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Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
Sub-specialty Training in
Pre-hospital Emergency Medicine
Curriculum Framework and Assessment Blueprint
Intercollegiate Board for Training in Pre-hospital Emergency Medicine
Produced by the Intercollegiate Board for Training in Pre-hospital Emergency Medicine (IBTPHEM).
Intercollegiate Board for Training in Pre-hospital Emergency MedicineCollege of Emergency Medicine7-9 Bream’s BuildingsLondonEC4A 1DTUnited Kingdom
©2012 IBTPHEM
All rights reserved. No part of this publication may be produced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the Intercollegiate Board for Training in Pre-hospital Emergency Medicine.
While every effort has been made to ensure the accuracy of the information contained in this publication, no guarantee can be given that all error and omissions have been excluded. No responsibility for loss occasioned to any person acting or refraining from action as a result of the material in this publication can be accepted by the Intercollegiate Board for Training in Pre-hospital Emergency Medicine or the contributors.
Photographs provided courtesy of the Emergency Medical Charity, Magpas.
Please refer to the IBTPHEM’s website at www.ibtphem.org.uk for any updates to this publication.
Printed by PMT Digital Print Ltd
Sub-specialty Training in Pre-hospital Emergency Medicine
Curriculum Framework and Assessment Blueprint
Approved by the General Medical Council on 20 July 2011
Version 4: Released on 20 February 2012
Intercollegiate Board for Training in Pre-hospital Emergency Medicine
College of Emergency Medicine7-9 Bream’s Buildings,
London, EC4A 1DT.United Kingdom
www.ibtphem.org.uk
3CONTENTS
CONTENTS
Introduction ............................................................................................................................ 5
Cross-Cutting Theme. Good Medical Practice ......................................................................... 9
Theme 1. Working in emergency medical systems .................................................................15
Theme 2. Providing Pre-hospital Emergency Medical Care ....................................................23
Theme 3. Using Pre-hospital Equipment ................................................................................49
Theme 4. Supporting Rescue and Extrication ........................................................................57
Theme 5. Supporting Safe Patient Transfer ............................................................................63
Theme 6. Supporting Emergency Preparedness and Response ..............................................69
Cross-cutting Theme A. Operational Practice .........................................................................75
Cross-cutting Theme B. Team Resource Management ...........................................................83
Cross-cutting Theme C. Clinical Governance ..........................................................................89
Annex. Assessment Tools ........................................................................................................95
INTRODUCTIONThis document details the elements of the curriculum for Pre-hospital Emergency Medicine (PHEM). It should be read in conjunction with (version 4) – referred to as ‘The Guide’.
CURRICULUM FRAMEWORKThe Curriculum Framework comprises six sub-specialty specific and four cross-cutting themes. ‘Themes’ are over-arching areas of pre-hospital professional practice. Within each theme are a number of discrete work roles or activities, which are referred to as ‘units’. Each unit contains grouped or related ‘elements’ of under-pinning knowledge, technical skill and behavioural attribute or non-technical skill – otherwise referred to as ‘competences’. These elements are described in detail within the tables in this document.
ASSESSMENT The 12 months of whole time equivalent (WTE) training required to complete PHEM sub-specialty training is delivered in two distinct phases: initial and developmental training (phase 1) and consolidation training (phase 2). Progression through these phases is measured by a combination of formative and summative assessment methods at local and national level. The overall assessment system (figure 1) comprises:
1. A defined number of educational and appraisal meetings.
2. A target number of work-place based training and learning opportunities over the full twelve months WTE of subspecialty training:
(a) 15 Mini-Clinical Evaluation Exercises (CEX),
(b) 30 Case-Based Discussions (CbD),
(c) 30 Direct Observation of Procedural Skills (DOPS)
(d) 10 Full case Simulations (SIM)
(e) 25 reviews of a duty period (using the Acute Care Assessment Tool (ACAT))
(f) 5 teaching observations
(g) 2 multi-source feedback (MSF) reviews
3. A locally managed structured assessment towards the end of the initial phase of training.
4. A nationally co-ordinated and managed structured assessment towards the end of each of the developmental and consolidation phases of training.
5. Structured training reports from Educational Supervisors
5INTRODUCTION
Con�nuous Assessment within training programmes
Phase 1 Local Forma�veAssessment
Phase 1 Educa�onalReview and STR
Phase 2 Educa�onalReview and STR
Ini�al Educa�onalReview
PHASE 1(1 month WTE ini�al and 5 month
WTE development training)
Phase 1Na�onal
Summa�veAssessment
Phase 2Na�onal
Summa�veAssessment
PHASE 2(six months WTE
consolida�on training)
Figure 1. Schematic representation of PHEM training
The tables show how each element within the curriculum framework maps to, or is ‘blueprinted’ against, the assessment system in relation to the range of assessment tools and the syllabus for the relevant ‘end-of-phase’ National Summative Assessment (NSA).
HOW TO USE THE THEME TABLESThe PHEM Curriculum is presented in the form of ten theme tables:
• Cross-cutting theme. Good medical practice.
• Theme 1. Working in emergency medical systems
• Theme 2. Providing pre-hospital emergency medical care
• Theme 3. Using pre-hospital equipment
• Theme 4. Supporting rescue and extrication
• Theme 5. Supporting safe patient transfer
• Theme 6. Supporting emergency preparedness and response
• Cross-cutting theme A. Operational practice
• Cross-cutting theme B. Team resource management
• Cross-cutting theme C. Clinical governance
The first curriculum theme table relates to the central role of Good Medical Practice (GMP). In contrast to the other tables, no specific learning or assessment methods are listed. This is because GMP has been incorporated into, and directly mapped against, all aspects of the curriculum.
The subsequent curriculum theme tables describe the theme, unit and element type in terms of underpinning knowledge (UK), technical skill (TS) and non-technical skill (NTS). The A column indicates the earliest formal assessment in which an individual element can be assessed. Note that phase 1 is sub-divided into phase 1 (a) and phase 1 (b) to reflect the initial and developmental phases of training. Details of the content and structure of assessments are given in The Guide.
The tables then provide recommended learning and assessment methods as defined in tables 1 and 2 below. The assessment methods with an asterisk in table 2 may be used for summative assessment. All may used to inform the Structured Training Report (STR) and, in turn, the relevant core specialty Annual Review of Competence Progression (ARCP). Only one method need be used for an individual element. Further details of assessment are provided in the Guide.
The final GMP column in the curriculum theme tables indicates the relationship between the individual elements and the GMP domains. The domain indicated is the dominant domain for that element.
The annex contains templates for each type of assessment together with guidance on the rating of satisfactory or unsatisfactory assessments.’
E-PORTFOLIOAll trainees should record their clinical and operational experience, work-place based assessments and other learning and development on the PHEM e-portfolio. Access to the e-portfolio can be obtained via www.phemportfolio.org or the IBTPHEM
6INTRODUCTION
Table 1. Recommended learning methods
Method Description
Directed Reading (DR)Reading recommended texts, journal articles and monographs whether available online or offline
Lectures and Tutorials (LT)Use of lectures, small group teaching and tutorials (including practical skills sessions) where the learning is moderated by the teacher
Deliberate Practice (DP)The repeated execution of a skill or task (without a mentor present) to develop a higher level.
Simulation Learning (SL)The simulation (at any level of fidelity and reality) of a situation in order to attain pre-determined learning objectives (e.g. simulated patients, simulated incident scenes, use of models, tabletop exercises)
Reflective Practice (RP)Reflection upon past events to critique performance and so guide further development
Role Modelling (RM)Role modelling is a process that allows trainees to learn new behaviours without the trial and error of doing things for themselves
Collaborative Learning (CL) Learning from peers through discussion of situations, cases or concepts
Experiential Learning (EL) Observation of or participation in events experienced by the learner
7INTRODUCTION
Table 2. Recommended assessment methods
Assessment method Role
Knowledge Test (KT)*Summative written assessment of underpinning knowledge using a combination of extended matched and single best answer questions (EMQ and SBAQ)
Mini-Clinical Evaluation Exercise (CEX)*
Evaluates a clinical encounter. May be used for formative and summative assessments
Case based discussion (CbD)Assesses performance in clinical reasoning, decision-making and application of knowledge.
Simulation (SIM)*Assessment of technical skills and non-technical skills such as task management, team working, situational awareness and decision-making.
Direct Observation of Procedural Skills (DOPS)*
Evaluates performance in undertaking a practical procedure. May be used for formative and summative assessments.
Multisource feedback (MSF)Assesses generic skills such as communication, leadership, team working, reliability etc.
Acute care assessment tool (ACAT)
Facilitates feedback on performance across a number of domains during a pre-hospital emergency medicine duty period.
Logbook (LOG)Supports the STR/ARCP in relation to clinical case mix, operational experience and achievement of competences.
Patient Survey (PS)Assesses performance in areas such as interpersonal and communication skills by concentrating on performance during patient consultations.
Teaching observation (TO)A form of formative assessment for complex knowledge and skills given the need for the teacher to demonstrate competence (and often mastery).
9CROSS-CUTTING THEME GOOD MEDICAL PRACTICE
CROSS-CUTTING THEME - GOOD MEDICAL PRACTICE Good Medical Practice (GMP) is the term given to the core ethical guidance provided to doctors by the General Medical Council (GMC). GMP sets out the principles and values on which good practice is founded; these principles together describe medical professionalism in action. The seven sections of GMP have, together with other GMC guidance on management and research, been distilled into four domains and 12 attributes – all of which are relevant to the clinical practice of PHEM.
DOMAINS AND ATTRIBUTES1. Knowledge skills and performance
1.1 Maintain your professional performance
1.2 Apply knowledge and experience to practice
1.3 Keep clear, accurate and legible records
2. Safety and quality
2.1 Put into effect systems to protect patients and improve care
2.2 Respond to risks to safety
2.3 Protect patients and colleagues from any risk posed by your health
3. Communication, partnership and teamwork
3.1 Communicate effectively
3.2 Work constructively with colleagues and delegate effectively
3.3 Establish and maintain partnerships with patients
4. Maintaining Trust
4.1 Show respect for patients
4.2 Treat patients and colleagues fairly and without discrimination
4.3 Act with honesty and integrity
In this first table, the units or attributes within each GMP Domain are listed and related to defined standards of practice. These standards have been adopted from the work by NHS London Deanery in the document Matching Evidence for appraisal to the GMC’s Framework for Revalidation, Version 4.2 June 2010.
The standards are then matched to the actual GMC guidance documents. The abbreviations represent the seven categories of GMP (2006) and the additional GMC guidance related to confidentiality, management and research.
• Good Clinical Care (GCC)
• Maintaining good medical care (MGMP)
• Relationships with colleagues (RwP)
• Working with colleagues (WwC)
• Teaching, Training, Appraising and Assessing (TTAA)
• Probity (Probity)
• Health (Health)
• Management for Doctors (2006) (MfD)
• Good Practice in Research (2010) (GpR)
• Confidentiality (2009) (CON)
In all subsequent tables in the Curriculum Framework, GMP domains are assigned to each group of elements. This assignment ensures that the assessment tools used for those particular groups of elements incorporate the relevant aspect of GMP.
CRO
SS-C
UTT
ING
TH
EME
- GO
OD
MED
ICA
L PR
ACTI
CE
10CROSS-CUTTING THEME GOOD MEDICAL PRACTICE
Dom
ain
Att
ribu
teSt
anda
rd (e
lem
ent)
GM
CG
uida
nce
Refe
renc
e pa
ragr
aph
Gui
danc
e D
ocum
ent
Dom
ain
1Kn
owle
dge,
sk
ills
and
perf
orm
ance
1.1
Mai
ntai
n yo
ur
prof
essi
onal
pe
rfor
man
ce
Mai
ntai
n kn
owle
dge
of th
e la
w a
nd o
ther
regu
latio
ns re
leva
nt to
pra
ctice
13
GM
P (M
GM
P)Ke
ep k
now
ledg
e an
d sk
ills
up to
dat
e 13
Parti
cipa
te in
pro
fess
iona
l dev
elop
men
t and
edu
catio
nal a
ctivi
ties
12
Take
par
t in
regu
lar
and
syst
emati
c au
dit
14
1.2
App
ly
know
ledg
e an
d ex
peri
ence
to
prac
tice
Reco
gnis
e an
d w
ork
with
in th
e lim
its o
f you
r co
mpe
tenc
e 3(
a)
GM
P (G
CC)
Ade
quat
ely
asse
ss th
e pa
tient
’s c
ondi
tions
2a
Prov
ide
or a
rran
ge a
dvic
e, in
vesti
gatio
ns o
r tr
eatm
ent w
here
nec
essa
ry
2b
Pres
crib
e dr
ugs
or tr
eatm
ent,
incl
udin
g re
peat
pre
scri
ption
s, s
afel
y an
d ap
prop
riat
ely
3b
Prov
ide
effec
tive
trea
tmen
ts b
ased
on
the
best
ava
ilabl
e ev
iden
ce
3c
Take
ste
ps to
alle
viat
e pa
in a
nd d
istr
ess
whe
ther
or
not a
cur
e m
ay b
e po
ssib
le
3d
Cons
ult c
olle
ague
s, o
r re
fer
to c
olle
ague
s, w
hen
it is
in th
e pa
tient
’s b
est i
nter
est
2(c)
, 3(a
), 3(
i),
54, 5
5G
MP
(GCC
)G
MP
(Ww
C)
Supp
ort p
atien
ts in
car
ing
for
them
selv
es
21(e
)G
MP
(Rw
P)
For d
octo
rs w
ith m
anag
emen
t, te
achi
ng o
r res
earc
h ro
les:
Follo
w a
ppro
pria
te n
ation
al re
sear
ch g
over
nanc
e gu
idel
ines
71
GM
P (P
robi
ty)
App
ly th
e sk
ills,
atti
tude
s, a
nd p
racti
ce o
f a c
ompe
tent
teac
her
/ tr
aine
r 16
GM
P (T
TAA
)
Wor
k eff
ectiv
ely
as a
man
ager
12
,17
MfD
1.3
Keep
cle
ar,
accu
rate
and
le
gibl
e re
cord
s
Keep
cle
ar, a
ccur
ate
and
legi
ble
reco
rds
3(f)
GM
P (G
CC)
Mak
e re
cord
s at
the
sam
e tim
e as
the
even
ts y
ou a
re re
cord
ing
or a
s so
on a
s po
ssib
le a
fter
war
ds
Reco
rd c
linic
al fi
ndin
gs, d
ecis
ions
, inf
orm
ation
giv
en to
pati
ents
, dru
gs p
resc
ribe
d an
d ot
her
info
rmati
on o
r tr
eatm
ent
11CROSS-CUTTING THEME GOOD MEDICAL PRACTICE
Dom
ain
Att
ribu
teSt
anda
rd (e
lem
ent)
GM
CG
uida
nce
Refe
renc
e pa
ragr
aph
Gui
danc
e D
ocum
ent
Dom
ain
2Sa
fety
and
Q
ualit
y
2.1
Put i
nto
effec
t sy
stem
s to
pr
otec
t pati
ents
an
d im
prov
e ca
re
Resp
ond
cons
truc
tivel
y to
the
outc
ome
of a
udit,
app
rais
als
and
perf
orm
ance
revi
ews
14(e
)
GM
P (M
GM
P)
Take
par
t in
syst
ems
of q
ualit
y as
sura
nce
and
qual
ity im
prov
emen
t 14
Com
ply
with
ris
k m
anag
emen
t and
clin
ical
gov
erna
nce
proc
edur
es
Co-o
pera
te w
ith le
gitim
ate
requ
ests
for
info
rmati
on fr
om o
rgan
isati
ons
mon
itori
ng p
ublic
hea
lth14
(i)
Prov
ide
info
rmati
on fo
r co
nfide
ntial
inqu
irie
s, s
igni
fican
t eve
nt re
porti
ng
14(g
)
Repo
rt s
uspe
cted
adv
erse
dru
g re
actio
ns14
(h)
Ensu
re a
rran
gem
ents
are
mad
e fo
r th
e co
ntinu
ing
care
of p
atien
ts w
here
nec
essa
ry40
, 48
GM
P (R
wP)
GM
P (W
wC)
For d
octo
rs w
ith m
anag
emen
t rol
es:
Mak
e su
re th
at a
ll st
aff fo
r w
hose
per
form
ance
you
are
resp
onsi
ble,
incl
udin
g lo
cum
s an
d st
uden
ts, a
re
prop
erly
sup
ervi
sed
14G
MP
(TTA
A)
Ensu
re s
yste
ms
are
in p
lace
for
colle
ague
s to
rais
e co
ncer
ns a
bout
ris
ks to
pati
ents
45
GM
P (W
wC)
2.2
Resp
ond
to r
isks
to
saf
ety
Repo
rt r
isks
in th
e he
alth
car
e en
viro
nmen
t to
your
em
ploy
ing
or c
ontr
actin
g bo
dies
6
GM
P (G
CC)
Safe
guar
d an
d pr
otec
t the
hea
lth a
nd w
ell b
eing
of v
ulne
rabl
e pe
ople
, inc
ludi
ng c
hild
ren
and
the
elde
rly
and
thos
e w
ith le
arni
ng d
ifficu
lties
26
, 28
GM
P (R
wP)
Take
acti
on w
here
ther
e is
evi
denc
e th
at a
col
leag
ue’s
con
duct
, per
form
ance
or
heal
th m
ay b
e pu
tting
pa
tient
s at
ris
k 43
, 44
GM
P (W
wC)
Resp
ond
prom
ptly
to r
isks
pos
ed b
y pa
tient
s 53
- 56
CON
Follo
w in
fecti
on c
ontr
ol p
roce
dure
s an
d re
gula
tions
13
GM
P (M
GM
P)
2.3
Prot
ect p
atien
ts
and
colle
ague
s fr
om a
ny r
isk
pose
d by
you
r he
alth
Mak
e ar
rang
emen
ts fo
r ac
cess
ing
inde
pend
ent m
edic
al a
dvic
e w
hen
nece
ssar
y 77
GM
P (H
ealth
)
Be im
mun
ised
aga
inst
com
mon
ser
ious
com
mun
icab
le d
isea
se w
here
vac
cine
s ar
e av
aila
ble
78
12
Dom
ain
Att
ribu
teSt
anda
rd (e
lem
ent)
GM
CG
uida
nce
Refe
renc
e pa
ragr
aph
Gui
danc
e D
ocum
ent
Dom
ain
3Co
mm
unic
ation
, pa
rtne
rshi
p an
d te
amw
ork
3.1
Com
mun
icat
e Eff
ectiv
ely
Com
mun
icat
e eff
ectiv
ely
with
col
leag
ues
with
in a
nd o
utsi
de th
e te
am
41(b
)G
MP
(Ww
C)
Expl
ain
to p
atien
ts w
hen
som
ethi
ng h
as g
one
wro
ng
30
GM
P (R
wP)
List
en to
pati
ents
and
resp
ect t
heir
vie
ws
abou
t the
ir h
ealth
22
(a),
27(a
)
Giv
e pa
tient
s th
e in
form
ation
they
nee
d in
ord
er to
mak
e de
cisi
ons
abou
t the
ir c
are
in a
way
they
can
un
ders
tand
22
(b),
27
Resp
ond
to p
atien
ts’ q
uesti
ons
22(c
), 27
(b)
Keep
pati
ents
info
rmed
abo
ut th
e pr
ogre
ss o
f the
ir c
are
29Tr
eat t
hose
clo
se to
the
patie
nt c
onsi
dera
tely
Pass
on
info
rmati
on to
col
leag
ues
invo
lved
in, o
r ta
king
ove
r, yo
ur p
atien
ts’ c
are
40, 5
1-53
GM
P (R
wP)
GM
P (W
wC)
Stan
dard
s fo
r do
ctor
s w
ith m
anag
emen
t rol
es:
Enco
urag
e co
lleag
ues
to c
ontr
ibut
e to
dis
cuss
ions
and
to c
omm
unic
ate
effec
tivel
y w
ith e
ach
othe
r 50
MfD
3.2
Wor
k co
nstr
uctiv
ely
with
Col
leag
ues
and
Del
egat
e Eff
ectiv
ely
Trea
t col
leag
ues
fair
ly a
nd w
ith re
spec
t 46
GM
P (W
wC)
Supp
ort c
olle
ague
s w
ho h
ave
prob
lem
s w
ith th
eir
perf
orm
ance
, con
duct
or
heal
th
41(d
)
Act
as
a po
sitiv
e ro
le m
odel
for
colle
ague
s 41
Ensu
re c
olle
ague
s to
who
m y
ou d
eleg
ate
have
app
ropr
iate
qua
lifica
tions
and
exp
erie
nce
54
Stan
dard
s fo
r do
ctor
s w
ith m
anag
emen
t rol
es:
Prov
ide
effec
tive
lead
ersh
ip
50M
FD
CROSS-CUTTING THEME GOOD MEDICAL PRACTICE
13CROSS-CUTTING THEME GOOD MEDICAL PRACTICE
Dom
ain
Att
ribu
teSt
anda
rd (e
lem
ent)
GM
CG
uida
nce
Refe
renc
e pa
ragr
aph
Gui
danc
e D
ocum
ent
Dom
ain
4M
aint
aini
ng
trus
t
4.1
Esta
blis
h an
d M
aint
ain
Part
ners
hips
w
ith P
atien
ts
Enco
urag
e pa
tient
s to
take
an
inte
rest
in th
eir
heal
th a
nd ta
ke a
ction
to im
prov
e an
d m
aint
ain
it4
21(f
)G
MP
(GCC
)G
MP
(Rw
P)
Be s
atisfi
ed th
at y
ou h
ave
cons
ent o
r ot
her
valid
aut
hori
ty b
efor
e yo
u un
dert
ake
any
exam
inati
on o
r in
vesti
gatio
n36
GM
P (R
wP)
4.2
Trea
t Pati
ents
an
d Co
lleag
ues
Fair
ly a
nd
With
out
Dis
crim
inati
on
Impl
emen
t and
com
ply
with
sys
tem
s to
pro
tect
pati
ents
con
fiden
tialit
y 37
GM
P (R
wP)
Be p
olite
, con
side
rate
and
hon
est a
nd re
spec
t pati
ents
’ dig
nity
and
pri
vacy
21
(a),
(b),
(d)
Trea
t eac
h pa
tient
fair
ly a
nd a
s an
indi
vidu
al
38-3
9, 2
1(c)
Stan
dard
s fo
r doc
tors
with
rese
arch
role
s:
Resp
ect t
he r
ight
s of
pati
ents
par
ticip
ating
in re
sear
ch.
