Elements and Performance Criteria

RANGE STATEMENT

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.


Anatomical and physiological concepts include:
Anatomical position and directional terms
Regional terms
Body planes and sections
Body cavities and membranes
Abdomino-pelvic regions and quadrants


Levels of organisation refer to:
Chemical level:
matter and energy
molecules, mixtures and compounds
chemical bonds
chemical reactions
inorganic compounds
organic compounds
Cellular level:
structure
functions
transport systems
organelles
growth and reproduction
Tissue level types, function and structure of:
epithelial tissue
connective tissue
epithelial membranes
nervous tissue
muscle tissue
Organ level
Organ/body system level
Organismal level


Structure and function of body systems must include but are not limited to the normal structure and function of the:
Integumentary system:
the skin and its layers
skin colour
appendages of the skin
functions of the skin
processes of thermoregulation
homeostatic imbalances of the skin
developmental aspects of the skin
Skeletal system:
bone tissue, its formation and classification
classification of bones, skeletal cartilages and joints
structure and functions of bone
bone homeostasis, growth and repair
the parts of the axial and appendicular skeletons
range of motion of joints
Muscular system:
mechanics of muscles
types, function and structure of muscle tissue
processes of muscle contraction
Nervous system including:
development of neurons
nervous tissue
neurophysiology
neural integration
central nervous system
peripheral nervous system
autonomic nervous system
sensation and somatic senses of pain and touch
special senses of taste, smell, vision, hearing, and balance
Endocrine system:
anatomy and physiology of organs and structures
neuroendocrine regulation
action of hormones
hormone classification
continued ...


Structure and function of body systems must include but are not limited to the normal structure and function of the:(contd)
Cardiovascular system:-
Blood:
components and characteristics
groups
clotting
Heart:
structure and function
blood flow
conduction system
ECG complex
function and output
cardiac cycle, stroke volume and heart rate
heart sounds
Blood vessels and haemodynamics:
structure and function
response to blood volume, pressure and perfusion
pressure cascades
blood and pulse pressures
circulatory routes
Lymphatic system:
organs, tissues, nodes and vessels
lymphocytes
Immune system:
protective functions
non-specific resistance
immunologic response
inflammatory response
natural and artificially acquired immunity
Respiratory system:
structure, function and protective mechanisms
gas laws
diffusion of respiratory gases
gas exchange (Boyle; Dalton; Charles; Henry)
external and internal ventilation and respiration.
principles of lung volumes: minute volume and oxygenation
transportation of respiratory gases
Digestive system:
structure and function
processes
Urinary system:
structure and function
urine composition
micturition reflex
continued ...


Structure and function of body systems must include but are not limited to the normal structure and function of the:(contd)
Reproductive systems:
structure and function (male and female)
female reproductive cycle
myosis
development of gametes
genetics


Homeostasis means:
Maintenance of internal environment including:
body temperature
body fluid composition (e.g. nutrient absorption by digestive system, nutrient distribution by cardiovascular system, absorption of oxygen and elimination of carbon dioxide by respiratory system, control of nutrient loss by urinary system)
body fluid volume (e.g. absorption of water from digestive system, loss of water through skin, distribution of water by cardiovascular system)
elimination of wastes from the body
maintenance of blood pressure
protection from infection
physical activity active and passive


Standard methods and protocols may include:
Clinical practice guidelines
Organisation protocols
Skills manuals
State/territory ambulance authority regulations and/or operational procedures
Internationally recognised scales, charts, guidelines and surveys (e.g. Glasgow coma scale, dermatome charts, blood pressure reading scales, national asthma guidelines)


Cellular metabolism involves:
Cellular respiration
Acid base balance
Anaerobic and aerobic energy production


Body temperature maintenance includes:
Metabolism of nutrients
Energy balance
Heat exchange


Common pharmacological terminology includes:
Therapeutic dose
Toxic dose
Titration
Half life
Indication
Contra-indication
Side-effect
Tolerance
Idiosyncrasy and allergy
Cumulative action
Antagonism
Synergism


Pharmacology includes:
Preparation, properties, uses and actions of drugs
Common drug forms:
creams
suspensions
tablets
pessaries
lotions
capsules
lozenges
suppositories
injectables
gases
vapours
aerosol
powders
Safe storage, handling and disposal of drugs


Pharmacokinetics refers to:
Routes of administration, including:
enteral; oral, sublingual, rectal
parenteral; intravenous, intramuscular, inhalation, endotracheal, topical, pessary/douche
Absorption, distribution, metabolism and excretion of drugs by the body


Pharmacodynamics refers to:
Drug interactions
Pharmacological response of drugs associated with the state/territory ambulance service protocols/ guidelines
Duration and magnitude of response associated with the state/territory ambulance service protocols/ guidelines


Rapid stabilisation and transport includes:
Golden Hour
Chain of survival
Time critical
Priority status
Transport consideration e.g. ground or aeromedical


Kinematics of trauma refers to:
Predicting injury patterns resulting from the forces and motions of energy
Predicting injury patterns resulting from the absence of essentials such as oxygen
Integrate the relationship between anatomy and the kinematics of trauma with assessment findings to develop an index of suspicion for specific injuries


Principles of energy exchange includes:
Physical laws of energy exchange (ie Newton's laws of motion)
Cavitation
Types of trauma, including:
blunt (e.g. MVA/Motor bike including pedestrian injury, organ collision and restraint injuries, falls and blasts)
penetrating


