non-disease, we are legitimis-ing patients’ sickness behaviour by provid-ing a disease label.” [163]

In a study of 100 individuals identified as having fibromyalgia, physical functioning decreased slightly over time, and individuals who had been diagnosed earlier had larger numbers of reported symptoms and greater severity. However, there was also a statisti-

cally significant improvement in satisfaction with health following classification.[164] The authors of the study concluded that the ‘fi-bromyalgia label’ does not have a meaning-ful adverse effect on clinical outcome over the long term.

The validity of fibromyalgia as a unique clinical entity is also a matter of contention because “no discrete boundary separates syndromes such as FMS, chronic fatigue syndrome, irritable bowel syndrome, or chronic muscular headaches.”[113][165] Because of this considerable symptomatic overlap, some researchers have proposed that fibromyalgia and other syndromes with overlapping symptoms be classified as functional somatic syndromes for some pur-poses.[166]

Some researchers believe that differences in psychological and autonomic nervous system profiles among affected individuals may indicate the existence of fibromyalgia subtypes. A 2007 review divides individuals with fibromyalgia into four groups as well as “mixed types”:[157]

1.”extreme sensitivity to pain but no associated psychiatric conditions” (may respond to medications that block the 5-HT3 receptor)2.”fibromyalgia and comorbid, pain-related depression” (may respond to antidepressants)3.”depression with concomitant fi-bromyalgia syndrome” (may respond to antidepressants)4.”fibromyalgia due to somatization” (may respond to psychotherapy).

Other researchers have suggested that de-pression may be a result of coping with the disabling impacts of a, thus far, incurable disease.[167


Continuing Education Article

Post Test Questions

1. “Fibrofog” which can be experienced by fibromyalgia patients refers to:a. blurred or cloudy visionb. white skin patchesc. cognitive dysfunctiond. spacial disorientation

2. The “ACR 1990” criteria for classification of fibromyalgia include all BUT: a. Pain in 11 out of 18 “tender points b. Widespread pain lasting at least 3 monthsc. Pain in all 4 quadrants of the bodyd. A pre or co-existing diagnosis of major depression

3. The three FDA approved drug therapies for fibromyalgia include all BUT:a. Pregabalin (Lyrica)b. Duloxetine (Cymbalta)c. Gabapentin (Neurontin)d. Milnaciprin (Salvella)

4. Fibromyalgia is seen in significantly more females than in men.a. true b. false

5. A single blood test can confirm or rule out the diagnosis of fibromyalgia. a. true b. false

6. There is no universally accepted treatment or cure for fibromyalgiaa. true b. false

7. Opiods are recommended and useful in treating the pain of fibromyalgia. a. true b. false

8. There is evidence of a genetic link in the development of fibromyalgia.a. true b. false

9. Aerobic exercise has been found effective in the treatment of fibromyalgia.a. true b. false

10. Fibromyalgia is degenerative and worsens over time.a true b. false

Answer SheetTo receive 1.0 CH’s/CEH’s for nursing or EMS (OE) circle your answers to the questions above on this answer sheet, detach and mail to with $5.00 payment to: RHEP, Attn: Sandy Berto, 655 Indian Hills Dr., Bldg # 21, Ottumwa, IA 52501

Name: Address: City:

State: Zip: DOB: SSN or Student ID:

Nursing EMS (please mark) Acid Reflux Diseases

1. A B C D 2. A B C D 3. A B 4. A B 5. A B

6. A B 7. A B 8. A B 9. A B 10. A B

You must obtain a score of 80% on the post test to receive 1.0 Contact hour for nursing or 1.0 CEH for EMS (OE). $5.00 fee. Submission deadline: December 31, 2012.

SubmissionDeadlineDecember 31, 2012

1-800-726-2585, ext. 5281

On-line pre-registration with payment via credit card is now available on some RHEP classes. Any course having a course num-ber that begins with “12/YR” or “13/YR” is eligible for on-line pre-reg-istration. For other classes starting with “12/CS,” “12/CF,” or ‘12/CW” individuals must still call or email to pre-register. To register on-line for a “12/YR”

On-Line Pre-registration Now Available for Some RHEP Classes

RESTC Education Center Remodel is Complete

Remodeling of the old IHCC horticulture build-ing into the RESTC Education Center is complete. All that remains is arrival of desks and chairs which have been ordered.