2, 5
GPR
Be h
ones
t and
obj
ectiv
e w
hen
appr
aisi
ng o
r as
sess
ing
colle
ague
s an
d w
hen
wri
ting
refe
renc
es
18-1
9G
MP
(TTA
A)
Resp
ond
prom
ptly
and
fully
to c
ompl
aint
s 31
GM
P (R
wP)
Prov
ide
care
on
the
basi
s of
the
patie
nt’s
nee
ds a
nd th
e lik
ely
effec
t of t
reat
men
t 7,
10
GM
P (G
CC)
4.3
Act
with
H
ones
ty a
nd
Inte
grity
Ensu
re y
ou h
ave
adeq
uate
inde
mni
ty o
r in
sura
nce
cove
r fo
r yo
ur p
racti
ce34
GM
P (R
wP)
Be h
ones
t in
finan
cial
and
com
mer
cial
dea
lings
73
GM
P (P
robi
ty)
Ensu
re a
ny p
ublis
hed
info
rmati
on a
bout
you
r se
rvic
e is
fact
ual a
nd v
erifi
able
60
, 61
GM
P (P
robi
ty)
Be h
ones
t in
any
form
al s
tate
men
t or
repo
rt, w
heth
er w
ritt
en o
r or
al, m
akin
g cl
ear
the
limits
of y
our
know
ledg
e an
d co
mpe
tenc
e 63
-65,
67-
68G
MP
(Pro
bity
)
Info
rm p
atien
ts a
bout
any
fees
and
cha
rges
bef
ore
star
ting
trea
tmen
t 72
(a)
GM
P (P
robi
ty)
Stan
dard
s fo
r doc
tors
with
rese
arch
role
s:
Obt
ain
appr
opri
ate
ethi
cal a
ppro
val f
or re
sear
ch p
roje
cts
5G
PR
Be h
ones
t in
unde
rtak
ing
rese
arch
and
repo
rting
rese
arch
resu
lts
71(b
)G
MP
(Pro
bity
)
Ensu
re th
at y
our
rese
arch
is a
udite
d re
gula
rly
43G
PR
15
THEME 1. WORKING IN EMERGENCY MEDICAL SYSTEMS Specialist practitioners in PHEM operate within wider Emergency Medical Services (EMS) Systems. These systems have a number of inter-dependent components. Having an understanding of these components, the way in which they interact and the wider regulatory framework surrounding them is essential for effective professional medical practice in this field.
UNITS1.1 Understand Emergency Medical Services (EMS) Systems models and components
1.2 Understand pre-hospital operational environments
1.3 Understand the training and regulation of pre-hospital healthcare personnel
1.4 Understand the process of ambulance emergency call handling, prioritisation, dispatch categorisation and resource management
1.5 Understand the role of pre-hospital emergency medical services within EMS
1.6 Understand the law relevant to Pre-hospital Emergency Medicine practice
1.7 Work effectively with emergency services
1.8 Work effectively with acute hospital services
1.9 Provide EMS clinical advice, support and co-ordination
1.10 Understand the pre-hospital and acute sector management structures within the wider healthcare system
Related GMP domains are assigned to each group of elements within units as follows:
1. Knowledge skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
THEME 1
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
16THEME 1
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 1.
Wor
king
in E
mer
genc
y M
edic
al S
yste
ms
1.1
Und
erst
and
Emer
genc
y M
edic
al
Serv
ices
(EM
S)
Syst
ems
mod
els
and
com
pone
nts
1.1.
1D
efine
an
Emer
genc
y M
edic
al S
ervi
ce (E
MS)
sys
tem
UK
DR,
LT,
CL
, EL
1 (a
)•
•1
1.1.
2Ca
tego
rise
the
com
pone
nts
of a
n EM
S sy
stem
UK
1 (a
)•
•1
1.1.
3Co
ntra
st d
iffer
ing
regi
onal
, nati
onal
and
inte
rnati
onal
m
odel
s of
EM
S sy
stem
s U
K1
(b)
••
1
1.1.
4Co
ntra
st E
MS
syst
ems
in d
evel
oped
and
dev
elop
ing
natio
nsU
K2
••
1
1.2
Und
erst
and
pr
e-ho
spita
l op
erati
onal
en
viro
nmen
ts
1.2.
1Ca
tego
rize
the
diffe
rent
env
ironm
ents
in w
hich
PH
EM
is p
racti
ced
UK
DR,
LT,
CL
, EL
••
1
1.2.
2Co
ntra
st E
MS
syst
ems
in u
rban
, rur
al a
nd re
mot
e se
tting
sU
K•
•1
1.2.
3
Eval
uate
the
impa
ct o
f diff
eren
t ope
rati
onal
en
viro
nmen
ts o
n:
(a) R
isk
to p
erso
nnel
UK
DR,
LT,
CL
, EL
••
2
(b) P
atien
t saf
ety
UK
••
2
(c) C
linic
al c
are
UK
••
1
(d) P
atien
t tra
nspo
rtU
K•
•1
1.2.
4D
emon
stra
te re
silie
nce
in a
dver
se p
re-h
ospi
tal
cond
ition
s N
TSRM
, RP
EL, S
L
••
•2
1.2.
5D
emon
stra
te ju
dici
ous
use
of re
sour
ces
NTS
••
•2
17THEME 1
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 1.
Wor
king
in E
mer
genc
y M
edic
al S
yste
ms
1.3
Und
erst
and
the
trai
ning
and
re
gula
tion
of p
re-
hosp
ital h
ealth
care
pr
ofes
sion
als
1.3.
1Li
st th
e ra
nge
of p
re-h
ospi
tal h
ealth
care
per
sonn
elU
K
DR,
LT,
CL
, EL
1 (a
)•
•3
1.3.
2Co
mpa
re th
e di
ffere
nces
in tr
aini
ng o
f pre
-hos
pita
l he
alth
care
per
sonn
elU
K1
(a)
••
3
1.3.
3Su
mm
aris
e th
e m
edic
al c
apab
ilitie
s of
pre
-hos
pita
l he
alth
care
per
sonn
el w
ithin
the
EMS
syst
emU
K1
(b)
••
3
1.3.
4Su
mm
aris
e th
e ro
le o
f the
rele
vant
regu
lato
ry b
odie
s fo
r he
alth
care
pro
fess
iona
lsU
K2
••
2
1.3.
5D
emon
stra
te re
spec
t for
indi
vidu
als
with
in th
e m
ulti-
prof
essi
onal
wor
kfor
ceN
TSRM
, EL
SL, R
P1
(b)
••
••
•4
1.4
Und
erst
and
the
proc
ess
of a
mbu
lanc
e em
erge
ncy
call
hand
ling,
pr
iori
tisati
on, d
ispa
tch
cate
gori
satio
n an
d re
sour
ce
man
agem
ent
1.4.
1
Des
crib
e th
e pr
oces
s of
am
bula
nce
serv
ice
emer
genc
y:
(a) C
all h
andl
ing
UK
DR,
LT,
SL
, CL,
EL
1 (a
)•
•1
(b) C
all p
rior
itisa
tion
UK
1 (a
)•
•1
(c) D
ispa
tch
UK
1 (a
)•
•1
(d) R
esou
rce
activ
ation
UK
1 (a
)•
•1
(e) R
esou
rce
man
agem
ent
UK
1 (a
)•
•1
1.4.
2
Expl
ain
the
conc
epts
und
erpi
nnin
g am
bula
nce
serv
ice
emer
genc
y:
(a) C
all p
rior
itisa
tion
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) R
esou
rce
man
agem
ent
UK
1 (b
)•
•1
1.4.
3Fo
rmul
ate
resp
onse
dec
isio
ns o
n th
e ba
sis
of
ambu
lanc
e se
rvic
e em
erge
ncy
call
info
rmati
onTS
1 (b
)•
••
•3
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
18THEME 1
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 1.
Wor
king
in E
mer
genc
y M
edic
al S
yste
ms
1.5
Und
erst
and
the
role
of p
re-h
ospi
tal
emer
genc
y m
edic
al
serv
ices
with
in E
MS
1.5.
1D
efine
the
role
of p
re-h
ospi
tal e
mer
genc
y m
edic
al
serv
ices
UK
DR,
LT,
SL
, CL,
EL
1 (a
)•
•1
1.5.
2Ca
tego
rise
the
activ
ities
of p
re-h
ospi
tal e
mer
genc
y m
edic
al s
ervi
ces
UK
1 (a
)•
•1
1.5.
3Cr
itiqu
e th
e ro
le o
f phy
sici
ans
oper
ating
with
in p
re-
hosp
ital e
mer
genc
y m
edic
al s
ervi
ces
UK
1 (a
)•
•1
1.6
Und
erst
and
the
law
rele
vant
to
Pre-
hosp
ital
Emer
genc
y M
edic
ine
prac
tice
1.6.
1D
iffer
entia
te la
wfu
l con
sent
to tr
eatm
ent b
etw
een
adul
ts
and
child
ren
UK
DR,
LT,
SL
, CL,
EL
1 (a
)•
•3
1.6.
2D
iffer
entia
te la
wfu
l ref
usal
of t
reat
men
t bet
wee
n ad
ults
an
d ch
ildre
nU
K1
(a)
••
3
1.6.
3Ex
plai
n th
e le
gal b
asis
for
the
emer
genc
y tr
eatm
ent o
f th
e in
capa
cita
ted
patie
ntU
K1
(a)
••
3
1.6.
4
Des
crib
e th
e em
erge
ncy
prov
isio
ns in
legi
slati
on fo
r:
(a) p
rote
cting
and
saf
egua
rdin
g pa
tient
s w
ith m
enta
l ill
ness
UK
DR,
LT,
SL
, CL,
EL
1 (a
)•
•2
(b) p
rote
cting
and
saf
egua
rdin
g ch
ildre
nU
K1
(a)
••
2
(c) p
rote
cting
and
saf
egua
rdin
g vu
lner
able
adu
ltsU
K1
(a)
••
2
1.6.
5
Des
crib
e th
e em
erge
ncy
prov
isio
ns in
legi
slati
on fo
r:
(a) E
mer
genc
y dr
ivin
g pr
oced
ure
UK
DR,
LT,
SL
, CL,
EL
1 (a
)•
•1
(b) H
elic
opte
r em
erge
ncy
med
ical
ser
vice
sU
K1
(a)
••
1
(c) A
ir a
mbu
lanc
e se
rvic
esU
K1
(a)
••
1
1.6.
6Ci
te e
xam
ples
whe
re c
onfid
entia
lity
may
law
fully
be
brea
ched
in p
re-h
ospi
tal e
mer
genc
y m
edic
al p
racti
ceU
K1
(a)
••
4
1.6.
7D
escr
ibe
the
lega
l req
uire
men
ts re
late
d to
dea
ths
outs
ide
of h
ospi
tal
UK
1 (a
)•
•1
19THEME 1
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 1.
Wor
king
in E
mer
genc
y M
edic
al S
yste
ms
1.7
Wor
k eff
ectiv
ely
with
em
erge
ncy
serv
ices
1.7.
1
Des
crib
e th
e ro
les
and
resp
onsi
biliti
es o
f:
(a) A
mbu
lanc
e au
thor
ities
and
ser
vice
s U
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) P
olic
e au
thor
ities
and
ser
vice
sU
K1
(b)
••
1
(c) F
ire a
utho
ritie
s an
d se
rvic
es
UK
1 (b
)•
•1
(d) R
escu
e au
thor
ities
and
ser
vice
sU
K1
(b)
••
1
(e) S
peci
alis
t res
cue
serv
ices
U
K1
(b)
••
1
(e) V
olun
tary
em
erge
ncy
serv
ices
UK
1 (b
)•
•1
1.7.
2
Com
pare
the
inci
dent
com
man
d st
ruct
ures
of:
(a) M
edic
al s
ervi
ces
UK
DR,
LT,
SL
, CL,
EL
1 (a
)•
•1
(b) A
mbu
lanc
e se
rvic
esU
K1
(a)
••
1
(c) P
olic
e se
rvic
esU
K1
(a)
••
1
(d) F
ire s
ervi
ces
UK
1 (a
)•
•
(e) R
escu
e se
rvic
esU
K1
(a)
••
1
1.7.
3
Expl
ain
the
med
ical
cap
abili
ties
of:
(a) P
olic
e pe
rson
nel
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) F
ire p
erso
nnel
UK
1 (b
)•
•1
(c) R
escu
e pe
rson
nel
UK
1 (b
)•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
20THEME 1
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 1.
Wor
king
in E
mer
genc
y M
edic
al S
yste
ms
1.7.
3 co
nt.
(d) S
peci
alis
t res
cue
pers
onne
lU
KD
R, L
T,
SL, C
L,
EL
1 (b
)•
•1
(e) V
olun
tary
em
erge
ncy
serv
ices
per
sonn
elU
K1
(b)
••
1
1.7.
4D
emon
stra
te e
ngag
emen
t with
loca
l, re
gion
al a
nd
natio
nal e
mer
genc
y se
rvic
es im
prov
emen
t pro
cess
esN
TSRP
, RM
, EL
1 (b
)•
••
••
2
1.8
Wor
k eff
ectiv
ely
with
acu
te h
ospi
tal
serv
ices
1.8.
1Ca
tego
rise
acu
te h
ospi
tal s
ervi
ces
UK
DR,
LT,
CL
, EL
1 (a
)•
•1
1.8.
2
Diff
eren
tiat
e, w
ithi
n an
EM
S Sy
stem
, the
pro
cess
for
acce
ssin
g:
(a) E
mer
genc
y de
part
men
tsU
K
DR,
LT,
CL
, EL
1 (a
)•
•1
(b) M
ajor
trau
ma
serv
ices
UK
1 (a
)•
•1
(c) B
urns
ser
vice
sU
K1
(a)
••
1
(d) S
pina
l inj
ury
serv
ices
UK
1 (a
)•
•1
(e) P
erin
atal
ser
vice
sU
K1
(a)
••
1
(f) C
hild
ren’
s se
rvic
esU
K1
(a)
••
1
(g) M
enta
l hea
lth s
ervi
ces
UK
1 (a
)•
•1
(h) S
peci
alis
t Med
ical
ser
vice
sU
K1
(a)
••
1
1.8.
3D
emon
stra
te e
ngag
emen
t with
acu
te h
ospi
tal e
mer
genc
y ac
cess
impr
ovem
ent p
roce
sses
NTS
RM, E
L,
CL1
(b)
••
•2
1.9
Prov
ide
EMS
clin
ical
adv
ice,
su
ppor
t and
co
-ord
inati
on
1.9.
1D
escr
ibe
the
proc
edur
es, p
roto
cols
and
gui
delin
es fo
r pr
ovid
ing
EMS
clin
ical
adv
ice,
sup
port
and
co-
ordi
natio
nU
K
KT, L
T, S
L
1 (b
)•
•3
1.9.
2D
escr
ibe
the
equi
pmen
t ava
ilabl
e to
pro
vide
EM
S cl
inic
al
advi
ce, s
uppo
rt a
nd c
o-or
dina
tion
UK
1 (b
)•
•3
21THEME 1
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 1.
Wor
king
in E
mer
genc
y M
edic
al S
yste
ms
1.9
Prov
ide
EMS
clin
ical
adv
ice,
su
ppor
t and
co-
ordi
natio
n
(con
t.)
1.9.
3Co
mpa
re ‘o
n-lin
e’ (r
emot
e te
leph
one/
radi
o su
ppor
t)
and
‘off-
line’
(doc
umen
ts th
at g
uide
pra
ctice
) med
ical
di
recti
onU
KKT
, LT,
SL
1 (b
)•
•3
1.9.
4
Prov
ide
effec
tive
on-
line
clin
ical
sup
port
by:
(a) C
omm
unic
ating
in a
n ap
prop
riat
e an
d pr
ofes
sion
al
man
ner
TS
SL, E
L,
RM
1 (b
)•
••
••
3
(b) O
btai
ns re
leva
nt in
form
ation
in a
tim
ely
man
ner
TS1
(b)
••
••
3
(c) D
raw
ing
appr
opri
ate
conc
lusi
ons
TS1
(b)
••
••
3
(d) R
elay
ing
the
deci
sion
to th
e cl
inic
ian
at s
cene
, en
suri
ng th
eir
unde
rsta
ndin
g.TS
1 (b
)•
••
•3
1.9.
