Elements and Performance Criteria

The Range of Variables explains the scope and context of the unit of competency allowing for differences between workplaces. The scope of variables chosen for training and assessment requirements will depend on the particular work situation.
Clinical procedures covers the surgical procedure and the type of anaesthetic which may include:
· General/regional/local anaesthetic and sedation
· Radiology/Radiotherapy anaesthesia
· General surgery
· Gastro-intestinal surgery
· Ear, nose and throat surgery
· Gynaecological surgery
· Obstetric surgery
· Orthopaedic surgery
· Vascular surgery
· Urological surgery
· Oral/dental/faciomaxillary surgery
· Cardiothoracic surgery
· Neurosurgery
· Plastic surgery
· Trauma/emergency surgery
· Ophthalmic surgery
Patients requiring anaesthetics include:
· Neonates
· Infants
· Children
· Adolescents
· Adults
· Elderly
· Pregnant women
· Impaired
· Traumatised
· Unconscious
· Immuno-compromised
· Male
· Female
Anaesthetist's requirements may include:
· Patient details eg age, gender, health status, problems anticipated
· Procedure to be undertaken
· Equipment and materials for procedure
Airway equipment must include:
· Range of nasal and oral endotracheal tubes
· Tracheostomy tubes
· Range of laryngoscopes, including fibreoptics
· Difficult intubation equipment
· Intubation aids
· Oropharyngeal/nasal/laryngeal airways
· Suction equipment for oesophageal and tracheal suction
· Throat packs
· Self inflating bag
· Anaesthetic circuits
· Face masks
· Connectors
· Filters
Assistance provided during induction procedure must include:
· Cricoid pressure
· Cellick's manaevour
Types of induction procedures must include:
· Rapid sequence induction
· Oral and nasal route
· Tracheostomy
Equipment made available for selection must include:
· Anaesthetic machine and components, including alarms and scavenger
· Ventilator and components
· Vaporisers or other systems designed for delivery of inhalation anaesthetic agents
· Breathing systems and attachments
· Oxygen masks
· Laryngoscopes, including fibreoptic laryngoscopes
· Intubation aids, including difficult intubation equipment
· Artificial airways
· Suction equipment for oesophageal and tracheal suction
Monitoring equipment
· Electrocardiography (ECG)
· Pulse oximetry
· Non-invasive and invasive blood pressure monitoring
· Temperature monitoring
· Central venous pressure (CVP) monitoring
· Intravascular monitoring
· Gas analysers, including oxygen, carbondioxide and anaesthetic agent
· Expired/inspired volume/pressure
· Neuromuscular transmission
· Cardiac output monitoring
· Cerebral activity monitoring
· Stethoscopes, including oesophageal
Other equipment
· Infusion equipment, including autotransfusion equipment and intra aortic balloon pumps, cell saving equipment, rapid infusion equipment
· Warming/cooloing equipment for patient and intravenous fluids
· Equipment to minimise heat loss
· Tourniquets and exsanguinators
· Neuromuscular function monitor
· Calf stimulators/compression devices
· Hunidifiers
Physiological parameters must include:
· Blood pressure and pulse
· Temperature
· Circulation
· Respiration
· Oxygenation
· Inspired/expired gases
· Airway pressure
· Neuro-muscular function
· Level of consciousness
· Doppler
· Changes in physiology
Fluids may include:
· Blood
· Urine
· Gastro-intestinal fluids
· Irrigation
· Intravenous
· Intra arterial
Personal protective equipment may include:
· Gown
· Gloves
· Mask
· Protective eyewear
· Apron
Clinical measurements may include:
· Arterial blood gas measurement
· Blood sugar level measurement
· Haemoglobin measurement 12 lead electrocardiograph
· Coagulation times
· Manual blood pressure and pulse
Patient positions may include:
· Supine
· Prone
· Lithotomy/Lloyd Davis
· Trendelenberg/reverse
· Lateral
· Jack knife
· Sitting
· Specific positioning related to the operative/clinical procedure
Protecting patient from injury may include:
· Support/padding
· Careful movement of joints
· Avoiding sudden and abnormal movements
· Protection from excessive heat loss

The Evidence Guide identifies the critical aspects of assessment, and the essential knowledge and skills to be demonstrated to confirm competency in this unit. The Evidence Guide is an integral part of the assessment of competency and it should be read carefully in conjunction with the Range of Variables, elements and performance criteria.
