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HLTAMB008

Assess and Deliver Standard Clinical Care

What you will learn by studying this unit

  • Assessment and interpretation of vital signs
  • How to accurately obtain and document patient medical history including
  • Advanced life support and advanced resuscitation
  • Assessing common causes and effects of trauma
  • How to respond to common environmental emergencies
  • Critical thinking and diagnostic reasoning techniques

This unit is a common unit in the paramedical and general health care sector and forms part of the range of health and community courses to offer.

Paramedical Units

HLT21020 Certificate II in Medical Service First Response

HLT31220 Certificate III in Basic Health Care

HLT31120 Certificate III in Non-Emergency Patient Transport

HLT41120 Certificate IV in Health Care

HLT51020 Diploma of Emergency Health Care

Health & Administration Units

HLT37315  Certificate III in Health Administration

HLT47315 Certificate IV in Health Administration

HLT37215 Certificate III in Pathology Collection

Nursing & Community Services Units

CHC43115 Certificate IV in Disability

CHC43015 Certificate IV in Ageing Support

HLT51020 Diploma of Nursing

Elements and Performance Criteria for this Paramedic/Medic unit

What does this mean? Elements, which tell me what I should be able to do if I am competent in this unit of a course; Performance Criteria, which tell me how I can show that I am competent in the individual tasks or activities to the required standards

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Perform pre-hospital/out-of-hospital patient assessment

1.1 Conduct pre-planning of assessment before arrival at scene based on information communicated in the request for service

1.2 Perform appropriate clinical surveys to collect and analyse assessment information at critical points

1.3 Use applied clinical knowledge to assess the mechanism of injury, pattern of injury and potential for injury to identify any non-obvious clinical signs during patient assessment

1.4 Use a critical questioning process to make links between patient’s illness or injury and information found at the scene

1.5 Base patient assessment on a demonstrable and clearly thought out series of problem-solving steps or linkages

2. Identify variations in physical health status

2.1 Integrate principles of anatomy and pathophysiology with assessment data for specific conditions, disorders, and injuries

2.2 Identify variations from normal homeostasis and body system functions using established clinical guidelines/protocols

2.3 Identify variations in cellular metabolism when assessing patient for poor states of perfusion

2.4 Analyse the need for and potential impact of treatments and pharmacological therapies on patient’s health status

2.5 Identify the effects on patient’s health status of pharmacological therapies based on pharmacology, pharmacokinetics, and pharmacodynamics

2.6 Use diagnostic reasoning when determining the potential for injury or illness

3. Plan pre-hospital/out-of-hospital patient care

3.1 Identify main patient complaints as a basis for prioritised treatment and care based on assessed patient needs and overall assessment of the scene

3.2 Analyse clinical and situational data gathered to plan treatment

3.3 Establish patient management plan based on primary and secondary survey, known patient history, assessment of the scene and factors related to distance from hospital or medical care

3.4 Evaluate the injury and potential for deterioration and develop contingency plans based on mechanisms of injury

3.5 Systematically evaluate and interpret patient assessment information to make judgements regarding patient care requirements

3.6 Ensure judgement, which forms the basis on which treatment is planned, can be reasonably justified in terms of the information available at the time

3.7 Differentiate between patients who require rapid stabilisation and transport because of trauma or illness, and those who require further on-the-scene assessment and management

3.8 Determine time-critical issues given resource considerations

4. Implement pre-hospital/out-of-hospital patient care procedures

4.1 Implement all care and treatment procedures to the level of own expertise and within established clinical guidelines and protocols

4.2 Commence pharmacological therapies as patient’s presenting condition determines, about established clinical guidelines and protocols and pharmacological requirements

4.3 Recognise the need for assistance where the situation or patient’s condition requires treatment that is outside the practice guidelines and seek help immediately

5. Monitor and evaluate pre-hospital/out-of-hospital patient care

5.1 Monitor all aspects of patient’s condition at appropriate intervals to establish trends

5.2 Assess potential effects on patient’s condition of procedures implemented

5.3 Monitor pharmacological therapy, noting effectiveness of treatment regime and amend according to patient’s condition

5.4 Recognise changes in patient’s condition and adapt management according to the scope or authority to practice of the attending officer