5Se
ek o
ppor
tuni
ties
to re
view
and
lear
n fr
om a
ny E
MS
clin
ical
adv
ice,
sup
port
and
co-
ordi
natio
n ac
tivity
NTS
1 (b
)•
••
••
1
1.10
Und
erst
and
the
pre-
hosp
ital
and
acut
e se
ctor
m
anag
emen
t st
ruct
ures
with
in
the
wid
er h
ealth
care
sy
stem
1.10
.1
Des
crib
e th
e cl
inic
al a
nd o
pera
tion
al m
anag
emen
t st
ruct
ures
rele
vant
to e
mer
genc
y ca
re w
ithi
n:
(a) T
he a
mbu
lanc
e se
rvic
esU
K
DR,
LT,
EL
1 (b
)•
•1
(b) T
he p
re-h
ospi
tal e
mer
genc
y m
edic
al s
ervi
ceU
K1
(b)
••
1
(c) T
he a
cute
hos
pita
l em
erge
ncy
serv
ices
UK
1 (b
)•
•1
(d) T
he h
ealth
ser
vice
, aut
hori
ty o
r bo
ard
UK
1 (b
)•
•1
1.10
.2D
escr
ibe
the
inte
r-ag
ency
and
inte
r-se
rvic
e lia
ison
an
d m
anag
emen
t str
uctu
res
for
emer
genc
y ca
re
with
in th
e w
ider
hea
lthca
re s
yste
mU
K2
••
1
1.10
.3Co
ntra
st th
e co
mm
issi
onin
g an
d fu
ndin
g of
EM
S sy
stem
s na
tiona
lly a
nd in
tern
ation
ally
UK
2•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
23
THEME 2. PROVIDING PRE-HOSPITAL EMERGENCY MEDICAL CARE Sub-specialist training in PHEM commences after completion of ST4 in Emergency Medicine or Anaesthesia. Trainees therefore have experience of emergency clinical care in the hospital environment. The established principles and techniques used in those settings often need to be modified for effective pre-hospital emergency use. In addition, the provision of emergency medical care in a relatively unsupported environment requires a greater in-depth knowledge of resuscitation in all age groups. The units within this theme reinforce resuscitation concepts learned during higher specialist training and relate them to the pre-hospital operational environment.
UNITS2.1 Assess patients in the pre-hospital phase
2.2 Provide immediate pre-hospital clinical care
2.3 Provide cardiopulmonary resuscitation in the pre-hospital environment
2.4 Manage acute medical emergencies in the pre-hospital environment
2.5 Manage injury in the pre-hospital environment
2.6 Provide analgesia, procedural sedation and anaesthesia in the pre-hospital environment
2.7 Manage obstetric emergencies in the pre-hospital environment
2.8 Manage the newborn in the pre-hospital environment
2.9 Manage injured or ill children in the pre-hospital environment
2.10 Manage the bariatric patient in the pre-hospital environment
2.11 Manage elderly patients in the pre-hospital environment
2.12 Manage acute behavioural disturbance in the pre-hospital environment
2.13 Manage chemical, biological and radiological emergencies
2.14 Provide end-of-life care and immediate management of bereavement
THEME 2
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
24
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.1
Ass
ess
patie
nts
in th
e pr
e-ho
spita
l ph
ase
2.1.
1D
escr
ibe
how
inte
rpre
tatio
n of
an
inci
dent
sce
ne m
ay
influ
ence
a p
atien
t ass
essm
ent
UK
DR,
LT,
SL
CL, E
L1
(a)
••
•3
2.1.
2
Cate
gori
se th
e fa
ctor
s w
hich
impa
ct o
n cl
inic
al
asse
ssm
ent o
f pati
ents
in t
he fo
llow
ing
situ
ation
s:
(a) p
riva
te d
omes
ticU
K
DR,
LT,
SL
CL, E
L
1 (b
)•
•2
(b) c
row
ded
publ
icU
K1
(b)
••
2
(c) g
eogr
aphi
cally
isol
ated
U
K1
(b)
••
2
(d) e
nviro
nmen
tally
exp
osed
U
K1
(b)
••
2
(e) m
ultip
le p
atien
ts
UK
1 (b
)•
•2
(f) p
atien
t is
new
born
, inf
ant o
r ch
ildU
K1
(b)
••
2
(g) h
azar
dous
, uns
afe
or u
nsta
ble
UK
1 (b
)•
•2
(h) h
igh
expr
esse
d em
otion
UK
1 (b
)•
•2
(i) p
erso
nally
em
otive
U
K1
(b)
••
4
2.1.
3
Des
crib
e st
rate
gies
to o
ptim
ise
clin
ical
ass
essm
ent
in:
4
(a) p
riva
te d
omes
tic s
ituati
onU
K
DR,
LT,
SL
CL, E
L
2•
•2
(b) c
row
ded
publ
ic s
ituati
onU
K2
••
2
(c) g
eogr
aphi
cally
isol
ated
situ
ation
UK
2•
•2
(d) e
nviro
nmen
tally
exp
osed
situ
ation
UK
2•
•2
(e) m
ultip
le p
atien
t situ
ation
UK
2•
•2
(f) h
azar
dous
, uns
afe
or u
nsta
ble
situ
ation
UK
2•
•2
THEME 2
25THEME 2
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.1
Ass
ess
patie
nts
in
the
pre-
hosp
ital p
hase
(con
t.)
(g) h
igh
expr
esse
d em
otion
situ
ation
UK
DR,
LT,
SL
CL, E
L
2•
•2
(h) p
erso
nally
em
otive
situ
ation
UK
2•
•4
2.1.
4D
escr
ibe
the
fact
ors
whi
ch im
pact
on
the
tem
po o
f cl
inic
al a
sses
smen
t in
a dy
nam
ic s
ituati
onU
K1
(b)
••
•1
2.1.
5D
escr
ibe
the
risk
s of
lone
wor
king
for
heal
thca
re
prof
essi
onal
sU
K2
••
2
2.1.
6D
escr
ibe
way
s in
whi
ch th
e ac
ute
illne
ss it
self,
and
the
anxi
ety
caus
ed b
y it,
can
influ
ence
pati
ent a
sses
smen
tU
K2
••
1
2.1.
7Cr
itiqu
e th
e ro
le o
f pre
-hos
pita
l mon
itori
ng in
ass
essi
ng
patie
nts
of a
ll ag
esU
K2
••
1
2.1.
8Cr
itiqu
e th
e ro
le o
f pre
-hos
pita
l inv
estig
ation
s in
as
sess
ing
patie
nts
of a
ll ag
esU
K2
••
1
2.1.
9D
emon
stra
te a
bilit
y to
per
form
an
orga
nise
d, s
truc
ture
d,
rele
vant
and
focu
sed
asse
ssm
ent a
cros
s th
e ra
nge
of
pre-
hosp
ital s
ituati
ons
in in
fant
s, c
hild
ren
and
adul
tsTS
LT, D
P,
SL, C
L,
EL
1 (b
)•
•1
2.1.
10D
emon
stra
te a
bilit
y to
acc
urat
ely
inte
rpre
t clin
ical
his
tory
an
d ph
ysic
al s
igns
in th
e pr
e-ho
spita
l env
ironm
ent i
n in
fant
s, c
hild
ren
and
adul
tsTS
1 (b
)•
•1
2.1.
11D
emon
stra
te a
ppro
pria
te u
se a
nd in
terp
reta
tion
of
pre-
hosp
ital m
onito
ring
in in
fant
s, c
hild
ren
and
adul
tsTS
1 (b
)•
•1
2.1.
12D
emon
stra
te a
ppro
pria
te u
se a
nd in
terp
reta
tion
of
pre-
hosp
ital i
nves
tigati
ons
in in
fant
s, c
hild
ren
and
adul
tsTS
2•
•1
2.1.
13D
emon
stra
te a
bilit
y to
bal
ance
ris
k an
d be
nefit
s of
ac
tions
pri
or to
full
patie
nt a
sses
smen
t TS
1 (b
)•
•1
2.1.
14D
emon
stra
tes
resp
ect f
or p
atien
ts p
riva
cy a
nd d
igni
ty
duri
ng p
atien
t ass
essm
ent
NTS
RM, R
P,
SL, C
L,
EL
1 (b
)•
••
•4
2.1.
15D
emon
stra
tes
appr
opri
ate
pers
ever
ance
in u
nder
taki
ng
patie
nt a
sses
smen
t N
TS1
(b)
••
••
4
2.1.
16D
emon
stra
tes
effec
tive
com
mun
icati
on w
ith p
atien
ts a
nd
thei
r fa
mily
dur
ing
clin
ical
ass
essm
ent
NTS
1 (b
)•
••
•3
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 26
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.2
Prov
ide
imm
edia
te p
re-
hosp
ital c
linic
al c
are
2.2.
1Cr
itiqu
e th
e se
quen
ce a
nd o
bjec
tives
of i
mm
edia
te
clin
ical
acti
ons
in m
anag
ing
criti
cally
unw
ell p
atien
tsU
KD
R, L
T, S
L CL
, EL
2•
•1
2.2.
2
Criti
que
the
imm
edia
te p
re-h
ospi
tal c
linic
al a
ction
s in
all
age
grou
ps fo
r m
anag
ing
and
supp
orti
ng:
(a) t
he a
irw
ayU
K
DR,
LT,
SL
CL, E
L
2•
••
1
(b) v
entil
ation
UK
2•
••
1
(c) c
ircul
ation
UK
2•
••
1
2.2.
3Cr
itiqu
e th
e cu
rren
t bes
t pra
ctice
in m
anag
ing
acut
e pa
in a
nd d
istr
ess
in th
e pr
e-ho
spita
l env
ironm
ent
UK
2•
••
1
2.2.
4Co
ntra
st th
e de
liver
y of
clin
ical
car
e be
twee
n th
e ac
ute
hosp
ital a
nd p
re-h
ospi
tal e
nviro
nmen
tsU
K2
••
1
2.2.
5D
escr
ibe
stra
tegi
es to
opti
mis
e th
e de
liver
y of
im
med
iate
clin
ical
car
e in
the
reso
urce
lim
ited
pr
e-ho
spita
l env
ironm
ent
UK
1 (b
)•
••
1
2.2.
6D
emon
stra
te a
str
uctu
red
prim
ary
asse
ssm
ent
TSLT
, DP,
SL,
CL
, EL
2•
••
•1
2.2.
7
Dem
onst
rate
the
imm
edia
te c
linic
al in
terv
enti
ons
in
all a
ge g
roup
s fo
r m
anag
ing
and
supp
orti
ng:
(a) t
he a
irw
ayTS
LT, D
P, S
L,
CL, E
L
1 (b
)•
••
1
(b) v
entil
ation
TS1
(b)
••
•1
(c) c
ircul
ation
TS1
(b)
••
•1
2.2.
8D
emon
stra
te th
e m
anag
emen
t of a
cute
pai
n an
d di
stre
ss in
all
age
grou
ps th
e pr
e-ho
spita
l en
viro
nmen
tTS
1 (b
)•
•1
2.2.
9D
emon
stra
te a
bilit
y to
pro
vide
saf
e an
d eff
ectiv
e im
med
iate
clin
ical
car
e in
all
age
grou
ps in
the
pr
e-ho
spita
l env
ironm
ent
TS1
(b)
••
•1
2.2.
10D
ispl
ay a
cal
m a
nd m
etho
dica
l app
roac
h to
pro
vidi
ng
imm
edia
te c
linic
al c
are
NTS
RM, R
P,
SL, E
L1
(b)
••
••
3
THEME 2 27
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.3
Prov
ide
card
iopu
lmon
ary
resu
scita
tion
in
the
pre-
hosp
ital
envi
ronm
ent
2.3.
1D
escr
ibe
the
clin
ical
feat
ures
of i
mpe
ndin
g ca
rdia
c ar
rest
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
2.3.
2Cr
itiqu
e th
e ro
le o
f CPR
in p
re-h
ospi
tal c
are
UK
2•
••
1
2.3.
3D
escr
ibe
the
epid
emio
logy
of p
re-h
ospi
tal c
ardi
ac a
rres
t w
ithin
the
EMS
syst
emU
K2
••
1
2.3.
4Co
ntra
st th
e de
liver
y of
CPR
bet
wee
n th
e ho
spita
l and
pr
e-ho
spita
l env
ironm
ents
U
K2
••
1
2.3.
5Re
call
the
curr
ent E
urop
ean
Resu
scita
tion
Coun
cil (
ERC)
gu
idan
ce o
n CP
R an
d em
erge
ncy
card
iova
scul
ar c
are
for
all a
ge g
roup
sU
K1
(b)
••
1
2.3.
6Ci
tes
evid
ence
for
supp
ortin
g de
cisi
on m
akin
g re
late
d to
ou
tcom
es o
f CPR
UK
2•
•1
2.3.
7D
escr
ibe
the
mec
hani
sms
for
indu
cing
ther
apeu
tic
hypo
ther
mia
in th
e pr
e-ho
spita
l pha
se a
fter
retu
rn o
f ci
rcul
ation
U
K2
••
1
2.3.
8
Des
crib
e in
dica
tion
s fo
r pr
e-ho
spit
al:
(a) O
pen
ches
t car
diac
com
pres
sion
sU
K
DR,
LT,
SL
, CL,
EL
2•
•1
(b) R
esus
cita
tive
thor
acot
omy
UK
2•
•1
(c) R
esus
cita
tive
hyst
erot
omy
UK
2•
•1
2.3.
9D
escr
ibe
polic
ies
and
proc
edur
es fo
r or
gan
and
tissu
e do
natio
n w
ithin
the
EMS
syst
emTS
2•
•2
2.3.
10D
emon
stra
te a
bilit
y to
reco
gnis
e ri
sk o
f im
pend
ing
card
iac
arre
stTS
LT, D
P,
SL, C
L,
EL
1 (b
)•
••
1
2.3.
11D
emon
stra
te a
pplic
ation
of s
trat
egie
s to
pre
vent
car
diac
ar
rest
TS1
(b)
••
1
2.3.
12D
emon
stra
te e
ffecti
ve m
anag
emen
t of p
re-h
ospi
tal
card
iac
arre
stTS
1 (b
)•
•1
2.3.
13D
emon
stra
te th
e ab
ility
to in
itiat
e an
d m
anag
e th
erap
eutic
hyp
othe
rmia
whe
n in
dica
ted
TS2
••
1
2.3.
14D
emon
stra
te a
bilit
y to
app
ropr
iate
ly a
pply
the
curr
ent
ERC
guid
elin
es in
the
pre-
hosp
ital e
nviro
nmen
tTS
1 (b
)•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 28
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.3.
15D
emon
stra
te a
bilit
y to
lead
a c
ardi
ac a
rres
t tea
m in
th
e pr
e-ho
spita
l env
ironm
ent
NTS
RM, R
P SL
, CL,
EL
1 (b
)•
•1
2.3.
16D
emon
stra
te a
bilit
y to
insp
ire c
onfid
ence
in a
mul
ti-di
scip
linar
y pr
e-ho
spita
l car
diac
arr
est t
eam
NTS
1 (b
)•
••
3
2.3.
17D
emon
stra
tes
abili
ty to
mak
e ra
tiona
l end
of l
ife
deci
sion
sN
TS1
(b)
••
•3
2.4
Man
age
acut
e m
edic
al e
mer
genc
ies
in th
e pr
e-ho
spita
l en
viro
nmen
t
2.4.
1D
escr
ibe
the
epid
emio
logy
of a
cute
med
ical
em
erge
ncie
s w
ithin
the
EMS
syst
emU
KD
R, L
T,
SL, C
L, E
L1
(b)
••
•1
2.4.
2
Des
crib
e th
e im
med
iate
pre
-hos
pita
l em
erge
ncy
man
agem
ent o
f the
follo
win
g ac
ute
med
ical
pr
esen
tati
ons:
(a) A
irw
ay o
bstr
uctio
n/ch
okin
g/st
rido
r U
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
••
1
(b) A
cute
bre
athl
essn
ess
UK
1 (b
)•
••
1
(c) A
cute
che
st p
ain
UK
1 (b
)•
••
1
(d) H
ypot
ensi
on a
nd s
hock
U
K1
(b)
••
•1
(e) P
alpi
tatio
ns a
nd c
ardi
ac a
rrhy
thm
iaU
K1
(b)
••
•1
(f) A
cute
hea
dach
e U
K1
(b)
••
•1
(g) A
cute
vom
iting
U
K1
(b)
••
•1
(h) A
cute
abd
omin
al/l
oin/
scro
tal p
ain
UK
1 (b
)•
••
1
(i) A
cute
con
fusi
onal
sta
te
UK
1 (b
)•
••
1
(j) C
olla
pse/
Tran
sien
t los
s of
con
scio
usne
ss
UK
1 (b
)•
••
1
(k) T
he u
ncon
scio
us p
atien
t U
K1
(b)
••
•1
THEME 2 29
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.4
Man
age
acut
e m
edic
al e
mer
genc
ies
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.4.
2co
nt.
(l) In
toxi
catio
n an
d po
ison
ing
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
••
1
(m) T
he fi
tting
pati
ent
UK
1 (b
)•
••
1
(n) A
cute
alle
rgic
reac
tion
UK
1 (b
)•
••
1
(o) A
cute
non
-tra
umati
c ne
ck/b
ack
pain
U
K1
(b)
••
•1
(p) S
udde
n w
eakn
ess/
para
lysi
s/ab
norm
al s
ensa
tion
UK
1 (b
)•
••
1
(q) A
cute
vis
ual d
istu
rban
ce/r
ed e
ye
UK
1 (b
)•
••
1
(r) A
cute
febr
ile il
lnes
s U
K1
(b)
••
•1
(s) A
cute
gas
troi
ntes
tinal
hae
mor
rhag
e U
K1
(b)
••
•1
(t) A
cute
lim
b pa
in a
nd/o
r sw
ellin
g U
K1
(b)
••
•1
(u) A
cute
rash
U
K1
(b)
••
•1
(v) A
cute
hae
mop
tysi
s U
K1
(b)
••
•1
(w) A
cute
epi
stax
is
UK
1 (b
)•
••
1
(x) A
cute
pai
n U
K1
(b)
••
•1
(y) A
cute
ther
mal
illn
ess
UK
1 (b
)•
••
1
(z) B
ites,
stin
gs a
nd e
nven
omati
onU
K1
(b)
••
•1
2.4.
3
Des
crib
e th
e ap
plie
d ph
arm
acol
ogy
of m
edic
ines
co
mm
only
use
d in
the
imm
edia
te m
anag
emen
t of
:
(a) A
irw
ay o
bstr
uctio
n/ch
okin
g/st
rido
r U
KD
R, L
T,
SL, C
L, E
L1
(b)
••
1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 30
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.4
Man
age
acut
e m
edic
al e
mer
genc
ies
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.4.
3co
nt.
(b) A
cute
bre
athl
essn
ess
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(c) A
cute
che
st p
ain
UK
1 (b
)•
•1
(d) H
ypot
ensi
on a
nd s
hock
U
K1
(b)
••
1
(e) P
alpi
tatio
ns a
nd c
ardi
ac a
rrhy
thm
iaU
K1
(b)
••
1
(f) A
cute
hea
dach
e U
K1
(b)
••
1
(g) A
cute
vom
iting
U
K1
(b)
••
1
(h) A
cute
abd
omin
al/l
oin/
scro
tal p
ain
UK
1 (b
)•
•1
(i) A
cute
con
fusi
onal
sta
te
UK
1 (b
)•
•1
(j) C
olla
pse/
Tran
sien
t los
s of
con
scio
usne
ss
UK
1 (b
)•
•1
(k) T
he u
ncon
scio
us p
atien
t U
K1
(b)
••
1
(l) In
toxi
catio
n an
d po
ison
ing
UK
1 (b
)•
•1
(m) T
he fi
tting
pati
ent
UK
1 (b
)•
•1
(n) A
cute
alle
rgic
reac
tion
UK
1 (b
)•
•1
(o) A
cute
non
-tra
umati
c ne
ck/b
ack
pain
U
K1
(b)
••
1
(p) S
udde
n w
eakn
ess/
para
lysi
s/ab
norm
al s
ensa
tion
UK
1 (b
)•
•1
(q) A
cute
vis
ual d
istu
rban
ce/r
ed e
ye
UK
1 (b
)•
•
(r) A
cute
febr
ile il
lnes
s U
K1
(b)
••
1
THEME 2 31
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.4
Man
age
acut
e m
edic
al e
mer
genc
ies
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
(s) A
cute
gas
troi
ntes
tinal
hae
mor
rhag
e U
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(t) A
cute
lim
b pa
in a
nd/o
r sw
ellin
g U
K1
(b)
••
1
(u) A
cute
rash
U
K1
(b)
••
1
(v) A
cute
hae
mop
tysi
s U
K1
(b)
••
1
(w) A
cute
epi
stax
is
UK
1 (b
)•
•1
(x) A
cute
pai
n U
K1
(b)
••
1
(y) A
cute
ther
mal
illn
ess
UK
1 (b
)•
•1
(z) B
ites,
stin
gs a
nd e
nven
omati
onU
K1
(b)
••
1
2.4.
