PARA202 - Paramedic Practice: Medical 1

Year

Credit points

Campus offering

Prerequisites

For Bachelor of Paramedicine: PARA108 Paramedic Practice: Trauma Emergencies

For Bachelor of Nursing/Bachelor of Paramedicine: PARA104 Foundations of Paramedic Practice

Teaching organisation

Unit rationale, description and aim

This unit will introduce students to the practical assessment and management of the medical presentations of cardiovascular, respiratory, gastrointestinal, renal and infectious processes of disease and emergencies explored in PARA201 Paramedic Theory: Medical 1. Students will apply clinical management based on the underpinning theory both in the laboratory environment and in the course of undertaking clinical placement.

It is critical that all paramedic professionals understand the concepts and principles of managing medical emergencies and apply appropriate management plans in the out-of-hospital setting. Paramedic professionals encounter situations and problems that require expedient, insightful and competent decision making to achieve optimal patient outcomes. Skills developed in this unit assist students to building knowledge of paramedic practice which will guide their future performance as a health care professional.

The aim of this unit is to assist student to achieve recognition, advanced assessment and management of cardiac, respiratory, gastrointestinal, renal and infectious medical 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 - Apply a paramedic clinical assessment framework to the patient presenting with a range of medical emergencies related to cardiovascular, respiratory, gastrointestinal, renal and infectious processes (GA1, GA3, GA4, GA5) 

LO2 - Apply appropriate paramedic interventions to patients presenting with a range of medical emergencies related to cardiovascular, respiratory, gastrointestinal, renal and infectious processes (GA1, GA3, GA4, GA5) 

LO3 - Apply the principle of time criticality to the management of various presentations related to cardiovascular, respiratory, gastrointestinal, renal and infectious processes (GA3, GA4, GA5) 

LO4 - Apply critical thinking and reflective practice to evaluate the effectiveness of various paramedic interventions applied to the management of various presentations (GA3, GA4, GA5, GA6) 

LO5 - Participate and complete clinical placement activities in a professional manner (GA3, GA5, GA6, GA7) 

LO6 - Deploy effective communication strategies to function within a team environment operating with the therapeutic objective (GA7, GA9) 

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

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 

Paramedicine Board of Australia Professional Capabilities for Registered Paramedics

Website of capabilities: https://www.paramedicineboard.gov.au/Professional-standards/Professional-capabilities-for-registered-paramedics.aspx

Content

Topics will include: 

• Cardiac intermediate 
• Perfusion Status Assessment 
• Review of chest auscultation 
• Cardiac management 
• Oxygen therapy and ventilation 
• Electrocardiogram 
• 3 Lead  
• Monitoring lead placement 
• Rhythm analysis and interpretation 
• Manual and semi-automatic external defibrillation 
• Defibrillation electrode placement 
• Fluid therapy 

Drug dose calculation and administration 

• Coagulation modifying agents 
• Nitrates 
• Analgesia 
• Antiemetics 

Respiratory intermediate 

• Respiratory Status Assessment (RSA) 
• Chest Auscultation 
• Review of basic airway management skills 
• Continuous Positive Airway Pressure (CPAP) 
• Laryngoscopy 
• Magill Forceps  
• Laryngeal Mask Airway (LMA) insertion 
• Insertion of a gastric tube via LMA 
• Pulse Oximetry 
• Nebulisation 
• Sellick manoeuvre 
• Backwards Upward Right and Pressure (BURP) manoeuvre 
• Endotracheal Intubation (preparation)  
• End Tidal Carbon Dioxide monitoring 
• Oxygen therapy 
• Predictors of difficult mask ventilation 
• Drug Dose Calculation and Administration 
• Bronchodilating agents 
• Adrenergic agents 
• Other relevant pharmacological agents 

GI/ Renal medical 

• Assessment of the patient with acute abdominal / genital pain 
• Abdominal assessment 
• Assessment of rebound tenderness 
• Principles of assessing referred pain 
• Management of the patient with acute abdominal / genital pain 
• Positioning and non-pharmacological pre-hospital management 
• Administration of associated pharmacology 
• Antiemetics, analgesia and fluid support 
• Renal and hepatic contraindications of associated pharmacology 
• Insertion of nasogastric tube via LMA 

Infections – specific presentations and sepsis 

• Ceftriaxone  

Learning and teaching strategy and rationale

Modes of delivery in this unit include 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 second year of the programme, this paramedic practice unit includes significant face-to-face teaching hours during which clinical laboratories are used to assist students in linking theory with practice. Clinical 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 80 hours within 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 marked as Pass/Fail. To pass this unit, all three assessment tasks need to be completed successfully. These assessments are required to build student knowledge which, by the conclusion of this programme, will allow 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. 

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

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

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

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

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 Manual. Brisbane: Queensland Ambulance Service. Retrieved from https://www.ambulance.qld.gov.au/clinical.html 

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