Critical questioning refers to:
Purposeful, informed questioning in the clinical setting to make sense of the information presented at the scene of injury or illness


Diagnostic reasoning refers to:
Using critical questioning in the clinical setting which requires careful identification of key problems, issues, and the risks involved in responding to client needs


Specific client conditions, disorders and injuries to be assessed and managed include:
Compromised integumentary system:
Epidermal wound healing
Deep wound healing including the inflammatory response
Wound infection
Burns trauma:
Any injury caused by the interaction of energy (thermal, chemical, electrical, or radiation) with biological matter:
pathophysiology of burns injuries
local and systemic responses
classifications of burn injury
extent and severity of burns injury e.g. Rule of Nines, Lund and Browder chart
Pathophysiology of burn shock
Musculo-skeletal system medical disorder or trauma:
Homeostatic imbalances of bone, cartilage and muscle including inherited, inflammatory and degenerative conditions
Pathophysiology of musculo-skeletal injury including:
soft tissue injury (i.e. closed wounds) e.g. contusion, haematoma and crush injury
open wounds e.g. abrasion, laceration, puncture, avulsion, amputation, and bite
causes and types of fractures
dislocations, strains and sprains
Crush injuries and compartment syndrome
Special circumstances:
Medico-legal and ethical considerations
Neurological insult:
brain injury including: concussion; contusion; Diffuse Axonal Injury (DAI); types of haematoma
traumatic brain injury including: primary and secondary injury; cerebral perfusion; raised intracranial pressure; herniation; cerebral agitation or irritation; Cushing's triad
cerebral thrombosis, cerebral embolism and cerebral haemorrhage
transient ischaemic attack (TIA)
continued ...


Specific client conditions, disorders and injuries to be assessed and managed include:(contd)
Spinal injury:
knowledge of sensory and motor functions
reflex arc e.g. autonomic dysreflexia
cardiovascular changes
Mental health and behavioural disorders:
psychological theory
collaborative approach to the care of clients and families with altered mental health status
legal and ethical nursing issues
issues related to psychosocial care
Metabolic disorders:
nutritional disorders
body temperature
homeostatic imbalances associated with metabolic rate
assessment findings of endocrinologic disorders including: diabetes mellitus, thyroid and adrenal
Poisoning, envenomation or overdose emergency:
neurotoxins; myotoxins; haemotoxins
illicit and prescribed
chemical, biological and radiological
Cardiovascular:
cardiovascular insult
dysrhythmias
cardiac disease hypotension/hypertension
blood diseases e.g. leukaemia; anaemia and sickle-cell
Hypoperfusion:
posture and venous return
stages of shock.
classifications of shock, including hypovolaemic, cardiogenic and distributive
complications of shock
Immunological conditions (infectious diseases e.g. meningococcal) hypersensitivity
Respiratory disorders or thoracic trauma:
pathophysiology associated with e.g. asthma, ARDS, pneumonia, emphysema, COPD
Abdominal disorders or trauma:
abdominal pain - somatic, visceral and referred
assessment techniques:
quadrants and regions
external signs
gastro-intestinal bleeding
disorders e.g. appendicitis, gastro-enteritis, hepatitis
continued ...


Specific client conditions, disorders and injuries to be assessed and managed include:(contd)
Urogenital disorders or trauma:
acute and chronic renal failure
dialysis
UTI
Obstetric/gynaecological disorders (e.g. ectopic pregnancy, spontaneous abortion, vaginal haemorrhage, pelvic inflammatory disease, endometriosis):
pre-delivery emergencies
post-delivery emergencies
Genetic disorders
Drugs or fluid therapies associated with body system trauma or medical disorder


Specific categories of clients to be assessed must include but are not limited to:
Adult client (male and female)
Obstetric client:
anatomic and physiologic changes associated with pregnancy
stages of labour
assessing neonate body temperature
APGAR
abnormal pregnancy and delivery
impact of other clinical considerations e.g. trauma
Neonatal and paediatric client:
differences in paediatric and adult anatomy and physiology - paediatric airway issues
communication issues
disease processes
pharmacodynamics of drugs
impact of other clinical considerations e.g. trauma
Geriatric client:
normal anatomical and physiological changes associated with ageing
impact of pre-existing medical problems
pharmacodynamics of drugs
impact of other clinical considerations e.g. trauma

EVIDENCE GUIDE

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:
Assessment must establish acquisition of Essential Knowledge across the Range Statement outlined in this unit prior to assessment of skills application
Skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory)
As a minimum, initial assessment must include appropriate written/oral/practical examinations to address Essential Knowledge and Skills as outlined in this unit
After successful completion of initial assessment, further assessment is to be conducted during workplace application under direct supervision
The application of skills and knowledge described in this competency unit should be assessed in conjunction with competency unit(s) related to specific ambulance care services, including HLTAMBCR502A Deliver standard clinical care
Candidates must demonstrate their ability to apply essential knowledge and skills identified for this competency unit before undertaking independent workplace application
Candidates must provide evidence of their ability to apply all clinical competencies consistently (over a period, usually of 12 months) as part of supervised clinical practice


Access and equity considerations:
All workers in the health industry should be aware of access and equity issues in relation to their own area of work
All workers should develop their ability to work in a culturally diverse environment
In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities


Related units:
This unit should be assessed in conjunction with the following related competency unit:
HLTAMBCR502B Deliver standard clinical care