4Cr
itiqu
e th
e di
agno
stic
tech
nolo
gies
that
can
be
used
to
ass
ist i
n di
ffere
ntiati
ng th
e ca
uses
of a
cute
med
ical
pr
esen
tatio
ns in
the
pre-
hosp
ital p
hase
UK
2•
•1
2.4.
5
App
rais
e th
e cu
rren
t be
st p
racti
ce in
the
pre
-hos
pita
l m
anag
emen
t of:
(a) A
naph
ylax
isU
K
DR,
LT,
SL
, CL,
EL
2•
••
1
(b) A
sthm
aU
K2
••
•1
(c) C
oron
ary
hear
t dis
ease
UK
2•
••
1
(d) S
epsi
sU
K2
••
•1
(e) M
enin
goen
ceph
aliti
sU
K2
••
•1
(f) S
trok
eU
K2
••
•1
(g) D
iabe
tic k
etoa
cido
sis
UK
2•
••
1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
32
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.4
Man
age
acut
e m
edic
al e
mer
genc
ies
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.4.
6D
escr
ibe
alte
rnati
ve p
athw
ays
to a
cces
sing
urg
ent
and
unsc
hedu
led
care
with
in th
e EM
S sy
stem
(‘t
reat
and
refe
r’)
UK
DR,
LT,
SL
, CL,
EL
2•
••
3
2.4.
7D
escr
ibe
guid
elin
es fo
r sa
fely
leav
ing
patie
nts
at
hom
e or
sce
ne w
ithin
the
EMS
syst
em
(‘tre
at a
nd le
ave’
)U
K2
••
•3
2.4.
8D
emon
stra
te a
bilit
y to
form
ulat
e a
diffe
renti
al
diag
nose
s fo
r an
acu
te e
mer
genc
y pr
esen
tatio
nTS
LT, D
P,
SL, C
L, E
L1
(b)
••
3
2.4.
9
Dem
onst
rate
the
imm
edia
te p
re-h
ospi
tal
emer
genc
y m
anag
emen
t of t
he fo
llow
ing
acut
e m
edic
al p
rese
ntati
ons:
(a) A
irw
ay o
bstr
uctio
n/ch
okin
g/st
rido
r TS
LT, D
P,
SL, C
L,
EL
1 (b
)•
•1
(b) A
cute
bre
athl
essn
ess
TS1
(b)
••
1
(c) A
cute
che
st p
ain
TS1
(b)
••
1
(d) H
ypot
ensi
on a
nd s
hock
TS
1 (b
)•
•1
(e) P
alpi
tatio
ns a
nd c
ardi
ac a
rrhy
thm
iaTS
1 (b
)•
•1
(f) A
cute
hea
dach
e TS
1 (b
)•
•1
(g) A
cute
vom
iting
TS
1 (b
)•
•1
(h) A
cute
abd
omin
al/l
oin/
scro
tal p
ain
TS1
(b)
••
1
(i) A
cute
con
fusi
onal
sta
te
TS1
(b)
••
1
(j) C
olla
pse/
Tran
sien
t los
s of
con
scio
usne
ss
TS1
(b)
••
1
(k) T
he u
ncon
scio
us p
atien
t TS
1 (b
)•
•1
(l) In
toxi
catio
n an
d po
ison
ing
TS1
(b)
••
1
THEME 2
33
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.4
Man
age
acut
e m
edic
al e
mer
genc
ies
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.4.
9co
nt.
(m) T
he fi
tting
pati
ent
TS
LT, D
P,
SL, C
L,
EL
1 (b
)•
•1
(n) A
cute
alle
rgic
reac
tion
TS1
(b)
••
1
(o) A
cute
non
-tra
umati
c ne
ck/b
ack
pain
TS
1 (b
)•
•1
(p) S
udde
n w
eakn
ess/
para
lysi
s/ab
norm
al s
ensa
tion
TS1
(b)
••
1
(q) A
cute
vis
ual d
istu
rban
ce/r
ed e
ye
TS1
(b)
••
1
(r) A
cute
febr
ile il
lnes
s TS
1 (b
)•
•1
(s) A
cute
gas
troi
ntes
tinal
hae
mor
rhag
e TS
1 (b
)•
•1
(t) A
cute
lim
b pa
in a
nd/o
r sw
ellin
g TS
1 (b
)•
•1
(u) A
cute
rash
TS
1 (b
)•
•1
(v) A
cute
hae
mop
tysi
s TS
1 (b
)•
•1
(w) A
cute
epi
stax
is
TS1
(b)
••
1
(x) A
cute
pai
n TS
1 (b
)•
•1
(y) A
cute
ther
mal
illn
ess
TS1
(b)
••
1
(z) B
ites,
stin
gs a
nd e
nven
omati
onTS
1 (b
)•
•1
2.4.
10D
emon
stra
te a
ppro
pria
te u
se o
f alte
rnati
ve p
athw
ays
to a
cces
sing
urg
ent a
nd u
nsch
edul
ed c
are
(‘tre
at a
nd
refe
r’) f
or a
cute
med
ical
con
ditio
nsTS
2•
••
3
2.4.
11A
pply
gui
delin
es fo
r sa
fely
leav
ing
patie
nts
at h
ome
or
scen
e w
ithin
the
EMS
syst
em (‘
trea
t and
leav
e’)
TS2
••
•3
2.4.
12D
emon
stra
te a
ppro
pria
tely
con
fiden
t app
roac
h to
m
anag
emen
t and
dec
isio
n m
akin
g fo
r ac
ute
med
ical
em
erge
ncie
sN
TSRM
, RP,
SL
, CL,
EL
2•
••
•3
THEME 2
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 34
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.4.
13D
ispl
ay a
cal
m a
nd m
etho
dica
l app
roac
h to
acu
te
med
ical
em
erge
ncie
sN
TSRM
, RP,
SL
, CL,
EL
2•
••
•3
2.4.
14Re
spec
ts th
e co
ntri
butio
n an
d ex
perti
se o
f oth
er
clin
icia
ns o
pera
ting
outs
ide
hosp
ital
NTS
2•
••
•3
2.5
Man
age
inju
ry
in th
e pr
e-ho
spita
l en
viro
nmen
t
2.5.
1D
efine
inju
ryU
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
2.5.
2Co
ntra
st th
e te
rms
‘inju
ry’ a
nd ‘t
raum
a’U
K1
(b)
••
1
2.5.
3D
escr
ibe
the
epid
emio
logy
of s
ever
e in
jury
and
maj
or
trau
ma
with
in th
e EM
S sy
stem
UK
1 (b
)•
•1
2.5.
4D
escr
ibe
the
func
tion
and
proc
edur
es o
f the
loca
l tr
aum
a sy
stem
UK
1 (b
)•
•1
2.5.
5Co
ntra
st th
e pa
thop
hysi
olog
y of
diff
eren
t typ
es o
f in
jury
in a
ll ag
e gr
oups
UK
1 (b
)•
••
•1
2.5.
6D
escr
ibe
the
prin
cipl
es o
f the
pre
-hos
pita
l m
anag
emen
t of p
atien
ts a
cros
s th
e sp
ectr
um o
f in
jury
sev
erity
UK
1 (b
)•
••
1
2.5.
7Co
ntra
st th
e m
anag
emen
t of t
he tr
aum
a pa
tient
in
pre-
hosp
ital a
nd a
cute
hos
pita
l env
ironm
ents
UK
1 (b
)•
••
1
2.5.
8
Des
crib
e th
e im
med
iate
pre
-hos
pita
l man
agem
ent
of th
e fo
llow
ing:
(a) I
njur
ies
to th
e he
adU
K
DR,
LT,
SL
, CL,
EL
1 (a
)•
••
•1
(b) I
njur
ies
to th
e fa
ceU
K1
(a)
••
••
1
(c) I
njur
ies
to th
e ne
ckU
K1
(a)
••
••
1
(d) I
njur
ies
to th
e th
orax
UK
1 (a
)•
••
•1
(e) I
njur
ies
to th
e ab
dom
enU
K1
(a)
••
••
1
(f) I
njur
ies
to th
e sp
ine
UK
1 (a
)•
••
•1
THEME 2 35
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.5
Man
age
inju
ry
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
(g) I
njur
ies
to th
e pe
lvis
UK
DR,
LT,
SL
, CL,
EL
1 (a
)•
••
•1
(h) I
njur
ies
to th
e lim
bsU
K1
(a)
••
••
1
(i) In
juri
es in
volv
ing
mul
tiple
bod
y re
gion
sU
K1
(a)
••
••
1
(j) T
herm
al in
jury
UK
1 (a
)•
••
•1
(k) E
lect
rocu
tion
UK
1 (a
)•
••
•1
(l) B
allis
tic a
nd b
last
inju
ryU
K1
(a)
••
••
1
(m) T
raum
atic
asph
yxia
UK
1 (a
)•
••
•1
(n) G
as e
volu
tion
inju
ryU
K1
(a)
••
••
1
2.5.
9
App
rais
e th
e cu
rren
t be
st p
racti
ce in
pre
-hos
pita
l:
(a) A
irw
ay m
anag
emen
tU
K
DR,
LT,
SL
, CL,
EL
2•
••
1
(b) V
entil
ator
y su
ppor
tU
K2
••
•1
(c) H
aem
orrh
age
cont
rol
UK
2•
••
1
(d) F
luid
resu
scita
tion
UK
2•
••
1
(e) S
pina
l im
mob
iliza
tion
UK
2•
••
1
(f) N
euro
prot
ectio
nU
K2
••
•1
2.5.
10D
escr
ibe
appr
oach
es to
inju
ry p
reve
ntion
and
con
trol
UK
2•
••
1
2.5.
11D
emon
stra
te a
bilit
y to
form
ulat
e a
diffe
renti
al
diag
nose
s fo
r th
e in
jure
d pa
tient
TSLT
, DP
SL, C
L, E
L1
(b)
••
1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 36
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.5
Man
age
inju
ry
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.5.
12
Dem
onst
rate
the
imm
edia
te p
re-h
ospi
tal
man
agem
ent o
f the
follo
win
g (in
pati
ents
of
all a
ge g
roup
s):
(a) I
njur
ies
to th
e he
adTS
LT, D
P SL
, CL,
EL
1 (b
)•
•1
(b) I
njur
ies
to th
e fa
ceTS
1 (b
)•
•1
(c) I
njur
ies
to th
e ne
ckTS
1 (b
)•
•1
(d) I
njur
ies
to th
e th
orax
TS1
(b)
••
1
(e) I
njur
ies
to th
e ab
dom
enTS
1 (b
)•
•1
(f) I
njur
ies
to th
e sp
ine
TS1
(b)
••
1
(g) I
njur
ies
to th
e pe
lvis
TS1
(b)
••
1
(h) I
njur
ies
to th
e lim
bsTS
1 (b
)•
•1
(i) In
juri
es in
volv
ing
mul
tiple
bod
y re
gion
sTS
1 (b
)•
•1
(j) T
herm
al in
jury
TS1
(b)
••
1
(k) E
lect
rocu
tion
TS1
(b)
••
1
(l) B
allis
tic a
nd b
last
inju
ryTS
1 (b
)•
•1
(m) T
raum
atic
asph
yxia
TS1
(b)
••
1
(n) G
as e
volu
tion
inju
ryTS
1 (b
)•
•1
2.5.
13D
emon
stra
te a
ppro
pria
te u
se o
f alte
rnati
ve p
athw
ays
to a
cces
sing
urg
ent a
nd u
nsch
edul
ed c
are
(‘tre
at a
nd
refe
r’) f
or in
jury
TS2
••
•3
2.5.
14A
pply
gui
delin
es fo
r sa
fely
leav
ing
patie
nts
with
in
juri
es a
t hom
e or
sce
ne w
ithin
the
EMS
syst
em
(‘tre
at a
nd le
ave’
)TS
2•
••
3
THEME 2 37
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.5
Man
age
inju
ry
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.5.
15D
emon
stra
te p
artic
ipati
on in
inju
ry p
reve
ntion
pr
ogra
mm
esTS
LT, D
P SL
, CL
, EL
2•
••
2
2.5.
16D
emon
stra
te a
ppro
pria
tely
con
fiden
t and
met
hodi
cal
appr
oach
to m
anag
emen
t and
dec
isio
n m
akin
g fo
r in
juri
esN
TS
RM, R
P,
SL, C
L,
EL
2•
••
•3
2.5.
17D
emon
stra
te a
bilit
y to
lead
a tr
aum
a te
am in
the
pre-
hosp
ital e
nviro
nmen
tN
TS2
••
••
3
2.5.
18D
emon
stra
te a
bilit
y to
insp
ire c
onfid
ence
with
in a
mul
ti-di
scip
linar
y pr
e-ho
spita
l tra
uma
team
NTS
2•
••
•3
2.6
Prov
ide
anal
gesi
a,
proc
edur
al s
edati
on
and
anae
sthe
sia
in th
e pr
e-ho
spita
l en
viro
nmen
t
2.6.
1D
escr
ibe
the
polic
ies
and
proc
edur
es re
late
d to
ana
lges
ia,
proc
edur
al s
edati
on a
nd p
re-h
ospi
tal e
mer
genc
y an
aest
hesi
a w
ithin
the
EMS
syst
emU
KD
R, L
T,
SL, C
L,
EL1
(b)
••
1
2.6.
2
Des
crib
e th
e ap
plie
d ph
arm
acol
ogy
of m
edic
ines
co
mm
only
use
d in
all
age
grou
ps fo
r:
(a) A
nalg
esia
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) P
roce
dura
l sed
ation
UK
1 (b
)•
•1
(c) E
mer
genc
y an
aest
hesi
aU
K1
(b)
••
1
2.6.
3
App
rais
e th
e cu
rren
t bes
t pra
ctice
in a
ll ag
e gr
oups
for
the
prov
isio
n of
pre
-hos
pita
l:
(a) A
nalg
esia
UK
DR,
LT,
SL
, CL,
EL
2•
••
1
(b) P
roce
dura
l sed
ation
UK
2•
••
1
(c) E
mer
genc
y an
aest
hesi
aU
K2
••
•1
2.6.
4Cr
itiqu
e th
e ro
le o
f reg
iona
l ana
esth
etic
tech
niqu
es
rele
vant
to p
re-h
ospi
tal p
racti
ceU
K2
••
1
2.6.
5Cr
itiqu
e th
e te
chni
que
of ra
pid
sequ
ence
indu
ction
of
anae
sthe
sia
in th
e pr
e-ho
spita
l env
ironm
ent
UK
2•
•1
2.6.
6
Des
crib
e th
e ap
plie
d ph
ysio
logy
of a
nalg
esia
, pro
cedu
ral
seda
tion
and
pre
-hos
pita
l em
erge
ncy
anae
sthe
sia
in a
ll ag
e gr
oups
rela
ting
to:
(a) A
irw
ay in
stru
men
tatio
nU
KD
R, L
T,
SL, C
L,
EL1
(b)
••
1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 38
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.6
Prov
ide
anal
gesi
a,
proc
edur
al s
edati
on
and
anae
sthe
sia
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
(b) V
entil
ation
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(c) C
ardi
ovas
cula
r st
atus
UK
1 (b
)•
•1
(d) N
euro
prot
ectio
nU
K1
(b)
••
1
2.6.
7
Cont
rast
the
pro
visi
on o
f pre
-hos
pita
l em
erge
ncy
anae
sthe
sia
betw
een:
(a) I
nfan
ts a
nd c
hild
ren
UK
DR,
LT,
SL
, CL,
EL
2•
••
•1
(b) B
aria
tric
pati
ents
UK
2•
••
•1
(c) P
regn
ant p
atien
tsU
K2
••
••
1
(d) E
lder
ly p
atien
tsU
K2
••
••
1
2.6.
8D
escr
ibe
the
man
agem
ent o
f the
diffi
cult
airw
ay in
th
e pr
e-ho
spita
l env
ironm
ent
UK
1 (a
)•
•1
2.6.
9
Ana
lyse
the
impa
ct o
f the
pre
-hos
pita
l env
iron
men
t on
dec
isio
n m
akin
g in
all
age
grou
ps re
late
d to
:
(a) A
nalg
esia
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) P
roce
dura
l sed
ation
UK
1 (b
)•
•1
(c) P
re-a
naes
theti
c as
sess
men
tU
K1
(b)
••
1
(d) T
he p
redi
cted
diffi
cult
airw
ayU
K1
(b)
••
1
(e) T
he fa
iled
airw
ayU
K1
(b)
••
1
(f) M
aint
enan
ce o
f ana
esth
esia
UK
1 (b
)•
•1
2.6.
10D
escr
ibe
the
pre-
hosp
ital
man
agem
ent
of
anae
sthe
tic-
rela
ted
com
plic
ation
s:
THEME 2 39
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.6
Prov
ide
anal
gesi
a,
proc
edur
al s
edati
on
and
anae
sthe
sia
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.6.
10
(a) H
yper
/hyp
oten
sion
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) H
ypox
iaU
K1
(b)
••
1
(c) H
yper
/Hyp
ocar
bia
UK
1 (b
)•
•1
(d) H
igh
infla
tion
pres
sure
sU
K1
(b)
••
1
(e) L
ow in
flatio
n pr
essu
res
UK
1 (b
)•
•1
(f) T
rach
eal t
ube
disp
lace
men
tU
K1
(b)
••
1
(g) G
astr
ic in
suffl
ation
UK
1 (b
)•
•1
(h) R
egur
gita
tion
/ vo
miti
ngU
K1
(b)
••
1
(i) U
npla
nned
ext
ubati
onU
K1
(b)
••
1
2.6.
11D
escr
ibe
the
regu
lato
ry fr
amew
ork
unde
rpin
ning
pre
-ho
spita
l em
erge
ncy
anae
sthe
sia.
UK
1 (b
)•
•1
2.6.
12Cr
itiqu
e pu
blis
hed
guid
elin
es re
late
d to
the
clin
ical
pr
actic
e of
pre
-hos
pita
l pro
cedu
ral s
edati
on a
nd
emer
genc
y an
aest
hesi
aU
K2
••
1
2.6.
13
Dem
onst
rate
app
ropr
iate
ris
k/be
nefit
ana
lysi
s fo
r
all a
ge g
roup
s fo
r pr
e-ho
spit
al:
(a) A
nalg
esia
TS
LT, D
P,
SL, C
L,
EL
1 (b
)•
••
1
(b) r
egio
nal a
naes
thes
iaTS
1 (b
)•
••
1
(c) p
roce
dura
l sed
ation
TS1
(b)
••
•1
(d) e
mer
genc
y an
aest
hesi
aTS
1 (b
)•
••
1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 40
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.6
Prov
ide
anal
gesi
a,
proc
edur
al s
edati
on
and
anae
sthe
sia
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.6.
14
Dem
onst
rate
, in
pati
ents
of a
ll ag
e gr
oups
, saf
e
pre-
hosp
ital
:
(a) a
nalg
esia
TS
LT, D
P,
SL, C
L,
EL
1 (b
)•
••
1
(b) r
egio
nal a
naes
thes
iaTS
1 (b
)•
••
1
(c) p
roce
dura
l sed
ation
TS1
(b)
••
•1
(d) e
mer
genc
y an
aest
hesi
aTS
1 (b
)•
••
1
2.6.