Critical aspects of assessment must include:
· Complies with organisational policies and procedures including those of OHS and infection control, and current standards Identification of the different methods of airway establishment
· Recognise the signs and symptoms, causes and remedial actions in the event of loss of airway
· Monitoring of range of physiological parameters with reference to standard values of normal physiological function for each patients' usual parameters relevant to providing assistance in anaesthesia
· Ability to maintain a patient's airway manually
· Knowledge of boundaries of responsibilities and ability to refer problems to supervisor, anaesthetist or other appropriate health professional
Concurrent assessment and relationship with other units:
· This unit can be assessed independently, however holistic assessment practice with other health services units of competency is encouraged
Essential knowledge must include:
· Anatomy and physiology relevant to providing assistance in anaesthesia
· Physiology of loss of airway, the signs and symptoms, the causes and the remedial actions, including maintenance of airway manually, insertion of nasal/oral airways
· Monitoring of patients' physiological systems relevant to providing assistance in anaesthesia
· Normal physiological parameters, and implications of deviation from normal, for a range of physiological functions relevant to providing assistance in anaesthesia
· Types of suction equipment, its indication for use and hazards associated with usage
· Fluid and electrolyte balance relevant to providing assistance in anaesthesia maintenance
· Medical terminology relevant to providing assistance in anaesthesia
· Clinical/operative procedures and the interrelationship with anaesthesia relevant to providing assistance in anaesthesia
· General knowledge of pathophysiology of disease relevant to providing assistance during anaesthesia
· Anaesthetic procedures relevant to providing assistance in anaesthesia
· Pre-medications and their effects relevant to providing assistance in anaesthesia
· Use of pain management equipment relevant to providing assistance during anaesthesia
· Occupational health and safety and infection control procedures/regulations relevant to providing assistance during anaesthesia
· Manual handling and patient positioning techniques relevant to providing assistance in anaesthesia
· Types and functions of anaesthetic equipment, their indications and limitations for use
· Medico-legal requirements relevant to providing assistance during anaesthesia
· Range of equipment in current use for anaesthetic/operative procedures, knowledge of manufacturers' operating guidelines and criteria for withdrawal of faulty equipment
Essential skills must include:
· Ability to prepare anaesthetic and monitoring equipment for use
· Ability to identify and manage faults in anaesthetic and monitoring equipment
· Ability to prepare patient sites correctly to interface with equipment
· Ability to secure an arterial/venous cannula
· Ability to establish and maintain a patient's airway manually using ventilation with bag and mask
· Ability to perform clinical measurements
· Basic computer skills relevant to providing assistance during anaesthesia
· Reading and writing skills-literacy competence required to fulfil job roles in a safe manner and as specified by the organisation. The level of skill required involves reading and documenting clinical information and understanding complex policy and procedure manuals.
· Oral communication skills-language competence required to fulfil job roles in a safe manner and as specified by the organisation. Assessors should look for skills in asking questions, providing clear information, listening to and understanding workplace instructions, and clarifying workplace instructions when necessary. Effective verbal and non verbal communication skills with a range of personnel within and outside of the organisation are essential. An ability to recognise and manage barriers to effective communication is also essential. Organisation may require competence in English or a community language, depending on client group
· Numeracy skills include the ability to complete basic arithmetic calculations, recording stock levels and statistical information
· Problem solving skills required include an ability to use available resources
· Ability to deal with conflict
· Ability to work with others within a team
· Ability to display empathy with patient and relatives
Resource implications:
· Access to appropriate workplace where assessment can take place
· Simulation of realistic workplace setting for assessment
· Relevant organisational policy, guidelines, procedures and protocols
Method of assessment:
· Observation of work activities
· Observation of simulation and/or role play
· Written tasks
· Relevant formal and informal education/training courses
· Case studies and scenarios
· Interviews/Questioning
· Role plays
Consistency in performance:
· It is recommended that assessment or information for assessment will be conducted or gathered over a period of time and cover the normal range of workplace situations
Context of assessment:
· This unit will be most appropriately assessed in the workplace or in a simulated workplace and under the normal range of workplace conditions