PARA108 - Paramedic Practice: Trauma Emergencies

Year

Credit points

Campus offering

Prerequisites

BIOL121 Human Biological Science 1 ; PARA104 Foundations of Paramedic Practice

Teaching organisation

Unit rationale, description and aim

This unit provides student the opportunity to achieve knowledge and skills in the assessment and management of a person exposed to trauma, environmental exposure and envenomation in the pre-hospital environment in accordance with general paramedic principles and relevant clinical practice guidelines. The learning in this unit complements the theoretical learning in PARA107: Paramedic Theory: Trauma Emergencies.

It is a requirement that paramedics are able to link theory with practice and perform clinical duties underpinned by a theoretical understanding. Foundational concepts such as critical thinking, clinical reasoning and clinical judgement will be introduced and practice skills will be developed and extended through scenario based learning in the laboratory. This unit is required by students to assist them to use theory to drive their clinical practice and to understand how practice is guided by a continual process of assessment, diagnosis, planning, implementation and evaluation - skills critical for the paramedic to deliver best practice.

The aim of this unit is to assist students to achieve proficiency in the practical aspects of recognition, assessment and management of trauma related presentations.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Demonstrate the assessment and management of people presenting with neurological, musculoskeletal, soft tissue, burns, exposure and envenomation related trauma (GA3, GA4, GA5, GA7) 

LO2 - Demonstrate a range of clinical skills required to effectively treat traumatic presentations (GA4, GA5, GA6, GA7)

LO3 - Apply the principles of fluid resuscitation to the management of people presenting with neurological, musculoskeletal, soft tissue, burns, exposure and envenomation related trauma (GA4, GA5, GA6, GA7)

LO4 - Apply appropriate paramedic pharmacological and non-pharmacological interventions, including fluid resuscitation, to the management of people presenting with neurological, musculoskeletal, soft tissue, burns, exposure and envenomation related trauma (GA4, GA5, GA6, GA7) 

LO5 - Use effective verbal and interpersonal skills in order to work as part of a team in assessing and managing trauma patients using a model that reflects current paramedic practice (GA9)

Graduate attributes

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

GA9 - demonstrate effective communication in oral and written English language and visual media 

COUNCIL OF AMBULANCE AUTHORITIES PARAMEDIC PROFESSIONAL COMPETENCY STANDARDS

CAA Competency Standards:

Content

Topics will include:

Paramedic clinical approach and assessment of the trauma patient

• Assessment of trauma patient
• Musculoskeletal injuries
• Crush injury / compartment syndrome 
• Soft tissue injuries
• Head and facial injuries
• Spinal injuries
• Neurological issues

• Management of environmental presentations
• Burns 
• Hypo / hyperthermia 
• Electric shock 
• Dysbarism
• Emersion

• Management of Toxicology / Toxinology
• Poisons 
• Bites and stings (marine / land)

• Assessment and management of the patient with acute abdominal / genital pain
• History
• Primary and secondary survey
• Principles of assessing referred pain
• Positioning and non-pharmacological pre-hospital management
• Administration of associated pharmacology
• Anti-emetics, analgesia and fluid support

• Management of trauma patient
• Splints
• Immobilisation
• Bandaging
• Extrication

• Basic airway management
• Chest auscultation
• Associated pharmacology 
• Routes of drug administration

Specific Skills

• Assessment
• Glasgow Coma Scale (GCS)
• Neurovascular status assessment
• Spinal assessment

• Haemorrhage control
• Thermoregulation techniques
• Pain assessment and management
• Pharmacological and non-pharmacological

• Splinting and bandaging
• Anatomical
• Mechanical

• Medication administration and handling
• Intravenous access
• Intramuscular administration
• Oxygen administration
• Intranasal administration
• Drug dose calculation
• Analgesic agents
• Antiemetic agents
• Fluid therapy

• Immobilisation / Pressure Immobilisation
• Extrication
• Helmet removal
• Airway management 
• Pulse oximetry
• Double / triple airway manoeuvre
• Manual clearance
• Rigid suction
• Laryngoscope
• Magill’s forceps
• Oropharyngeal airway / nasopharyngeal airway
• Bag valve mask / Intermittent Positive Pressure Ventilation / Intermittent Positive Pressure breathing / Positive End Expiratory Pressure 
• Oxygen therapy
• Chest auscultation

• Chest decompression

Learning and teaching strategy and rationale

Modes of delivery in this unit include lectures, laboratories, simulations, online activities and self-directed study. Consistent with adult learning principles, the teaching and learning strategies used within these modes of delivery will provide students with foundational and advanced knowledge and skills relevant to professional paramedic practice. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers. 

Students entering university need significant support to transition into a learning and teaching environment where they are required to drive their own learning. To guide students in their learning feedback is required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. Practicum assists students to link theory with its application. Located in the first/second year of the programme, this paramedic practice unit includes significant face-to-face teaching hours during which clinical are used to assist students in linking theory with practice. Lectures are utilised to convey content and its central principles while laboratories and simulation deliver interactive learning sessions which assist students in applying their theory with practice while also providing an opportunity to learn community skills. The supervised clinical placement provides a safe environment where students can provide assisted person-centred care essential for successful paramedic practice. Students will undertake a clinical placement of 40 hours within non-emergency, emergency, simulated emergency or other appropriate environments.

Assessment strategy and rationale

A range of assessment procedures consistent with University assessment requirements will be used to meet the unit learning outcomes and develop graduate attributes. The on-campus assessment will provide an opportunity for students to demonstrate developed skills in the safety of a simulated experience.  

There are two hurdles in this clinical practice unit; the hurdles assess knowledge that is so essential to the unit that the student cannot progress in the course if a pass is not achieved in each hurdle. In real world practice it is a requirement that the paramedic student demonstrates professional competence on clinical placement. The online tests are graded as Pass/Fail. To pass this unit, all three assessment tasks need to be completed successfully. These assessments are required to build student knowledge and skills which, by the conclusion of this programme, will enable the student to graduate as a safe and effective paramedic.

Overview of assessments

Representative texts and references

Ambulance Victoria (2016). Ambulance Victoria clinical practice guidelines for Ambulance and MICA Paramedics. Doncaster: Ambulance Victoria.

Ambulance Victoria (2015). Clinical work instructions. Doncaster, Victoria: Ambulance Victoria.

Bryant, B., & Knights, K. (2015). Pharmacology for health professionals (4th ed). Chatswood, N.S.W.: Elsevier Australia.

Curtis, K., & Ramsden, Clair. (2015). Emergency and trauma care for nurses and paramedics (2nd

             ed.). Sydney: Mosby- Elsevier.

Copstead, L., & Banasik, J. (Eds). (2013). Pathophysiology ( 5th ed.). Philadelphia, PA: Saunders.

Martini, F., Nath, J. & Bartholomew, E. (2015). Fundamentals of anatomy & physiology (10th Global ed.). Boston: Pearson.  

Marieb, E.N., & Hoehn, K. (2016). Human anatomy and physiology ( 10th Global ed.). Harlow: Pearson Education Limited. 

McCance, K., & Huether. S, (2014). Pathophysiology: The biologic basis for disease in adults and children  (7th ed.). St Louis: Mosby.

Queensland Ambulance Service (2017). Clinical practice guidelines (CPG) and clinical practice procedures (CPP). Brisbane: Queensland Ambulance Service.

Queensland Ambulance Service (2017). Drug therapy protocols (DTP). Brisbane: Queensland Ambulance Service.

Sanders, M. J. (2012). Mosby’s paramedic textbook (4th ed.). St Louis, MO.: Mosby.