15D
emon
stra
te te
chni
ques
for
man
agin
g fa
iled
dire
ct
lary
ngos
copy
TS1
(b)
••
•1
2.6.
16D
emon
stra
te te
chni
ques
for
man
agin
g a
diffi
cult
airw
ayTS
1 (b
)•
••
1
2.6.
17
Dem
onst
rate
the
pre-
hosp
ital
man
agem
ent
of
com
mon
ana
esth
etic-
rela
ted
com
plic
ation
s:
(a) H
yper
/hyp
oten
sion
TS
LT, D
P,
SL, C
L,
EL
1 (b
)•
•1
(b) H
ypox
iaTS
1 (b
)•
•1
(c) H
yper
/Hyp
ocar
bia
TS1
(b)
••
1
(d) H
igh
infla
tion
pres
sure
sTS
1 (b
)•
•1
(e) L
ow in
flatio
n pr
essu
res
TS1
(b)
••
1
(f) T
rach
eal t
ube
disp
lace
men
tTS
1 (b
)•
•1
(g) G
astr
ic in
suffl
ation
TS1
(b)
••
1
(h) R
egur
gita
tion
/ vo
miti
ngTS
1 (b
)•
•1
(i) U
npla
nned
ext
ubati
onTS
1 (b
)•
•1
THEME 2 41
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.6
Prov
ide
anal
gesi
a,
proc
edur
al s
edati
on
and
anae
sthe
sia
in th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
2.6.
18
Dem
onst
rate
, in
pati
ents
of a
ll ag
e gr
oups
, an
appr
opri
atel
y co
nfide
nt a
nd m
etho
dica
l app
roac
h to
:
(a) a
nalg
esia
NTS
RM, R
P,
SL, E
L
1 (b
)•
••
•3
(b) r
egio
nal a
naes
thes
iaN
TS1
(b)
••
••
3
(c) p
roce
dura
l sed
ation
NTS
1 (b
)•
••
•3
(d) e
mer
genc
y an
aest
hesi
a.N
TS1
(b)
••
••
3
2.7
Man
age
obst
etri
c em
erge
ncie
s in
th
e pr
e-ho
spita
l en
viro
nmen
t
2.7.
1Re
call
the
anat
omic
and
phy
siol
ogic
cha
nges
of
preg
nanc
y U
KD
R, L
T,
SL, C
L,
EL
2•
•1
2.7.
2Re
call
the
stag
es o
f lab
our,
the
proc
ess
of d
eliv
ery
and
the
com
mon
com
plic
ation
sU
K2
••
1
2.7.
3
Diff
eren
tiat
e ac
ute
pre-
hosp
ital
pre
sent
ation
s re
late
d:
(a) d
irect
ly to
pre
gnan
cyU
K
DR,
LT,
SL
, CL,
EL
2•
•1
(b) t
o la
bour
and
chi
ldbi
rth
UK
2•
•1
(c) t
o ac
ute
med
ical
em
erge
ncie
s in
a p
regn
ant
patie
ntU
K2
••
1
(d) t
o in
jury
in a
pre
gnan
t pati
ent
UK
2•
•1
2.7.
4
Criti
que
pre-
hosp
ital
man
agem
ent
stra
tegi
es:
(a) a
nte-
part
um h
aem
orrh
age
UK
DR,
LT,
SL
, CL,
EL
2•
•1
(b) p
ost-
part
um h
aem
orrh
age
UK
2•
•1
(c) o
bstr
ucte
d la
bour
UK
2•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 42
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.7
Man
age
obst
etri
c em
erge
ncie
s in
th
e pr
e-ho
spita
l en
viro
nmen
t(c
ont.
)
(d) c
ardi
ac a
rres
tU
K
DR,
LT,
SL
, CL,
EL
2•
•1
2.7.
5D
escr
ibe
the
appl
ied
phar
mac
olog
y of
em
erge
ncy
care
of t
he p
regn
ant p
atien
tU
K2
••
1
2.7.
6Co
ntra
st th
e op
tions
for
emer
genc
y pr
e-ho
spita
l de
liver
yU
K2
••
1
2.7.
7D
emon
stra
te th
e as
sess
men
t of t
he p
regn
ant p
atien
t in
the
pre-
hosp
ital e
nviro
nmen
tTS
LT, D
P, S
L,
CL, E
L2
••
1
2.7.
8
Dem
onst
rate
pre
-hos
pita
l man
agem
ent
of:
(a) a
pati
ent w
ith a
pre
gnan
cy re
late
d em
erge
ncy
TS
LT, D
P,
SL,C
L,
EL
2•
•1
(b) e
mer
genc
y ch
ildbi
rth
TS2
••
1
(c) a
n ac
ute
med
ical
em
erge
ncy
in a
pre
gnan
t pati
ent
TS2
••
1
(d) m
ajor
trau
ma
in a
pre
gnan
t pati
ent
TS2
••
1
2.7.
9D
emon
stra
te e
ffecti
ve p
hysi
cal m
anoe
uvre
s in
ab
norm
al la
bour
and
pos
t-pa
rtum
hae
mor
rhag
eTS
2•
•1
2.7.
10D
emon
stra
te th
e te
chni
que
for
peri
-mor
tem
sur
gica
l de
liver
yTS
2•
••
1
2.7.
11D
emon
stra
te th
e te
chni
que
for
emer
genc
y ep
isio
tom
yTS
2•
••
1
2.8
Man
age
the
new
born
in th
e
pre-
hosp
ital
envi
ronm
ent
2.8.
1Re
call
the
appl
ied
phys
iolo
gy a
nd a
nato
my
of th
e ne
wbo
rn b
aby
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
2.8.
2D
escr
ibe
the
initi
al c
are
of th
e ne
wbo
rn
UK
1 (b
)•
•1
2.8.
3D
escr
ibe
cond
ition
s of
the
new
born
com
mon
ly
enco
unte
red
in th
e pr
e-ho
spita
l setti
ngU
K1
(b)
••
1
THEME 2 43
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.8
Man
age
the
new
born
in th
e pr
e-ho
spita
l env
ironm
ent
(con
t.)
2.8.
4Co
mpa
re th
e di
ffere
nces
in g
ener
al c
are
betw
een
term
and
pre
-ter
m n
ewbo
rns
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
••
1
2.8.
5Cr
itiqu
e th
e ro
le o
f new
born
life
sup
port
in th
e
pre-
hosp
ital e
nviro
nmen
tU
K1
(b)
••
1
2.8.
6D
emon
stra
te p
rovi
sion
of c
are
to th
e ne
wly
bor
n in
th
e pr
e-ho
spita
l env
ironm
ent
TSLT
, DP,
SL
, CL,
EL
1 (b
)•
•1
2.8.
7D
emon
stra
te re
susc
itatio
n of
the
new
born
TS
1 (b
)•
•1
2.8.
8D
emon
stra
te th
e ab
ility
to re
cogn
ise
the
emoti
onal
ne
eds
of th
e m
othe
r an
d fa
mily
NTS
RM, R
P, S
L CL
, EL
1 (b
)•
•4
2.9
Man
age
inju
red
or
ill c
hild
ren
in
the
pre-
hosp
ital
envi
ronm
ent
2.9.
1D
escr
ibe
the
epid
emio
logy
of s
ever
e ill
ness
in th
e pa
edia
tric
pre
-hos
pita
l pop
ulati
onU
KD
R, L
T,
SL, C
L,
EL
1 (b
)•
•1
2.9.
2Re
call
the
appl
ied
anat
omy
and
phys
iolo
gy o
f the
in
fant
and
chi
ldU
K1
(b)
••
1
2.9.
3
Des
crib
e th
e im
med
iate
pre
-hos
pita
l em
erge
ncy
man
agem
ent o
f the
follo
win
g ac
ute
med
ical
pr
esen
tati
ons
in in
fant
s an
d ch
ildre
n:
(a) A
irw
ay o
bstr
uctio
n/ch
okin
g/st
rido
rU
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) A
cute
resp
irato
ry d
istr
ess
UK
1 (b
)•
•1
(c) C
entr
al c
yano
sis
UK
1 (b
)•
•1
(d) S
hock
UK
1 (b
)•
•1
(e) A
bnor
mal
pul
se ra
te o
r rh
ythm
UK
1 (b
)•
•1
(f) D
ecre
ased
con
scio
us le
vel
UK
1 (b
)•
•1
(g) S
eizu
res
UK
1 (b
)•
•1
(h) S
udde
n w
eakn
ess/
para
lysi
s/ab
norm
al s
ensa
tion
UK
1 (b
)•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 44
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.9
Man
age
inju
red
or
ill c
hild
ren
in th
e pr
e-ho
spita
l env
ironm
ent
(con
t.)
2.9.
3co
nt.
(i) In
toxi
catio
n an
d po
ison
ing
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(j) H
ypog
lyca
emia
UK
1 (b
)•
•1
(k) A
cute
vom
iting
UK
1 (b
)•
•1
(l) A
cute
abd
omin
al/l
oin/
scro
tal p
ain
UK
1 (b
)•
•1
(m) A
cute
febr
ile il
lnes
sU
K1
(b)
••
1
(n) A
cute
rash
UK
1 (b
)•
•1
(o) A
cute
pai
nU
K1
(b)
••
1
(p) B
ites,
stin
gs a
nd e
nven
omati
onU
K1
(b)
••
1
(q) A
cute
alle
rgic
reac
tion
UK
1 (b
)•
•1
(r) N
on-a
ccid
enta
l inj
ury
UK
1 (b
)•
•4
2.9.
4
App
rais
e th
e cu
rren
t be
st p
racti
ce in
the
pr
e-ho
spit
al m
anag
emen
t of
:
(a) I
nfec
tious
upp
er a
irw
ay c
ompr
omis
eU
K
DR,
LT,
SL
, CL,
EL
2•
••
1
(b) A
sthm
aU
K2
••
•1
(c) A
naph
ylax
isU
K1
(b)
••
1
(d) S
epsi
sU
K1
(b)
••
1
(e) M
enin
goen
ceph
aliti
sU
K1
(b)
••
1
(f) S
eizu
res
UK
1 (b
)•
•1
(g) D
iabe
tic k
etoa
cido
sis
UK
2•
••
1
THEME 2 45
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.9.
5D
escr
ibe
the
appl
ied
phar
mac
olog
y of
com
mon
ly u
sed
med
icin
es g
iven
in th
e pr
e-ho
spita
l env
ironm
ent t
o al
l ag
e gr
oups
UK
DR,
LT,
SL
, CL,
EL
2•
••
1
2.9.
6Ex
plai
n w
hy d
rug
pres
crib
ing
in c
hild
ren
shou
ld b
e ba
sed
on a
pae
diat
ric
spec
ific
form
ular
yU
K1
(b)
••
2
2.9.
7D
escr
ibe
fluid
man
agem
ent i
n cr
itica
l illn
ess
or in
jury
in
all a
ge g
roup
sU
K1
(b)
••
1
2.9.
8D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r sa
fegu
ardi
ng
child
ren
with
in th
e EM
S sy
stem
UK
1 (b
)•
•2
2.9.
9Re
call
that
chi
ld a
buse
can
be
due
to n
egle
ct, e
moti
onal
, ph
ysic
al a
nd s
exua
l abu
seU
K1
(a)
••
2
2.9.
10Re
cogn
ise
sign
s of
phy
sica
l abu
se s
ugge
stive
of n
on-
acci
dent
al in
jury
UK
1 (a
)•
•1
2.9.
11A
pply
kno
wle
dge
of th
e or
gani
satio
n of
pae
diat
ric
criti
cal
care
to p
re-h
ospi
tal d
estin
ation
tria
ge d
ecis
ions
UK
1 (b
)•
••
1
2.9.
12D
emon
stra
te th
e ab
ility
to fo
rmul
ate
a di
ffere
ntial
di
agno
ses
for
an a
cute
, und
iffer
entia
ted
emer
genc
y pr
esen
tatio
n in
all
age
grou
psTS
LT, D
P, S
L,
CL, E
L1
(b)
••
1
2.9.
13
Dem
onst
rate
the
imm
edia
te p
re-h
ospi
tal e
mer
genc
y m
anag
emen
t of t
he fo
llow
ing
acut
e m
edic
al
pres
enta
tion
s in
chi
ldre
n:
(a) A
irw
ay o
bstr
uctio
n/ch
okin
g/st
rido
rTS
LT, D
P,
SL, C
L,
EL
1 (b
)•
•1
(b) A
cute
resp
irato
ry d
istr
ess
TS1
(b)
••
1
(c) C
entr
al c
yano
sis
TS
1 (b
)•
•1
(d) S
hock
TS1
(b)
••
1
(e) A
bnor
mal
pul
se ra
te o
r rh
ythm
TS1
(b)
••
1
(f) D
ecre
ased
con
scio
us le
vel
TS1
(b)
••
1
(g) S
eizu
res
TS1
(b)
••
1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 46
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.9
Man
age
inju
red
or
ill c
hild
ren
in th
e pr
e-ho
spita
l env
ironm
ent
(con
t.)
2.9.
13co
nt.
(h) S
udde
n w
eakn
ess/
para
lysi
s/ab
norm
al s
ensa
tion
TS
LT, D
P,
SL, C
L,
EL
1 (b
)•
•1
(i) In
toxi
catio
n an
d po
ison
ing
TS1
(b)
••
1
(j) H
ypog
lyca
emia
TS1
(b)
••
1
(k) A
cute
vom
iting
TS1
(b)
••
1
(l) A
cute
abd
omin
al/l
oin/
scro
tal p
ain
TS1
(b)
••
1
(m) A
cute
febr
ile il
lnes
sTS
1 (b
)•
•1
(n) A
cute
rash
TS1
(b)
••
1
(o) A
cute
pai
nTS
1 (b
)•
•1
(p) B
ites
sting
s an
d en
veno
mati
onTS
1 (b
)•
•1
(q) A
cute
alle
rgic
reac
tion
TS1
(b)
••
1
(r) N
on-a
ccid
enta
l inj
ury
TS1
(b)
••
1
2.9.
14
Dem
onst
rate
the
pre-
hosp
ital
man
agem
ent
of:
(a) I
nfec
tious
upp
er a
irw
ay c
ompr
omis
eTS
LT, D
P,
SL, C
L,
EL
1 (b
)•
•1
(b) A
sthm
aTS
1 (b
)•
•1
(c) A
naph
ylax
isTS
1 (b
)•
•1
(d) S
epsi
sTS
1 (b
)•
•1
(e) M
enin
goen
ceph
aliti
sTS
1 (b
)•
•1
(f) S
eizu
res
TS1
(b)
••
1
(g) D
iabe
tic k
etoa
cido
sis
TS1
(b)
••
1
THEME 2 47
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.9
Man
age
inju
red
or
ill c
hild
ren
in
the
pre-
hosp
ital
envi
ronm
ent
(con
t.)
2.9.
15D
emon
stra
te a
dapt
ation
s to
clin
ical
pra
ctice
ne
cess
ary
for
perf
orm
ing
effec
tive
clin
ical
ex
amin
ation
and
inte
rven
tions
in a
ll ag
e gr
oups
TSLT
, DP,
SL
, CL,
EL
1 (b
)•
•1
2.9.
16D
emon
stra
te th
e ab
ility
to m
anag
e a
child
refu
sing
tr
eatm
ent f
or a
pos
sibl
e lif
e th
reat
enin
g co
nditi
onN
TS1
(b)
••
4
2.9.
17D
emon
stra
te a
ppro
pria
tely
con
fiden
t and
met
hodi
cal
appr
oach
to m
anag
emen
t and
dec
isio
n m
akin
g fo
r pa
edia
tric
med
ical
em
erge
ncie
sN
TSRM
, RP,
SL
, CL,
EL
1 (b
)•
•3
2.9.
18D
emon
stra
tes
abili
ty to
trea
t chi
ldre
n w
ith p
atien
ce,
dign
ity a
nd re
spec
tN
TS1
(b)
••
•4
2.10
Man
age
the
bari
atri
c pa
tient
in
the
pre-
hosp
ital
envi
ronm
ent
2.10
.1D
escr
ibe
the
appl
ied
anat
omy
and
phys
iolo
gy o
f the
ba
riat
ric
patie
ntU
K
DR,
LT,
SL
, CL,
EL
2•
•1
2.10
.2Cr
itiqu
e th
e lim
itatio
ns o
f sta
ndar
d cl
inic
al e
quip
men
t an
d m
onito
ring
in th
e ba
riat
ric
patie
ntU
K2
••
2
2.10
.3D
escr
ibe
the
appl
ied
phar
mac
olog
y of
com
mon
ly
used
pre
-hos
pita
l dru
gs in
bar
iatr
ic p
atien
tsU
K2
••
1
2.10
.4Cr
itiqu
e ve
ntila
tion
stra
tegi
es in
bar
iatr
ic p
atien
tsU
K2
••
1
2.10
.5Ev
alua
te th
e lim
itatio
ns o
f res
cue
equi
pmen
t and
ve
hicl
es fo
r ba
riat
ric
patie
nts
UK
2•
•2
2.10
.6D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r the
tran
spor
t of
bar
iatr
ic p
atien
ts w
ithin
the
EMS
syst
emU
K2
••
•1
2.10
.7D
escr
ibe
stra
tegi
es to
faci
litat
e re
scue
and
ext
rica
tion
of th
e ba
riat
ric
patie
ntU
K2
••
•1
2.10
.8Pe
rfor
m a
cal
cula
tion
of id
eal b
ody
wei
ght i
n ba
riat
ric
patie
nts
TSLT
, DP,
SL
, CL,
EL
2•
•1
2.10
.9Se
lect
app
ropr
iate
man
ual h
andl
ing
adju
ncts
for
mov
ing
bari
atri
c pa
tient
sTS
2•
•2
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 2 48
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 2.
Pro
vidi
ng p
re-h
ospi
tal e
mer
genc
y m
edic
al c
are
2.11
Man
age
elde
rly
patie
nts
in th
e pr
e-ho
spita
l env
ironm
ent
2.11
.1D
escr
ibe
the
appl
ied
anat
omy
and
phys
iolo
gy o
f age
ing
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
2.11
.2D
escr
ibe
the
epid
emio
logy
of i
njur
y an
d ill
ness
in th
e el
derl
y po
pula
tion
UK
1 (b
)•
•1
2.11
.3A
ppre
ciat
e th
e eff
ect o
f pol
ypha
rmac
y in
the
elde
rly
UK
1 (b
)•
••
1
2.11
.4D
escr
ibe
the
appl
ied
phar
mac
olog
y of
com
mon
ly u
sed
drug
s us
ed in
the
pre-
hosp
ital e
nviro
nmen
t in
elde
rly
patie
nts
UK
1 (b
)•
•1
2.11
.5D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r pr
otec
ting
vuln
erab
le a
dults
with
in th
e EM
S sy
stem
UK
1 (b
)•
•2
2.11
.6In
corp
orat
e w
ider
psy
chos
ocia
l iss
ues
in p
re-h
ospi
tal
tria
ge a
nd d
ecis
ion
mak
ing
for
elde
rly
patie
nts
UK
1 (b
)•
••
4
2.12
Man
age
acut
e be
havi
oura
l di
stur
banc
e in
th
e pr
e-ho
spita
l en
viro
nmen
t
2.12
.1Ca
tego
rise
the
rang
e of
men
tal h
ealth
dis
orde
rs
pres
entin
g as
pre
-hos
pita
l em
erge
ncie
sU
K2
••
•1
2.12
.2D
escr
ibe
acut
e m
enta
l hea
lth s
ervi
ce p
rovi
sion
with
in th
e EM
S sy
stem
UK
2•
•1
2.12
.3Ex
plai
n th
e m
ulti-
disc
iplin
ary
natu
re o
f chi
ld a
nd
adol
esce
nt m
enta
l hea
lth s
ervi
ces
UK
2•
•1
2.12
.4D
iffer
entia
te o
rgan
ic b
rain
syn
drom
es fr
om a
cute
ps
ychi
atri
c ill
ness
UK
2•
••
1
2.12
.5A
ppre
ciat
e th
at a
cute
beh
avio
ural
dis
turb
ance
can
be
a ca
use
or c
onse
quen
ce o
f inj
ury
UK
2•
••
1
2.12
.6
Des
crib
e st
rate
gies
for
unde
rtak
ing
a pr
e-ho
spit
al:
(a) m
enta
l sta
te e
xam
inati
onU
K
DR,
LT,
SL
, CL,
EL
2•
•1
(b) s
elf h
arm
ris
k as
sess
men
tU
K2
••
2
(c) s
uici
de r
isk
asse
ssm
ent
UK
2•
•2
(d) v
iole
nce
risk
ass
essm
ent
UK
2•
•2
(e) s
elf h
arm
ris
k as
sess
men
tU
K2
••
2
2.12
.7
Des
crib
e st
rate
gies
for:
(a) c
ontr
ol a
nd re
stra
int
UK
DR,
LT,
SL
, CL,
EL
2•
•2
(b) r
apid
tran
quili
satio
nU
K2
••
2
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 3 49
THEME 3. USING PRE-HOSPITAL EQUIPMENTPre-hospital and in-transit emergency care requires use of a wide range of medicines, devices and portable equipment. Practitioners must be competent in both the application and operation of specific equipment items and the principles underlying their function and design.