The building ex-terior received new paint and new win-dows. The interior was completely gutted and rede-signed to allow for two classrooms, an

office, male and female locker rooms and storage. The Education Center was designed for use for classes also using the RESTC Training Facility but is open for use by any RHEP partner for any class or meeting.

Indian Hills Named Aspen Finalist Again

or “13/YR” class:1) go to the Indian Hills website: www.indianhills.edu2) Select “Web Advisor” under “quick Links” on the left of the page3) Click on “Continuing Educa-tion” in the gold box on the right4) Click on “Register and Pay for a Continuation Education Class”

5) Type in the course number if known, or use one of the other listed criteria to search for a class 6) Click on the class to learn more about it (or)7) Check the class to begin the registration process Payment via credit card is required at the time of pre-reg-istration when registering on-line.

For the second year in a row, Indian Hills Community College has been selected as one of the best commu-nity colleges in the nation. The Aspen Institute College Excellence Program has included Indian Hills in its list of the top 120 community colleges, challenging IHCC to compete for the $1 million funding for the Aspen Prize for Community College Excellence. The Aspen Institute identified the 120 community col-leges – 10 percent of all institutions – using a formula that assesses performance and improvement in four ar-eas: graduation rates, degrees awarded, student reten-tion rates and equity in student outcomes. The colleges will now compete for the prestigious honor following a year-long research process into how well their students learn, complete degrees and get jobs with competitive wages after graduating. “It’s a great honor for Indian Hills Community College to be recognized nationally for student success two years in a row by the prestigious Aspen Foundation,” said IHCC President Dr. Jim Lindenmayer. “There are many fine

IHCC Programs Receive Accreditation

community colleges in this country and to be selected as one of the best-performing institutions with regard to stu-dent success is a great testi-mony to our faculty and staff as well as our students.”“The success of our nation’s community colleges is more important than ever before,” said Aspen Institute’s Josh Wyner. “At a time when a col-lege degree is essential to en-tering the middle class, com-munity colleges like Indian Hills offer the most promising path to education and em-ployment for literally millions of Americans.”

Three of IHCC’s Health programs have recently re-ceived national accreditation. The Paramedic Special-ist program has received 5 year accreditation by the Commission on Accreditation of Allied Health Programs (CAAHEP). The Medical Laboratory Technician and Clinical Laboratory Assistant programs have also re-ceived 5 year accreditation from the National Accred-iting Agency for Clinical Laboratory Sciences (NAACLS). IHCC’s dental assistant program and occupational therapy assistant (OTA) programs have submitted self-studies and await accreditation site visits. After com-pletion of remodeling both these programs will have new classroom and lab spaces to show to the site visit teams.

Indian Hills Community CollegeRural Health Education Partnership655 Indian Hills Drive, Bldg # 21Ottumwa, IA 52501

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Senior Lunch & Learn Receives Funding

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The Rural Health Education Partnership at Indian Hills Community College is delighted to announce that the Wapello County Area Agency on Aging Board is sponsoring the monthly Senior Lunch and Learn program for the entire year of 2012. Through this very generous gift of $2400, RHEP is able to provide transportation at no charge to senior participants by the Ottumwa Transit Bus to and from the Ottumwa Housing Towers to IHCC. This gift will also enable the seniors to enjoy a nutritious lunch at each monthly event, without an increase in cost to seniors. A huge thank you is extended to the Wapello County Area Agency on Aging; the executive committee consisting of Rick Johnson, Lynelle Diers, and Leslie Docekal. Other board mem-

bers to include in this note of appreciation are Peg Amos, Orville Buckingham, Maxine Collins, Oran Derby, Sally Fite, Jerry Parker, Darlene Peta, Charles Reed, and Madeline Schertz.For information about the senior Lunch and Learn program, contact Sandy Berto at 683-5183 or email [email protected].

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