Pre-Hospital Provider Competencies

Transcription

1 Pre-Hospital Provider Competencies Topics Skillset A B C D E F G H Pass in BLS + AED Pass in ALS Wear correct PPE for incident Demonstrate understanding of scene safety Safety Scene Management Level of Care Provider Perform dynamic risk assessment of scene Consider casualty safety Perform dynamic risk assessment of casualties Communicate effectively with Emergency Services Basic knowledge of the capabilities of different Emergency Services Personnel Ability to use appropriate radio communications Awareness of triage Competence in triage seive Competence in triage sort & management skills for multiple casualties Ability to make decions on casualty dispersement Ability to incident command Demonstrate forensic awareness

2 Recognise life-threatening haemorrhage Effectively manage catastrophic limb bleed Catastrophic Bleed Spinal Airway Effectively manage catastrophic junctional bleed Able to apply direct pressure Able to apply indirect pressure Competent application of tourniquet Competent in use of haemostatic / packing Appreciate MOI high risk for spinal injury Appropriate C-spine management Put head in neutral alignment Inspect and clear airway Head tilt chin lift + neutral alignment Jaw thrust Postural airway management Use of suction Size and insert nasopharyngeal airway Size and Insert oropharyngeal airway Size and insert supraglottic airway device PALM Perform surgical airway Perform needle cricothyroidotomy in children Endotracheal tube insertion Competent to RSI assist

3 Identify if patient is breathing normally Correctly assess breathing rate, depth and quality Perform basic chest eamination (RV FLAPS WET) Identify life-threatening chest conditions Management of tension pneumothora Breathing Recognition of tension pneumothora development Finger thoracostomy Needle decompression Chest drain insertion Management of sucking chest wound Recognition of a sucking chest wound Application & management of occlusive chest dressings Management of flail chest Recognition of immediately life-threatening flail chest Splintage of immediately life-threatening flail chest Appropriate pain management to assist ventilation Management of cardiac tamponade Recognition of cardiac tamponade Thoracostomy Management of massive haemothora Recognition of massive haemothora/ internal chest bleeding Competent management of massive haemothora Understanding of enviro limitations of pulse oimetry, use if appropriate Ability to monitor & react to end tidal CO2 Administration of Oygen Safely configure an Oygen system for use Free-flow oygen (+ correct mask choice) Nebulisation Nebulisation with T-piece Oygen delivery via Bag-valve-mask Oygen delivery via mechanical ventilator (PPR) if available Use of epired air ventilation (mouth-to-mouth/to nose) Use of pocket-mask ventilation

4 Assess presence of circulation Measure pulse rate and rhythm Assess blood pressure Measure capillary refill time Circulation Assessment of heart sounds Use of pre-hospital imaging techniques Assessment of blood loss Perform haemorrhage control Apply direct pressure Elevation of limb Apply indirect pressure Wound packing Wound closure Splintage as a haemorrhage control method Use of haemostatic agents Application of windlass Use of appropriate medication for haemorrhage control Application of pelvic splintage Use of traction devices Attain intravascular access (IV/IO) Administration of appropriate IV fluids Ability to administer blood products (if available and appropriate) Application of appropriate wound dressings Ability to perform a twelve lead ECG Ability to interpret a twelve lead ECG

5 Assess AVPU Use Glasgow Coma Score Assess PERL Disability Eposure Casualty handling Obstetrics Identify indicators of underlying head injury Assessment of traumatic brain injury Perform a FASTest (acute stroke) Perform a more indepth neurological eamination Assess neurovascular status Assess Blood Glucose level with a glucometer Differentiate Cold from Hypothermia Differentiate heat ehaustion from Heat stroke Recognise possibility of and prevent hypothermia Recognise possibility of and prevent hyperthermia Assessment,treatment and casualty handling of patients eposed to etremes of temperature in an austere environment. Appropriate packaging of patient for evacuation Assist with transfer of patient Manage transfer of patient to appropriate evacuation device Ability to medically assist in safe etrication of a patient in an operational environment Ability to medically manage the safe etrication of a patient in an operational enviorn Ability to understand and make disposition decision Provide appropriate clinical handover to net echelon of care Casualty handling techniques (appropriate to level and environ) Ability to carry out cabcde appropriately in a pregnant woman Manage the complications of pregnancy Management of pregnancy-related bleeding Manage a normal delivery Manage the common complications of delivery Aware of the complications of rescue packaging and transport