UNITS3.1 Apply equipment governance principles and practice
3.2 Understand and use personal protective equipment
3.3 Operate all types of commonly used pre-hospital emergency medical device
3.4 Operate common non-medical pre-hospital equipment
3.5 Manage and administer medicines
Related GMP domains are assigned to each group of elements within units as follows:
1. Knowledge skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
50
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 3.
Usi
ng p
re-h
ospi
tal e
quip
men
t
3.1
App
ly e
quip
men
t go
vern
ance
pri
ncip
les
and
prac
tice
3.1.
1Ca
tego
rise
pre
-hos
pita
l equ
ipm
ent
UK
DR,
LT,
SL
, EL,
CL
1 (a
)•
•1
3.1.
2D
escr
ibe
the
prin
cipl
es o
f equ
ipm
ent g
over
nanc
e
UK
1 (b
)•
•2
3.1.
3D
escr
ibe
the
rele
vanc
e of
the
regu
lato
ry fr
amew
ork
for
med
ical
dev
ices
UK
1 (b
)•
•1
3.1.
4
App
ly e
quip
men
t go
vern
ance
pro
cedu
res:
(a) i
n th
e pr
e-de
ploy
men
t pha
seTS
DR,
LT,
SL
, EL,
D
P
1 (b
)•
••
2
(b) d
urin
g de
ploy
men
t and
clin
ical
car
eTS
1 (a
)•
••
•2
(c) o
n co
mpl
etion
of d
eplo
ymen
tTS
1 (a
)•
••
•2
3.1.
5D
emon
stra
te a
pro
fess
iona
l app
roac
h to
equ
ipm
ent
gove
rnan
ce
NTS
RM, E
L,
SL1
(b)
••
•2
3.2
Und
erst
and
and
use
pers
onal
pr
otec
tive
equi
pmen
t
3.2.
1Ca
tego
rise
per
sona
l pro
tecti
ve e
quip
men
t (PP
E)
UK
DR,
LT,
SL
, EL,
CL
1 (a
)•
••
1
3.2.
2D
escr
ibe
the
prin
cipl
es u
nder
lyin
g PP
E fu
nctio
n an
d de
sign
U
K1
(a)
••
1
3.2.
3D
escr
ibe
whe
n PP
E m
ust b
e us
ed
UK
1 (a
)•
•2
3.2.
4D
escr
ibe
proc
edur
es fo
r ch
ecki
ng a
nd m
aint
aini
ng
PPE
UK
1 (a
)•
•2
3.2.
5D
emon
stra
te th
e co
rrec
t use
of P
PE
TSD
R, L
T,
SL, E
L,
DP
1 (a
)•
••
2
3.2.
6D
emon
stra
te th
e ab
ility
to o
pera
te w
hils
t usi
ng P
PE
TS1
(a)
••
•2
3.2.
7D
emon
stra
te a
pro
fess
iona
l app
roac
h to
use
of P
PE
NTS
RM, E
L, S
L1
(b)
••
•2
Des
crib
e th
e pr
inci
ples
und
erly
ing
the
func
tion
and
de
sign
of p
re-h
ospi
tal:
(a) A
irw
ay m
anag
emen
t dev
ices
UK
DR,
LT,
SL
, EL,
CL
1 (a
)•
••
1
THEME 3
51
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 3.
Usi
ng p
re-h
ospi
tal e
quip
men
t
3.3
Ope
rate
all
type
s of
com
mon
ly
used
pre
-hos
pita
l em
erge
ncy
med
ical
de
vice
s
3.3.
1
(b) V
entil
ator
y su
ppor
t dev
ices
UK
DR,
LT,
SL
, EL,
CL
1 (a
)•
••
1
(c) D
evic
es fo
r co
ntro
lling
hae
mor
rhag
e U
K1
(a)
••
•1
(d) D
evic
es fo
r ac
cess
ing
the
circ
ulati
on
UK
1 (a
)•
••
1
(e) D
evic
es fo
r su
ppor
ting
the
circ
ulati
on
UK
1 (a
)•
••
1
(f) D
evic
es fo
r ad
min
iste
ring
med
icin
es a
nd b
lood
pr
oduc
tsU
K1
(a)
••
•1
(g) D
evic
es fo
r m
anag
ing
soft
tiss
ue in
juri
es, w
ound
s an
d bu
rns
UK
1 (a
)•
••
1
(h) D
evic
es fo
r im
mob
ilizi
ng jo
ints
, lim
bs a
nd p
atien
tsU
K1
(a)
••
•1
(i) D
evic
es fo
r ne
ar p
atien
t tes
ting
UK
1 (b
)•
••
1
(j) D
evic
es fo
r te
mpe
ratu
re m
anag
emen
tU
K1
(b)
••
•1
(k) D
evic
es fo
r no
n-in
vasi
ve p
atien
t mon
itori
ngU
K1
(a)
••
•1
(l) D
evic
es fo
r in
vasi
ve p
atien
t mon
itori
ngU
K1
(b)
••
•1
(m) D
evic
es fo
r im
agin
g an
d di
agno
sis
UK
2•
••
1
(n) D
evic
es fo
r m
ovin
g an
d ha
ndlin
g pa
tient
sU
K1
(b)
••
•1
3.3.
2
Com
pare
the
effec
tive
ness
of d
iffer
ent
devi
ces
wit
hin
each
of:
(a) A
irw
ay m
anag
emen
t dev
ices
UK
DR,
LT,
SL
, EL,
CL
1 (b
)•
••
•1
(b) V
entil
ator
y su
ppor
t dev
ices
U
K1
(b)
••
••
1
(c) D
evic
es fo
r co
ntro
lling
hae
mor
rhag
e U
K1
(b)
••
••
1
(d) D
evic
es fo
r ac
cess
ing
the
circ
ulati
on
UK
1 (b
)•
••
•1
(e) D
evic
es fo
r su
ppor
ting
the
circ
ulati
on
UK
1 (b
)•
••
•1
(f) D
evic
es fo
r ad
min
iste
ring
med
icin
e an
d bl
ood
prod
ucts
UK
1 (b
)•
••
•1
(g) D
evic
es fo
r m
anag
ing
soft
tiss
ue in
juri
es, w
ound
s an
d bu
rns
UK
1 (b
)•
••
•1
THEME 3
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 3 52
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 3.
Usi
ng p
re-h
ospi
tal e
quip
men
t
3.3
Ope
rate
all
type
s of
com
mon
ly
used
pre
-hos
pita
l em
erge
ncy
med
ical
de
vice
s (c
ont)
3.3.
2
(h) D
evic
es fo
r im
mob
ilizi
ng jo
ints
, lim
bs a
nd p
atien
tsU
K
DR,
LT,
SL
, EL,
CL
1 (b
)•
••
•1
(i) D
evic
es fo
r ne
ar p
atien
t tes
ting
UK
2•
••
•1
(j) D
evic
es fo
r te
mpe
ratu
re m
anag
emen
tU
K2
••
••
1
(k) D
evic
es fo
r no
n-in
vasi
ve p
atien
t mon
itori
ngU
K1
(a)
••
••
1
(l) D
evic
es fo
r in
vasi
ve p
atien
t mon
itori
ngU
K1
(b)
••
••
1
(m) D
evic
es fo
r im
agin
g an
d di
agno
sis
UK
1 (b
)•
••
•1
(n) D
evic
es fo
r m
ovin
g an
d ha
ndlin
g pa
tient
sU
K1
(a)
••
••
1
3.3.
3
Dem
onst
rate
con
fiden
t and
tech
nica
lly c
orre
ct
oper
ation
of:
(a) A
irw
ay m
anag
emen
t dev
ices
TS
DR,
LT,
SL
, EL,
CL
1 (a
)•
••
••
1
(b) V
entil
ator
y su
ppor
t dev
ices
TS
1 (a
)•
••
••
1
(c) D
evic
es fo
r co
ntro
lling
hae
mor
rhag
e TS
1 (a
)•
••
••
1
(d) D
evic
es fo
r ac
cess
ing
the
circ
ulati
on
TS1
(a)
••
••
•1
(e) D
evic
es fo
r su
ppor
ting
the
circ
ulati
on
TS1
(a)
••
••
•1
(f) D
evic
es fo
r ad
min
iste
ring
med
icin
e an
d bl
ood
prod
ucts
TS1
(a)
••
••
•1
(g) D
evic
es fo
r m
anag
ing
soft
tiss
ue in
juri
es, w
ound
s an
d bu
rns
TS1
(b)
••
••
•1
(h) D
evic
es fo
r im
mob
ilizi
ng jo
ints
, lim
bs a
nd p
atien
tsTS
1 (a
)•
••
••
1
(i) D
evic
es fo
r ne
ar p
atien
t tes
ting
TS2
••
••
•1
(j) D
evic
es fo
r te
mpe
ratu
re m
anag
emen
tTS
2•
••
••
1
(k) D
evic
es fo
r no
n-in
vasi
ve p
atien
t mon
itori
ngTS
1 (a
)•
••
••
1
(l) D
evic
es fo
r in
vasi
ve p
atien
t mon
itori
ngTS
1 (b
)•
••
••
1
(m) D
evic
es fo
r im
agin
g an
d di
agno
sis
TS2
••
••
•1
(n) D
evic
es fo
r m
ovin
g an
d ha
ndlin
g pa
tient
sTS
1 (a
)•
••
••
1
THEME 3 53
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 3.
Usi
ng p
re-h
ospi
tal e
quip
men
t
3.3
Ope
rate
all
type
s of
com
mon
ly
used
pre
-hos
pita
l em
erge
ncy
med
ical
de
vice
s (c
ont)
3.3.
4
Dem
onst
rate
cor
rect
man
agem
ent o
f cri
tica
l dev
ice
failu
res
and,
whe
re re
leva
nt, a
larm
s w
ithi
n ea
ch o
f:
(a) A
irw
ay m
anag
emen
t dev
ices
TS
DR,
LT,
SL
, EL,
CL
1 (a
)•
••
••
1
(b) V
entil
ator
y su
ppor
t dev
ices
TS
1 (a
)•
••
••
1
(c) D
evic
es fo
r co
ntro
lling
hae
mor
rhag
e TS
1 (a
)•
••
••
1
(d) D
evic
es fo
r ac
cess
ing
the
circ
ulati
on
TS1
(a)
••
••
•1
(e) D
evic
es fo
r su
ppor
ting
the
circ
ulati
on
TS1
(a)
••
••
•1
(f) D
evic
es fo
r ad
min
iste
ring
med
icin
e an
d bl
ood
prod
ucts
TS1
(a)
••
••
•1
(g) D
evic
es fo
r m
anag
ing
soft
tiss
ue in
juri
es, w
ound
s an
d bu
rns
TS1
(b)
••
••
•1
(h) D
evic
es fo
r im
mob
ilizi
ng jo
ints
, lim
bs a
nd p
atien
tsTS
1 (a
)•
••
••
1
(i) D
evic
es fo
r ne
ar p
atien
t tes
ting
TS1
(a)
••
••
•1
(j) D
evic
es fo
r te
mpe
ratu
re m
anag
emen
tTS
2•
••
••
1
(k) D
evic
es fo
r no
n-in
vasi
ve p
atien
t mon
itori
ngTS
1 (a
)•
••
••
1
(l) D
evic
es fo
r in
vasi
ve p
atien
t mon
itori
ngTS
1 (b
)•
••
••
1
(m) D
evic
es fo
r im
agin
g an
d di
agno
sis
TS1
(b)
••
••
•1
(n) D
evic
es fo
r m
ovin
g an
d ha
ndlin
g pa
tient
sTS
1 (a
)•
••
••
1
3.3.
5D
emon
stra
te a
pro
fess
iona
l app
roac
h to
mai
ntai
ning
kn
owle
dge
and
skill
s in
the
oper
ation
of m
edic
al
equi
pmen
tN
TSRM
, CL,
EL
, SL
1 (b
)•
••
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 3 54
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 3.
Usi
ng p
re-h
ospi
tal e
quip
men
t
3.4
Ope
rate
com
mon
no
n-m
edic
al
pre-
hosp
ital
equi
pmen
t
3.4.
1
Des
crib
e th
e op
erati
on o
f com
mon
pre
-hos
pita
l:
(a) C
omm
unic
ation
s eq
uipm
ent
UK
DR,
LT,
SL,
Cl
, EL
1 (a
)•
••
•1
(b) A
udio
visu
al re
cord
ing
equi
pmen
t U
K1
(b)
••
••
1
(c) I
ncid
ent m
anag
emen
t equ
ipm
ent
UK
1 (b
)•
••
•1
(d) N
avig
ation
equ
ipm
ent
UK
1 (a
)•
••
•1
(e) I
nfor
mati
on m
anag
emen
t equ
ipm
ent
UK
1 (b
)•
••
•1
3.4.
2
Dem
onst
rate
con
fiden
t and
tech
nica
lly c
orre
ct
oper
ation
of :
(a) C
omm
unic
ation
s eq
uipm
ent
TS
LT, S
L, C
L,
EL, R
P
1 (a
)•
••
1
(b) A
udio
visu
al re
cord
ing
equi
pmen
t TS
1 (b
)•
••
1
(c) I
ncid
ent m
anag
emen
t equ
ipm
ent
TS1
(b)
••
•1
(d) N
avig
ation
equ
ipm
ent
TS1
(a)
••
•1
(e) I
nfor
mati
on m
anag
emen
t equ
ipm
ent
TS1
(b)
••
•1
3.4.
3D
emon
stra
te a
pro
fess
iona
l app
roac
h to
mai
ntai
ning
sk
ills
and
know
ledg
e in
the
oper
ation
of n
on-m
edic
al
equi
pmen
tN
TSRM
, SL,
EL
1 (b
)•
••
••
1
THEME 3 55
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 3.
Usi
ng p
re-h
ospi
tal e
quip
men
t
3.5
Man
age
and
adm
inis
ter
med
icin
es
3.5.
1D
escr
ibe
the
prin
cipl
es o
f goo
d pr
e-ho
spita
l med
icin
es
man
agem
ent
UK
DR,
LT,
SL
, CL,
EL
1 (a
)•
••
1
3.5.
2D
escr
ibe
the
prin
cipl
es o
f saf
e pr
e-ho
spita
l pre
scri
bing
UK
1 (b
)•
•1
3.5.
3Ca
tego
rise
med
icin
es u
sed
in P
re-h
ospi
tal E
mer
genc
y M
edic
ine
UK
1 (a
)•
•1
3.5.
4D
escr
ibe
the
rele
vanc
e of
the
regu
lato
ry fr
amew
ork
for
med
icin
es in
pre
-hos
pita
l pra
ctice
U
K1
(b)
••
2
3.5.
5D
escr
ibe
the
appl
icati
on o
f con
trol
led
drug
s le
gisl
ation
an
d pr
oced
ures
to p
re-h
ospi
tal p
racti
ceU
K1
(b)
••
••
1
3.5.
6Li
st m
edic
al g
ases
in c
omm
on p
re-h
ospi
tal u
seU
K1
(a)
••
•1
3.5.
7D
escr
ibe
the
dang
ers
of m
edic
al g
ases
use
d in
pr
e-ho
spita
l car
e an
d th
e pr
ecau
tions
that
ens
ure
safe
ty
duri
ng a
dmin
istr
ation
UK
1 (a
)•
••
2
3.5.
8Li
st b
lood
pro
duct
s in
pre
-hos
pita
l use
UK
1 (b
)•
•1
3.5.
9D
emon
stra
te s
afe
pres
crip
tion
and
disp
ensi
ng o
f m
edic
ines
TS
LT, S
L,
CL, E
L
1 (b
)•
••
1
3.5.
10D
emon
stra
te p
repa
ratio
n of
med
icin
es fo
r pa
rent
eral
use
TS1
(a)
••
•1
3.5.
11D
emon
stra
te s
afe
and
effec
tive
adm
inis
trati
on o
f m
edic
ines
by
all r
oute
sTS
1 (a
)•
••
1
3.5.
12D
emon
stra
te c
ompl
ianc
e w
ith le
gisl
ation
rela
ted
to
Cont
rolle
d D
rugs
TS1
(a)
••
•2
3.5.
13D
emon
stra
te s
afe
use
of a
med
ical
gas
cyl
inde
r TS
1 (a
)•
••
1
3.5.
14H
andl
e, tr
ansp
ort a
nd s
tore
med
ical
gas
cyl
inde
rs s
afel
y in
the
pre-
hosp
ital e
nviro
nmen
tTS
1 (b
)•
••
1
3.5.
15D
emon
stra
te s
afe
and
effec
tive
adm
inis
trati
on o
f blo
od
prod
ucts
TS1
(b)
••
•1
3.5.
16D
emon
stra
te a
pro
fess
iona
l app
roac
h to
man
agem
ent
and
adm
inis
trati
on o
f med
icin
esN
TSRM
, SL,
CL
, EL
1 (b
)•
••
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 4 57
THEME 4. SUPPORTING RESCUE AND EXTRICATIONPre-hospital emergency medical services are frequently targeted at patients who, because of physical entrapment, physical geography or functional geographic constraints, cannot just be taken to the nearest appropriate hospital. This competence theme focuses on the underpinning knowledge, technical skills and non-technical skills required to manage a trapped patient and effectively interact with professional rescue service personnel at common pre-hospital rescue situations.
UNITS4.1 Work within the rescue environment
4.2 Understand entrapment
4.3 Support Extrication
4.4 Clinically manage the trapped patient
Related GMP domains are assigned to each group of elements within units as follows:
1. Knowledge skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
58
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 4.
Sup
porti
ng re
scue
and
ext
rica
tion
4.1
Wor
k w
ithin
the
resc
ue e
nviro
nmen
t
4.1.