5.5 Evaluate patient care interventions used against pre-hospital/out-of-hospital best practice for clinical care

6. Hand over patient requiring pre-hospital/out-of-hospital patient care to receiving facility

6.1 Document relevant patient details according to local standard operation procedures

6.2 Maintain patient confidentiality at all times

6.3 Ensure documentation for handover procedures conveys all necessary information

6.4 Maintain patient care until responsibility for patient care is taken over by staff of the receiving agency

6.5 Convey information appropriately to those individuals involved in ongoing patient care to facilitate understanding and optimise continuing patient care

Performance Evidence for HLTAMB008 Assess and Deliver Standard Clinical Care

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

  • performed the activities outlined in the performance criteria of this unit during a period of at least 160 hours under clinical supervision in the workplace
  • performed a clinical assessment and implemented standard care in a pre-hospital/out-of-hospital context on 5 different patients for an illness or trauma impacting health status, including:
  • performing primary survey
  • performing secondary survey – systematic head to toe physical body examination including vital signs and level of consciousness
  • considering psychosocial, developmental and cultural considerations
  • considering mechanism of injury, pattern of injury and potential for injury
  • planning and implementing standard clinical care based on assessment and time-criticality
  •  monitoring patient and implementing health care procedures and/or therapies
  • safely delivering patient to receiving facility or service
  • implemented the following standard clinical care interventions under a variety of conditions and circumstances within the established clinical guidelines and protocols:
  • providing airway management for a patient
  • attaching leads, recording and interpreting an electrocardiograph (ECG) to analyse cardiac dysrhythmia
  • performing manual direct current counter shock on an adult simulation manikin according to established clinical guidelines and protocols
  • administering and responding to the effects of pharmacological therapy to treat and manage patient’s illness or condition
  • performed advanced life support on an adult, child, and infant simulation manikin according to established clinical guidelines and protocols.

Knowledge Evidence, HLTAMB008 Assess and Deliver Standard Clinical Care

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role.

Knowledge covered in the HLTAMB008 – Assess and Deliver Standard Clinical Care consists of:

  • assessment and interpretation of vital signs
  • advanced life support and advanced resuscitation, including procedures and equipment as specified within established clinical guidelines and protocols
  • critical thinking and diagnostic reasoning techniques and processes:
    • process of critical questioning, including purposeful, informed questioning in the clinical setting to make sense of the information presented at the scene of injury or illness
    • process of diagnostic reasoning in the clinical setting, which requires careful identification of key problems, issues, and the risks involved in responding to patient needs
    • potential impacts of a range of factors in relation to identified body systems and their components
      • internal (such as physical, mental, emotional factors)
      • external (for example, in relation to specific patient assessment procedures)
    • concept of rapid stabilisation and transport including:
      • golden hour
      • chain of survival
      • time criticality
      • priority status
      • transport consideration – for example, ground or aeromedical
  • causes and effects of trauma including:
    • kinematics of trauma
    • blunt, penetrating, falls, blasts and motor vehicle accidents
    • crush injuries and compartment syndrome
    • physical laws of energy exchange (Newton’s laws of motion)
    • cavitation
    • impact and clinical consideration for trauma to a pregnant person
  • common environmental emergencies
  • how to accurately obtain and document patient medical history including pre-existing conditions, allergies, social and emotional wellbeing, and current medication or treatment plans to provide to receiving health facility workers
  • national and State/Territory legal and ethical considerations for emergency health care workers relevant to pre-hospital/out-of-hospital care, and how these are applied in organisations, including:
    • children in the workplace
    • continuing professional education
    • discrimination
    • duty of care
    • human rights
    • informed consent
    • mandatory reporting
    • practice standards
    • practitioner/client boundaries
    • privacy, confidentiality, and disclosure
    • specific Commonwealth and State/Territory legislation or regulation for health care workers which cover, for example:
      • children and young people
      • anti-discrimination
      • disability
      • health, drugs, and poisons
      • mental health
      • health records and information privacy
      • industrial relations
    • National Safety and Quality Health Service (NSQHS) Standards
    • work role boundaries, i.e., responsibilities and limitations
    • work health and safety
  • organisation policies, procedures and established clinical guidelines and protocols for patient care and emergency equipment
  • pharmacology therapy and concepts underpinning pharmacology:
    • pharmacological agents for the management of common disorders
    • pharmacokinetics including routes of administration – enteral, parenteral, inhalation, topical
    • preparation, properties, uses, and actions of pharmacology
    • pharmacology terminology
    • absorption, distribution, metabolism, and excretion of pharmacological products by the body
    • pharmacodynamics- pharmacological interactions
    • safe storage, handling, and disposal of pharmacological products
    • jurisdictional protocols and guidelines associated with administration, duration, magnitude and pharmacological response
  • primary survey and secondary survey
  • variations from normal functioning of body systems involving anatomy, physiology and pathophysiology, including:
    • pathophysiology of integumentary system, including:
      • compromised integumentary system burns trauma or injury caused by the interaction of energy (thermal, chemical, electrical, or radiation)
      • pathophysiology of burns injuries, local and systemic responses and burn shock
      • classifications of burns injury and extent and severity of burns injury
    • pathophysiology of musculoskeletal injury, including:
      • soft tissue injury
      • causes and types of fractures, dislocations, strains, and sprains
    • pathophysiology of the cardiovascular system, including:
      • cardiovascular insult
      • how to interpret and analyse dysrhythmias and apply electric shock to obtain normal rhythm – for example asystole, ventricular fibrillation, ventricular tachycardia or heart block
      • classifications and complications of shock including hypovolaemia, cardiogenic and distributive
    • pathophysiology of the neurovascular system, including:
      • brain injury including concussion, contusion, diffuse axonal injury (DAI), haematomas
      • traumatic brain injury including primary and secondary injury, cerebral perfusion, raised intracranial pressure, herniation, cerebral agitation or irritation
      • cerebral thrombosis, transient ischaemic attack (TIA), cerebral embolism and cerebral haemorrhage
      • dementia
      • seizures and febrile convulsions
      • autonomic dysreflexia
    • poisoning, envenomation or overdose emergencies including:
      • neurotoxins, myotoxins, haemotoxins, illicit drugs
      • chemical, biological and radiological
    • pathophysiology of the respiratory system, including:
      • differences in paediatric and adult airways
      • thoracic disorders or trauma
      • respiratory disorders including asthma, acute respiratory distress syndrome, croup, epiglottis, pneumonia, emphysema, chronic obstructive airway disease
      • gas laws and gas exchange (Boyle, Dalton, Charles, Henry)
      • external and internal ventilation and respiration
      • principles of lung volumes – minute volume and oxygenation
    • pathophysiology of the digestive and endocrine system, including:
      • abdominal disorders including diabetes mellitus, thyroid and adrenal gland conditions
      • nutritional disorders, appendicitis, gastroenteritis, and hepatitis
      • abdominal trauma including visceral, referred and somatic pain, gastrointestinal bleeding
    • processes of metabolism, including:
      • cellular respiration
      • anaerobic and aerobic energy production
    • pathophysiology of the urinary and reproductive system, including:
      • acute and chronic renal failure and obstetric and gynaecological disorders (for example, ectopic pregnancy, spontaneous abortion, vaginal haemorrhage, pelvic inflammatory disease, endometriosis)
      • stages of labour – pre-delivery emergencies and post-delivery emergencies
      • assessing neonate body temperature and Apgar scores

Assessment Conditions for HLTAMB008 Assess and Deliver Standard Clinical Care

Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions.

The following conditions must be met for HLTAMB008 – Assess and Deliver Standard Clinical Care:

  • use of suitable facilities, equipment and resources, including client health information
  • modelling of industry operating conditions, including:
  • analysis of health information of real people
  • integration of problem-solving activities

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

To see more details on this paramedical unit HLTAMB008 – Assess and Deliver Standard Clinical Care click here to view the full details here on training.gov

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