6 Ability to carry-out Basic Life Support protocols on a child and infant Ability to provide basic resuscitation to a neonate Paediatrics Mental health Thermal injury Musculoskeletal injuries Knowledge of normal anatomy & physiology of a child Knowledge of the differences in triage parameters for children of different ages Manage common childhood emergencies Completed a appropriate child & vulnerable adult training <3yrs ago if operationally encountered Awareness of simple consent issues Awareness of simple mental health issues Be able to perform a competency assessment Be able to understand and apply the current Mental Health Act Be able to understand and apply the current Mental Capacity Act Ability to perform a mental capacity assessment Ability to administer appropriate medication as necessary Understand the law regarding section 136 (or equivalent) and 'Place of Safety' Ability to assess the etent and severity of thermal injury Recognise when specialist input is needed Recognise public health risks of chemical agents and carry out appropriate actions Understand and apply the HAZMAT code Apply appropriate treatment and burns dressings Competence in managing the severe complications of burns (i.e. escharotomy) Make appropriate referral Ability to perform basic joint eaminations Identification of disclocation Recognition of likely fracture Recognition & appropriate initial treatment of soft tissue injury Reduction of dislocations where appropriate Reduction of fractures where appropriate Use of appropriate analgesia Management of open fractures according to current NICE guidelines

7 Drowning Death Medical Recognition and management of unconscious drowned patient Recognition and management of conscious drowned patient Recognition of late complications of drowning Identification of life etinct in eceptional circumstances Understanding of life etinct in remote or SAR environ protocols Recognition of life etinct in remote or SAR environ Legal recognition of life etinct in routine pre-hospital practise Ability to recognise common medical emergencies Ability to treat common medical emergencies Ability to provide definitive treatment of certain medical conditions Ability to definitively treat and discharge a patient at scene. Demonstrate the immediate pre-hospital emergency management of the following acute medical presentation Airway obstruction / choking / stridor Acute breathlessness Cardiac arrest and peri-arrest Hypotension and shock Palpitation and cardaic arrhythmia Acute headache Acute vomiting Acute abdominal / loin / scrotal pain Acute confusional state Collapse / transient loss of consciousness The unconscious patient Intoication and poisoning The fitting patient Acute allergic reaction Acute non-traumatic neck / back pain Sudden weakness / paralysis / abnormal sensation Acute visual disturbance / red eye Acute febrile illness Acute gastrointestinal haemorrhage Acute limb pain and/or swelling

8 Acute rash Acute haemoptysis Acute epistais Acute pain Acute thermal illness Bites, strings and envenomation Clinical recognition and management of diabetic hypoglycaemia Recognition and management of diabetic hyperglycaemia Recognition and immediate mangement of Stroke/TIA Headache management Recognition and management of sudden weakness Assessment, diagnosis and management of GI disturbance/abdo pain Recognition of main causes of chest pain Management/ referral for main causes of chest pain - Myocardial Infarction Medical Myocardial Infarction drug management, including analgesia Direct referral to PCI for STEMI patients Management/ referral for main causes of chest pain - Musc skeletal injury Management/ referral for main causes of chest pain - Pulmonary embolus Management/ referral for main causes of chest pain - costochondritis Management/ referral for main causes of chest pain - angina Management/ referral for main causes of chest pain - pneumonia Management/ referral for main causes of chest pain - aortic dissection Management/ referral for main causes of chest pain - pleurisy Management/ referral for main causes of chest pain - pericarditis Management/ referral for main causes of chest pain - pneumothora Management/ referral for main causes of chest pain - chest infection Management/ referral for main causes of chest pain - indigestion 12 lead ECG completion/interpretation Recognition of non-traumatic limb swelling Recognition of Allergy/Anaphylais/Bites and stings

9 IM adrenaline for Anaphylais Recognition of common Toicity and Poisoning Management for common toins/poisons Recognition of Meningitis in adults and children Medical Management of Meningitis in adults and children IV/IM/IO Antibiotics for Meningitis Recognition/Management of Sepsis Recognition/management of hypothermia Recognition/management of eposure/cold injuries Recognition/management of heat ehaustion Recognition/management of heat stroke Annee of Additional Skills some Level H providers may have: Rapid Sequence Induction (RSI) Thoracotomy efast (Etended Focused Asessment with Sonography for Trauma) Emergency Caesarean Section