1
Des
crib
e th
e sp
ecifi
c ha
zard
s to
resc
ue in
the
fo
llow
ing
situ
ation
s:
(a) R
oad
traffi
c co
llisi
ons
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) I
ndus
tria
l site
inci
dent
sU
K1
(b)
••
1
(c) A
ircra
ft re
late
d in
cide
nts
UK
2•
•1
(d) A
gric
ultu
ral s
ite in
cide
nts
UK
1 (b
)•
•1
(e) R
emot
e ar
ea in
cide
nts
UK
2•
•1
(f) C
onfin
ed s
pace
inci
dent
sU
K2
••
1
(g) C
olla
psed
str
uctu
res
UK
2•
•1
(h) E
xplo
sive
dev
ice
inci
dent
sU
K1
(b)
••
1
(i) F
irear
ms
inci
dent
sU
K1
(b)
••
1
(j) S
cene
s of
vio
lent
ass
ault
UK
1 (b
)•
•1
(k) H
azar
dous
mat
eria
ls in
cide
nts
UK
2•
•1
(l) In
cide
nts
at h
eigh
tU
K1
(b)
••
1
(m) I
ncid
ents
on
stee
p sl
opes
UK
2•
•1
(n) W
ater
rela
ted
inci
dent
sU
K2
••
1
(o) F
ires
UK
1 (b
)•
•1
4.1.
2
Expl
ain
the
resc
ue c
apab
iliti
es o
f:
(a) P
olic
e pe
rson
nel
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) F
ire p
erso
nnel
UK
1 (b
)•
•1
THEME 4
59
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 4.
Sup
porti
ng re
scue
and
ext
rica
tion
4.1
Wor
k w
ithin
the
resc
ue e
nviro
nmen
t
4.1.
2(c
ont)
(c) M
edic
al p
erso
nnel
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(d) S
peci
alis
t res
cue
pers
onne
lU
K2
••
1
(e) V
olun
tary
em
erge
ncy
serv
ices
per
sonn
elU
K2
••
1
4.1.
3Cr
itiqu
e th
e ro
le o
f pre
-hos
pita
l em
erge
ncy
med
icin
e sp
ecia
lists
in re
scue
UK
••
1
4.1.
4Ex
plai
n th
e co
ncep
t of g
ener
ic r
isk
asse
ssm
ents
for
resc
ue o
pera
tions
UK
••
2
4.1.
5D
escr
ibe
the
rela
tions
hip
betw
een
gene
ric
risk
as
sess
men
t and
dyn
amic
ris
k as
sess
men
t for
resc
ue
oper
ation
sU
K•
•2
4.1.
6D
escr
ibe
the
phys
iolo
gica
l, ps
ycho
logi
cal a
nd p
hysi
cal
effec
ts o
n pa
tient
s of
resc
ue o
pera
tions
in d
iffer
ent
setti
ngs
UK
••
1
4.1.
7D
escr
ibe
the
phys
iolo
gica
l, ps
ycho
logi
cal a
nd p
hysi
cal
effec
ts o
f res
cue
oper
ation
s on
resc
ue a
nd h
ealth
care
pe
rson
nel
UK
••
1
4.1.
8D
escr
ibe
stra
tegi
es to
opti
mis
e th
e re
scue
en
viro
nmen
t for
clin
ical
ass
essm
ent a
nd c
are
UK
••
2
4.1.
9Pr
epar
e a
gene
ric
risk
ass
essm
ent f
or m
edic
al
pers
onne
l sup
porti
ng a
typi
cal r
escu
e op
erati
on
with
in th
e EM
S sy
stem
TSLT
, SL,
CL
, EL,
D
P
••
2
4.1.
10D
emon
stra
te a
dyn
amic
ris
k as
sess
men
t in
prac
tice
at
a re
scue
ope
ratio
nTS
••
•2
4.1.
11D
emon
stra
te re
silie
nce
acro
ss th
e sp
ectr
um o
f res
cue
envi
ronm
ents
NTS
RM, S
L,
CL, E
L•
••
•1
4.2
Und
erst
and
entr
apm
ent
4.2.
1Ca
tego
rise
ent
rapm
ent ‘
mec
hani
sms’
UK
DR,
LT,
SL,
CL
, EL
••
•1
THEME 4
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 4 60
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 4.
Sup
porti
ng re
scue
and
ext
rica
tion
4.2
Und
erst
and
entr
apm
ent
4.2.
2
Des
crib
e th
e ty
pica
l ‘m
echa
nism
s’ o
f ent
rapm
ent
in
the
follo
win
g si
tuati
ons:
(a) R
oad
traffi
c co
llisi
ons
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
(b) I
ndus
tria
l site
inci
dent
sU
K1
(b)
••
1
(c) A
ircra
ft re
late
d in
cide
nts
UK
2•
•1
(d) A
gric
ultu
ral s
ite in
cide
nts
UK
1 (b
)•
•1
(e) R
emot
e ar
ea in
cide
nts
UK
2•
•1
(f) C
onfin
ed s
pace
inci
dent
sU
K2
••
1
(g) C
olla
psed
str
uctu
res
UK
2•
•1
(h) E
xplo
sive
dev
ice
inci
dent
sU
K1
(b)
••
1
(i) F
irear
ms
inci
dent
sU
K1
(b)
••
1
(j) S
cene
s of
vio
lent
ass
ault
UK
1 (b
)•
•1
(k) H
azar
dous
mat
eria
ls in
cide
nts
UK
2•
•1
(l) In
cide
nts
at h
eigh
tU
K1
(b)
••
1
(m) I
ncid
ents
on
stee
p sl
opes
UK
2•
•1
(n) W
ater
rela
ted
inci
dent
sU
K2
••
1
(o) F
ires
UK
1 (b
)•
•1
THEME 4 61
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 4.
Sup
porti
ng re
scue
and
ext
rica
tion
4.3
Supp
ort
Extr
icati
on
4.3.
1D
escr
ibe
the
prin
cipl
es o
f ext
rica
tion
UK
DR,
LT,
D
P, S
L,
RP, C
L,
EL
1 (b
)•
•1
4.3.
2Cr
itiqu
e th
e ro
le o
f med
ical
inte
rven
tions
in fa
cilit
ating
ex
tric
ation
UK
2•
•1
4.3.
3D
escr
ibe
tech
nica
l ext
rica
tion
proc
esse
s fo
r ro
ad tr
affic
rela
ted
entr
apm
ent
UK
1 (b
)•
•1
4.3.
4Ev
alua
te th
e ca
pabi
lities
and
lim
itatio
ns o
f com
mon
ly
used
resc
ue a
nd e
xtri
catio
n eq
uipm
ent
UK
2•
•1
4.3.
5D
escr
ibe
stra
tegi
es fo
r ex
pedi
ting
extr
icati
onU
K2
••
1
4.3.
6D
emon
stra
te a
bilit
y to
mak
e a
rapi
d as
sess
men
t of t
he
extr
icati
on n
eeds
of a
trap
ped
patie
ntTS
DR,
LT,
D
P, S
L,
RP,
1 (b
)•
••
•1
4.3.
7D
emon
stra
te a
bilit
y to
man
age
clin
ical
equ
ipm
ent d
urin
g th
e ex
tric
ation
pro
cess
TS
1 (b
)•
••
•1
4.3.
8D
emon
stra
te a
bilit
y to
faci
litat
e ex
tric
ation
thro
ugh
med
ical
inte
rven
tion
TS1
(b)
••
••
1
4.3.
9U
ses
clin
ical
judg
emen
t to
influ
ence
the
tem
po o
f res
cue
oper
ation
sTS
2•
••
•1
4.3.
10D
ispl
ay c
onfid
ence
in s
uppo
rting
ext
rica
tion
NTS
N/A
1 (b
)•
•1
4.3.
11D
ispl
ay m
edic
al le
ader
ship
in c
o-or
dina
ting
med
ical
and
re
scue
inte
rven
tions
NTS
2•
•3
4.4
Clin
ical
ly m
anag
e th
e tr
appe
d pa
tient
4.4.
1D
escr
ibe
the
adve
rse
phys
iolo
gica
l effe
cts
spec
ifica
lly
asso
ciat
ed w
ith e
ntra
pmen
tU
K
DR,
LT,
SL
, RP,
CL
, EL
1 (b
)•
•1
4.4.
2D
escr
ibe
pain
man
agem
ent s
trat
egie
s fo
r th
e tr
appe
d pa
tient
UK
1 (b
)•
•1
4.4.
3Cr
itiqu
e th
e ro
le o
f pati
ent m
onito
ring
dur
ing
entr
apm
ent
and
extr
icati
onU
K2
••
1
4.4.
4Cr
itiqu
e cl
inic
al s
trat
egie
s fo
r in
jury
man
agem
ent i
n th
e tr
appe
d pa
tient
com
pare
d to
the
non-
trap
ped
patie
ntU
K2
••
1
4.4.
5Cr
itiqu
e cl
inic
al s
trat
egie
s fo
r or
gan
and/
or s
yste
m
supp
ort i
n th
e tr
appe
d pa
tient
com
pare
d to
the
no
n-tr
appe
d pa
tient
UK
2•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 4 62
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 4.
Sup
porti
ng re
scue
and
ext
rica
tion
4.4
Clin
ical
ly m
anag
e th
e tr
appe
d pa
tient
(con
t.)
4.4.
6
Des
crib
e cl
inic
al s
trat
egie
s fo
r th
e m
anag
emen
t of
tr
appe
d pa
tien
ts w
ith:
(a) i
mpa
lem
ent
UK
DR,
LT,
SL
, RP,
CL
, EL
2•
••
1
(b) c
rush
inju
ryU
K2
••
•1
(c) h
ypot
herm
iaU
K2
••
•1
(d) p
rolo
nged
ent
rapm
ent
UK
2•
••
1
(e) s
ever
e lim
b en
trap
men
tU
K2
••
•1
4.4.
7 D
escr
ibe
the
impa
ct o
f med
ical
inte
rven
tion
on
resc
ue ti
mes
cale
s an
d te
chni
ques
UK
2•
•1
4.4.
8D
iffer
entia
te th
e le
vel a
nd n
atur
e of
clin
ical
in
terv
entio
ns a
t diff
eren
t sta
ges
of e
xtri
catio
nU
K2
••
1
4.4.
9D
escr
ibe
stra
tegi
es fo
r m
anag
ing
entr
apm
ent o
f mor
e th
an o
ne p
atien
t at a
n in
cide
ntU
K2
••
1
4.4.
10D
emon
stra
te a
bilit
y to
mak
e a
rapi
d as
sess
men
t of
the
clin
ical
nee
ds o
f a tr
appe
d pa
tient
TSLT
, DP,
SL
, RP,
RM
, CL,
EL
2•
•1
4.4.
11D
emon
stra
te e
ffecti
ve m
anag
emen
t of t
he tr
appe
d pa
tient
TS2
••
1
4.4.
12D
ispl
ay c
onfid
ence
in m
anag
ing
the
trap
ped
patie
ntN
TS
RM, E
L,
SL, R
P,
DP
2•
••
•3
4.4.
13D
ispl
ay le
ader
ship
in c
o-or
dina
ting
mul
ti-pr
ofes
sion
al
med
ical
car
e of
trap
ped
patie
nts
NTS
2•
••
•3
4.4.
14D
emon
stra
te a
com
pass
iona
te p
atien
t-fo
cuss
ed
appr
oach
thro
ugho
ut re
scue
and
ext
rica
tion
NTS
2•
••
•4
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 5 63
THEME 5. SUPPORTING SAFE PATIENT TRANSFERThis theme covers the competences required to make destination hospital triage decisions, select the most appropriate transport platform, provide safe, effective and focused in-transit critical care and ensure that the patients’ condition and immediate needs are communicated to receiving hospital clinical staff. As with other competence themes, many of the elements are common across all clinical services. The constituent Units within this theme are:
UNITS5.1 Understand the concepts underpinning transfer medicine
5.2 Understand the applied physiology of patient transfer
5.3 Co-ordinate and plan patient transfer
5.4 Prepare patients for transport
5.5 Utilise a range of patient transport modalities
5.6 Clinically manage patients during transport
Related GMP domains are assigned to each group of elements within units as follows:
1. Knowledge skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
THEME 5 64
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 5.
Sup
porti
ng s
afe
pati
ent t
rans
fer
5.1
Und
erst
and
the
conc
epts
un
derp
inni
ng tr
ansf
er
med
icin
e(c
ont.
)
5.1.
3D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r pr
e-ho
spita
l and
em
erge
nt in
ter-
faci
lity
(inte
r-ho
spita
l) tr
ansf
er w
ithin
the
EMS
syst
em
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•2
5.1.
4Cr
itiqu
e th
e ne
ed fo
r pr
e-ho
spita
l and
em
erge
nt
inte
r-fa
cilit
y tr
ansf
er w
ithin
the
EMS
syst
em
UK
1 (b
)•
•1
5.1.
5Co
ntra
st th
e ri
sks
and
bene
fits
asso
ciat
ed w
ith e
xten
ded
pre-
hosp
ital a
nd e
mer
gent
inte
r-fa
cilit
y tr
ansf
erU
K1
(b)
••
1
5.1.
6Ci
te th
e ev
iden
ce re
late
d to
the
risk
s an
d be
nefit
s of
ex
tend
ed p
re-h
ospi
tal t
rans
fer
(fac
ility
by-
pass
) and
em
erge
ncy
inte
r-fa
cilit
y tr
ansf
er
UK
2•
•1
5.1.
7D
escr
ibe
lines
of a
ccou
ntab
ility
and
resp
onsi
bilit
y in
re
latio
n to
pre
-hos
pita
l tra
nsfe
r an
d em
erge
nt
inte
r-fa
cilit
y tr
ansf
er
UK
1 (b
)•
•1
5.1.
8D
escr
ibe
the
role
s an
d re
spon
sibi
lities
of a
ll st
aff
acco
mpa
nyin
g th
e pa
tient
dur
ing
tran
sfer
UK
1 (b
)•
•1
5.1.
9A
naly
se th
e et
hica
l and
lega
l iss
ues
rela
ted
to p
atien
t tr
ansf
erU
K2
••
1
5.1.
10D
emon
stra
te a
pro
fess
iona
l app
roac
h to
tran
sfer
m
edic
ine
NTS
RM, S
L, R
P1
(b)
••
••
•4
5.2
Und
erst
and
the
appl
ied
phys
iolo
gy o
f pa
tient
tran
sfer
5.2.
1D
escr
ibe
the
phys
iolo
gica
l and
phy
sica
l effe
cts
of
mov
emen
t of p
atien
tsU
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
5.2.
2D
escr
ibe
the
phys
iolo
gica
l and
phy
sica
l effe
cts
of tr
ansf
er
on a
tten
dant
sU
K1
(b)
••
1
5.2.
3D
escr
ibe
the
phys
iolo
gica
l effe
cts
of a
ltitu
de o
n pa
tient
s du
ring
tran
sfer
UK
1 (b
)•
•1
5.2.
4D
emon
stra
te a
bilit
y to
inte
grat
e pa
tient
dia
gnos
is w
ith
the
phys
iolo
gica
l effe
cts
of tr
ansp
ort
TSD
R, L
T, S
L CL
, EL
1 (b
)•
••
1
5.2.
5D
emon
stra
te re
silie
nce
whe
n un
dert
akin
g pa
tient
tran
sfer
NTS
RM, E
L, S
L2
•4
5.3
Co-o
rdin
ate
and
plan
pati
ent t
rans
fer
5.3.
1D
escr
ibe
the
prin
cipl
es o
f pla
nnin
g an
d co
-ord
inati
ng
patie
nt tr
ansf
erU
KD
R, L
T,
SL, D
P,
CL, E
L
1 (b
)•
•1
5.3.
2D
escr
ibe
the
prin
cipl
es d
eter
min
ing
desti
natio
n ho
spita
l se
lecti
onU
K1
(a)
••
1
THEME 5 65
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 5.
Sup
porti
ng s
afe
pati
ent t
rans
fer
5.3
Co-o
rdin
ate
and
plan
pati
ent t
rans
fer
(con
t.)
5.3.
3Li
st th
e eq
uipm
ent r
equi
red
for
pre-
hosp
ital a
nd
inte
r-fa
cilit
y tr
ansf
erU
KD
R, L
T, S
L,
DP,
CL,
EL
1 (a
)•
•1
5.3.
4D
emon
stra
te th
e ab
ility
to re
conc
ile th
e ri
sks
and
bene
fits
of tr
ansf
erTS
LT, S
L,
DP,
CL,
EL
1 (b
)•
••
•1
5.3.
5D
emon
stra
te th
e ab
ility
to d
eter
min
e co
nsum
able
re
sour
ce re
quire
men
ts fo
r tr
ansf
erTS
1 (b
)•
••
1
5.3.
6Co
-ord
inat
e ex
tend
ed p
re-h
ospi
tal t
rans
fer
TS2
••
••
1
5.3.
7Co
-ord
inat
e em
erge
ncy
inte
r-fa
cilit
y tr
ansf
erTS
2•
••
•1
5.3.
8D
emon
stra
te a
pro
fess
iona
l app
roac
h to
the
plan
ning
an
d co
-ord
inati
on o
f pati
ent t
rans
fer
NTS
RM, E
L,
SL, R
P
1 (b
)•
••
•4
5.3.
9D
emon
stra
te th
e ab
ility
to a
ckno
wle
dge
futil
ity a
nd
avoi
d in
appr
opri
ate
inte
r-fa
cilit
y tr
ansf
erN
TS1
(b)
••
••
4
5.4
Prep
are
patie
nts
for
tran
spor
t
5.4.
1Li
st s
trat
egie
s fo
r op
timis
ing
a pa
tient
’s p
hysi
olog
y pr
ior
to tr
ansf
erU
KD
R, L
T,
SL, C
L,
EL
1 (b
)•
•1
5.4.
2D
escr
ibe
pre-
tran
sfer
mea
sure
s to
min
imis
e ri
sks
to
patie
nts
duri
ng tr
ansf
er
UK
1 (b
)•
•2
5.4.
3D
emon
stra
te a
bilit
y to
det
erm
ine
whe
n pa
tient
s ar
e in
thei
r op
timum
clin
ical
con
ditio
n fo
r tr
ansf
er
TS
LT, S
L,
CL, D
P,
EL
1 (b
)•
••
•1
5.4.
4D
emon
stra
te c
orre
ct p
repa
ratio
n of
pati
ents
for
safe
pr
e-ho
spita
l tra
nsfe
r TS
2•
••
•1
5.4.
5D
emon
stra
te c
orre
ct p
repa
ratio
n of
pati
ents
for
safe
in
ter-
faci
lity
tran
sfer
TS2
••
••
1
5.4.
6D
emon
stra
te a
pro
fess
iona
l app
roac
h to
pre
para
tion
of p
atien
ts fo
r tr
ansf
erN
TSRM
, SL,
EL
, RP
1 (b
)•
••
•4
5.5
Util
ise
a ra
nge
of p
atien
t tra
nspo
rt
mod
aliti
es
5.5.
1Cl
assi
fy p
atien
t tra
nspo
rt m
odal
ities
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
5.5.
2D
iffer
entia
te th
e ri
sks
and
bene
fits
of ro
ad, h
elic
opte
r, fix
ed w
ing
and
othe
r tr
ansp
ort m
odal
ities
UK
2•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 5 66
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 5.
Sup
porti
ng s
afe
pati
ent t
rans
fer
5.5
Util
ise
a ra
nge
of p
atien
t tra
nspo
rt
mod
aliti
es(c
ont.
)
5.5.
3D
escr
ibe
the
trai
ning
requ
irem
ents
for
pers
onne
l es
corti
ng p
atien
ts a
ccor
ding
to tr
ansp
ort m
odal
ityU
KD
R, L
T,
SL, C
L,
EL
1 (b
)•
•1
5.5.
4D
escr
ibe
the
risk
s, b
enefi
ts a
nd le
gal c
onst
rain
ts
pert
aini
ng to
tra
nspo
rting
rela
tives
UK
2•
•1
5.5.
5D
emon
stra
te th
e ab
ility
to tr
ansf
er p
atien
ts u
sing
a
rang
e of
tran
spor
t mod
aliti
esTS
LT, S
L,
EL, D
P2
••
•1
5.5.
6D
emon
stra
te a
pro
fess
iona
l app
roac
h to
the
use
of
diffe
rent
tran
spor
t mod
aliti
esN
TSRM
, SL,
EL,
CL
, RP
2•
••
•4
5.6
Clin
ical
ly m
anag
e pa
tient
s du
ring
tr
ansp
ort
5.6.
1 Cr
itiqu
e th
e m
inim
um s
tand
ards
for
mon
itori
ng
duri
ng tr
ansf
er
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
••
•1
5.6.
2D
escr
ibe
the
inte
rven
tions
whi
ch c
an b
e un
dert
aken
du
ring
tran
sfer
U
K1
(b)
••
1
5.6.
3D
escr
ibe
the
com
mon
pro
blem
s ex
peri
ence
d du
ring
pa
tient
tran
sfer
U
K1
(b)
••
1
5.6.
4
Des
crib
e th
e sp
ecifi
c cl
inic
al m
anag
emen
t of
the
fo
llow
ing
pati
ent g
roup
s be
fore
and
dur
ing
pre-
hosp
ital
or
emer
genc
y in
ter-
faci
lity
tran
sfer
:
(a) P
atien
ts w
ith m
ajor
hea
d in
juri
esU
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
••
•1
(b) P
atien
ts w
ith c
onta
giou
s di
seas
esU
K2
••
••
1
(c) P
atien
ts w
ith u
nsta
ble
spin
al o
r pe
lvic
frac
ture
sU
K1
(b)
••
••
1
(d) P
atien
ts w
ith m
ajor
bur
nsU
K1
(b)
••
••
1
(e) P
atien
ts w
ith s
ingl
e or
gan/
syst
em fa
ilure
UK
1 (b
)•
••
•1
(f) P
atien
ts w
ith m
ultip
le o
rgan
/sys
tem
failu
reU
K2
••
••
1
(g) P
atien
ts w
ho a
re p
regn
ant
UK
2•
••
•1
(h) P
atien
ts w
ho a
re c
hild
ren
UK
2•
••
•1
THEME 5 67
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 5.
Sup
porti
ng s
afe
pati
ent t
rans
fer
5.6
Clin
ical
ly m
anag
e pa
tient
s du
ring
tr
ansp
ort
(con
t.)
5.6.
4co
nt.
(i) P
atien
ts w
ho a
re in
fant
sU
KD
R, L
T,
SL, C
L,
EL
2•
••
•1
(j) P
atien
ts w
ho a
re n
eona
tes
UK
2•
••
•1
(k) P
atien
ts w
ith a
cute
beh
avio
ural
dis
turb
ance
UK
2•
••
•1
5.6.
5D
eter
min
e ap
prop
riat
e ch
oice
s of
sed
ation
, mus
cle
rela
xatio
n an
d an
alge
sia
to m
aint
ain
the
patie
nt’s
cl
inic
al s
tatu
s du
ring
tran
sfer
(for
all
age
grou
ps)
TS
LT, S
L,
EL, D
P
2•
••
•1
5.6.
6D
emon
stra
te th
e sa
fe p
re-h
ospi
tal t
rans
fer
of a
ll ag
e gr
oups
of v
entil
ated
pati
ents
TS1
(b)
••
••
1
5.6.
7D
emon
stra
te th
e sa
fe in
ter-
faci
lity
tran
sfer
of a
ll ag
e gr
oups
of v
entil
ated
pati
ents
TS2
••
••
1
5.6.
8M
aint
ain
accu
rate
clin
ical
reco
rds
befo
re, d
urin
g an
d aft
er tr
ansf
er
TS1
(b)
••
••
1
5.6.
9D
emon
stra
te th
e ab
ility
to m
aint
ain
mon
itori
ng o
f vi
tal s
igns
thro
ugho
ut tr
ansf
er
TS1
(b)
••
••
1
5.6.
10
Dem
onst
rate
the
abili
ty to
man
age
sudd
en in
-tra
nsit
lo
ss o
f:
(a) a
irw
ay c
ontr
olTS
LT, S
L,
EL, D
P
1 (b
)•
••
•1
(b) o
xyge
nTS
1 (b
)•
••
•1
(c) v
ascu
lar
acce
ssTS
1 (b
)•
••
•1
(d) m
onito
ring
TS1
(b)
••
••
1
(e) i
nfus
ions
TS1
(b)
••
••
1
(f) p
ower
TS1
(b)
••
••
1
5.6.
11D
emon
stra
te a
pro
fess
iona
l app
roac
h to
the
clin
ical
m
anag
emen
t of p
atien
ts u
nder
goin
g pr
e-ho
spita
l or
emer
gent
inte
r-fa
cilit
y tr
ansf
erN
TSRM
, EL,
SL, R
P1
(b)
••
••
•4
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 6 69
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
THEME 6. SUPPORTING EMERGENCY PREPAREDNESS AND RESPONSEThis theme encompasses the competences required to ensure that practitioners are appropriately prepared and equipped for larger scale emergency incidents in terms of their understanding of emergency planning and the principles of major incident management.
UNITS6.1 Understand principles of emergency preparedness, response and recovery
6.2 Respond to emergencies at operational (bronze) level
6.3 Respond to emergencies at tactical (silver) level
6.4 Understand the psychosocial and mental health aspects of multiple casualty incidents
Related GMP domains are assigned to each group of elements within units as follows:
1. Knowledge skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
THEME 6 70
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 6.
Sup
porti
ng e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se
6.1
Und
erst
and
prin
cipl
es o
f em
erge
ncy
prep
ared
ness
, re
spon
se a
nd
reco
very
6.1.
1
Defi
ne, i
n th
e co
ntex
t of e
mer
genc
y pl
anni
ng:
(a) p
repa
redn
ess,
U
K
DR,
LT,
SL, C
L,
EL
1 (b
)•
•2
(b) r
espo
nse
UK
1 (b
)•
•2
(c) r
ecov
ery
UK
1 (b
)•
•2
6.1.
2D
escr
ibe
curr
ent n
ation
al g
uida
nce
and
legi
slati
on in
re
latio
n to
em
erge
ncy
prep
ared
ness
and
resp
onse
UK
1 (b
)•
•1
6.1.
3Ca
tego
rise
cla
sses
of m
ajor
inci
dent
UK
1 (b
)•
••
1
6.1.
4Li
st th
e ca
pabi
lities
of s
ervi
ces
and
agen
cies
invo
lved
in
em
erge
ncy
prep
ared
ness
, res
pons
e an
d re
cove
ry
UK
1 (b
)•
•1
6.1.
5
Eval
uate
the
pos
sibl
e ro
les
of t
he S
ub-S
peci
alis
t in
PH
EM a
t the
:
(a) o
pera
tiona
l (br
onze
) lev
el
UK
DR,
LT,
SL, C
L,
EL
1 (b
)•
•1
(b) t
actic
al (s
ilver
) lev
elU
K1
(b)
••
1
(c) s
trat
egic
(gol
d) le
vel
UK
1 (b
)•
•1
6.1.
6Ev
alua
te le
sson
s id
entifi
ed fr
om h
isto
rica
l maj
or
inci
dent
s U
K2
••
1
6.1.
7Cr
itiqu
e th
e ro
le o
f the
hea
lth s
ervi
ces
in th
e m
ulti-
agen
cy m
ajor
inci
dent
UK
2•
•1
6.1.
8Cr
itiqu
e th
e et
hica
l iss
ues
surr
ound
ing
deci
sion
-m
akin
g du
ring
a h
ealth
maj
or in
cide
ntU
K2
••
4
6.1.
9D
emon
stra
te th
e ab
ility
to p
repa
re a
gen
eric
maj
or
inci
dent
pla
nTS
LT, S
L,
CL, E
L,
DP
2•
••
2
6.1.
10D
emon
stra
te th
e ap
plic
ation
of t
he p
rinc
iple
s of
em
erge
ncy
prep
ared
ness
and
resp
onse
TS
2•
•2
THEME 6 71
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 6.
Sup
porti
ng e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se
6.2
Resp
ond
to
emer
genc
ies
at
oper
ation
al (b
ronz
e)
leve
l
6.2.
1Cr
itiqu
e th
e ra
nge
of s
kills
requ
ired
by h
ealth
ser
vice
pe
rson
nel f
or a
n eff
ectiv
e m
ajor
inci
dent
resp
onse
UK
DR,
LT,
SL,
CL
, EL
2•
•3
6.2.
2
List
the
duti
es o
f the
ope
rati
onal
leve
l:
(a) M
edic
al C
omm
ande
rU
K
DR,
LT,
SL,
CL
, EL
1 (b
)•
•1
(b) A
mbu
lanc
e Co
mm
ande
rU
K1
(b)
••
1
(c) F
ire C
omm
ande
rU
K1
(b)
••
1
(d) P
olic
e Co
mm
ande
rU
K1
(b)
••
1
6.2.
3D
escr
ibe
the
polic
ies
and
proc
edur
es re
latin
g to
op
erati
onal
leve
l med
ical
sta
ff w
ithin
the
EMS
syst
emU
K1
(b)
••
1
6.2.
4D
escr
ibe
the
prin
cipl
es o
f tri
age
UK
1 (b
)•
•1
6.2.
5Cr
itiqu
e co
mm
only
use
d tr
iage
tool
sU
K1
(b)
••
•1
6.2.
6D
escr
ibe
the
com
pone
nts
of in
cide
nt d
ebri
efing
UK
1 (b
)•
•1
6.2.
7D
emon
stra
te fa
mili
arity
with
pol
icie
s an
d pr
oced
ures
fo
r op
erati
onal
leve
l med
ical
com
man
dTS
DR,
LT,
DP,
SL
, EL
1 (b
)•
•1
6.2.
8D
emon
stra
te th
e ab
ility
to m
aint
ain
a co
mpr
ehen
sive
de
cisi
on lo
gTS
1 (b
)•
••
1
6.2.
9D
emon
stra
te th
e ab
ility
to a
ppro
pria
tely
use
tria
ge
tool
sTS
1 (b
)•
••
1
6.2.
10D
emon
stra
te th
e ab
ility
to c
ompe
tent
ly p
erfo
rm th
e ro
le o
f an
oper
ation
al le
vel m
edic
al c
omm
ande
rTS
1 (b
)•
••
3
6.2.
11D
emon
stra
te p
artic
ipati
on in
inci
dent
deb
riefi
ngTS
1 (b
)•
••
3
6.2.
12D
emon
stra
te th
e et
hica
l app
licati
on o
f tri
age
NTS
RM, E
L,
SL, R
P
1 (b
)•
••
•1
6.2.
13D
emon
stra
te c
onfid
ence
in u
nder
taki
ng tr
iage
NTS
1 (b
)•
••
•1
6.2.
14D
emon
stra
te c
onfid
ence
in th
e pe
rfor
man
ce o
f the
ro
le o
f the
ope
ratio
nal l
evel
med
ical
com
man
der
NTS
1 (b
)•
••
•3
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
THEME 6 72
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 6.
Sup
porti
ng e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se
6.3
Resp
ond
to
emer
genc
ies
at
tacti
cal (
silv
er) l
evel
6.3.
1
List
the
duti
es o
f the
tacti
cal l
evel
:
(a) M
edic
al C
omm
ande
rU
K
DR,
LT,
SL
, RP,
CL
, EL
2•
•1
(b) A
mbu
lanc
e Co
mm
ande
rU
K2
••
1
(c) F
ire C
omm
ande
rU
K2
••
1
(d) P
olic
e Co
mm
ande
rU
K2
••
1
6.3.
2D
escr
ibe
the
polic
ies
and
proc
edur
es re
latin
g to
ta
ctica
l lev
el m
edic
al s
taff
with
in th
e EM
S sy
stem
UK
2•
•1
6.3.
3Ev
alua
te th
e ro
le p
laye
d by
the
med
ia a
t maj
or
inci
dent
s U
K2
••
1
6.3.
4Ev
alua
te le
sson
s id
entifi
ed re
latin
g to
tacti
cal
com
man
d of
his
tori
cal m
ajor
inci
dent
sU
K2
••
•2
6.3.
5
Eval
uate
str
ateg
ies
for
man
agin
g:
(a) A
mul
ti-se
ctor
inci
dent
UK
DR,
LT,
SL
, RP,
CL
, EL
2•
••
3
(b) A
cas
ualty
cle
arin
g st
ation
UK
2•
••
1
(c) A
sur
vivo
r re
cepti
on c
entr
eU
K2
••
•3
(d) T
he d
ecea
sed
UK
2•
•4
(e) C
omm
unic
ation
UK
2•
•3
(f) M
ulti-
disc
iplin
ary
brie
fings
UK
2•
•3
(g) S
usta
inab
ility
UK
2•
•3
THEME 6 73
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 6.
Sup
porti
ng e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se
6.3
Resp
ond
to
emer
genc
ies
at
tacti
cal (
silv
er) l
evel
(c
ont)
6.3.
6D
emon
stra
te fa
mili
arity
with
pol
icie
s an
d pr
oced
ures
fo
r ta
ctica
l lev
el m
edic
al c
omm
and
TS
LT, S
L,
DP,
RP,
CL
, EL
2•
••
1
6.3.
7D
emon
stra
te th
e ab
ility
to m
aint
ain
a co
mpr
ehen
sive
de
cisi
on lo
gTS
2•
••
1
6.3.
8D
emon
stra
te th
e ab
ility
to c
ompe
tent
ly p
erfo
rm th
e ro
le o
f a ta
ctica
l lev
el m
edic
al c
omm
ande
rTS
2•
••
1
6.3.
9
Dem
onst
rate
the
abili
ty to
man
age:
(a) A
mul
ti-se
ctor
inci
dent
TS
LT, S
L,
DP,
RP,
CL
, EL
2•
••
3
(b) A
cas
ualty
cle
arin
g st
ation
TS2
••
•1
(c) A
sur
vivo
r re
cepti
on c
entr
eTS
2•
••
3
(d) T
he d
ecea
sed
TS2
••
•4
(e) C
omm
unic
ation
TS2
••
•3
(f) M
ulti-
disc
iplin
ary
brie
fings
TS2
••
•3
(g) S
usta
inab
ility
TS2
••
•3
6.3.
10D
emon
stra
te a
bilit
y to
con
duct
an
inci
dent
deb
riefi
ngTS
2•
••
3
6.4
Und
erst
and
the
psyc
hoso
cial
and
m
enta
l hea
lth a
spec
ts
of m
ultip
le c
asua
lty
inci
dent
s
6.4.
1D
emon
stra
te u
nder
stan
ding
of k
ey te
rms
used
in
psyc
hoso
cial
and
men
tal h
ealth
car
e of
em
erge
ncie
s an
d m
ajor
inci
dent
sU
K
DR,
LT,
SL
, CL,
EL
2•
•1
6.4.
2D
escr
ibe
the
defin
ing
natu
re o
f eve
nts
and
circ
umst
ance
s th
at a
re p
sych
osoc
ially
trau
mati
cU
K2
••
3
6.4.
3D
escr
ibe
the
com
mon
psy
chos
ocia
l res
pons
es o
f pe
ople
affe
cted
by,
or
invo
lved
in, e
mer
genc
ies
and
maj
or in
cide
nts
UK
2•
••
1
6.4.
4D
escr
ibe
the
com
mon
cop
ing
mec
hani
sms
that
pe
ople
of a
ll ag
es u
se w
hen
face
d w
ith e
vent
s th
at
caus
e se
vere
str
ess
UK
2•
••
1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
74
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Them
e 6.
Sup
porti
ng e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se
6.4
Und
erst
and
the
psyc
hoso
cial
and
m
enta
l hea
lth a
spec
ts
of m
ultip
le c
asua
lty
inci
dent
s(c
ont)
6.4.
5D
efine
psy
chos
ocia
l res
ilien
ce in
the
cont
ext o
f tr
aum
atic
even
ts a
nd c
ircum
stan
ces
and
its p
erso
nal
and
colle
ctive
dim
ensi
ons
UK
DR,
LT,
SL
, CL,
EL
2•
••
1
6.4.
6D
emon
stra
te a
n un
ders
tand
ing
of th
e na
ture
of
dist
ress
and
its
diffe
renti
ation
from
men
tal d
isor
ders
U
K2
••
•1
6.4.
7D
escr
ibe
in o
utlin
e th
e ev
iden
ce-b
ased
pri
ncip
les
for
psyc
hoso
cial
and
men
tal h
ealth
car
e fo
r pe
ople
who
ar
e aff
ecte
d by
em
erge
ncie
s an
d m
ajor
inci
dent
sU
K2
••
•1
6.4.
8Cr
itiqu
e lo
cal,
natio
nal a
nd in
tern
ation
al g
uide
lines
on
men
tal h
ealth
and
psy
chos
ocia
l sup
port
in e
mer
genc
y se
tting
s U
K2
••
1
6.4.
9D
emon
stra
te th
e ab
ility
to c
ondu
ct in
itial
psy
chos
ocia
l as
sess
men
ts in
a ra
nge
of p
re-h
ospi
tal e
nviro
nmen
tsTS
LT, S
L,
RP, R
M,
CL, E
L
2•
•3
6.4.
10D
emon
stra
te th
e ab
ility
to id
entif
y pa
tient
s w
ho m
ay
requ
ire u
rgen
t spe
cial
ist m
enta
l hea
lth c
are
TS2
••
3
6.4.
11
Dem
onst
rate
, in
the
cont
ext o
f int
erac
ting
wit
h pe
rson
s in
volv
ed in
em
erge
ncie
s an
d m
ajor
in
cide
nts:
(a) A
ctive
list
enin
gTS
LT, S
L,
RP, R
M,
CL, E
L
2•
••
3
(b) A
bilit
y to
diff
eren
tiate
dis
tres
s fr
om d
isor
der
TS2
••
•1
(c) A
ction
s to
avo
id a
dver
se p
sych
olog
ical
reac
tions
(in
clud
ing
pani
c)TS
2•
••
4
6.4.
12D
emon
stra
te a
bilit
y to
gai
n ac
cess
to a
ppro
pria
te
imm
edia
te p
sych
osoc
ial s
uppo
rtTS
2•
••
2
6.4.
13M
aint
ains
aw
aren
ess
of o
wn
psyc
hoso
cial
cop
ing
stra
tegi
es a
nd n
eeds
NTS
N/A
2•
•3
6.4.
14M
aint
ains
a p
rofe
ssio
nal a
ppro
ach
to c
onsi
dera
tion
of p
sych
osoc
ial a
nd m
enta
l hea
lth a
spec
ts o
f mul
tiple
ca
sual
ty in
cide
nts
NTS
2•
•3
THEME 6
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
75CROSS-CUTTING THEME A
CROSS-CUTTING THEME A. OPERATIONAL PRACTICEMaintaining safe and effective operational practice is a generic or cross-cutting theme of professional practice within PHEM. This theme concerns the knowledge, skills and non-technical skills required to maintain safe and effective operational practice within a pre-hospital emergency medicine service provider.
UNITSA.1 Apply the curriculum framework to local operations
A.2 Respond to incidents by road
A.3 Respond to incidents by air
A.4 Utilise telecommunications and voice procedure
A.5 Apply principles of dynamic risk assessment at incident scenes
A.6 Provide scene management
A.7 Maintain records
A.8 Apply infection prevention and control principles and procedures
A.9 Apply moving and handling principles and procedures
A.10 Apply principles of Equality and Diversity
Related GMP domains are assigned to each group of elements within units as follows:
1. Knowledge skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
CROSS-CUTTING THEME A 76
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
A. O
pera
tion
al p
racti
ce
A.1
App
ly th
e cu
r-ri
culu
m fr
amew
ork
to
loca
l ope
ratio
ns
A.1
.1
Criti
que
how
you
r lo
cal P
HEM
ope
rati
on:
(a) W
orks
with
in th
e EM
S sy
stem
UK
DR,
LT,
CL
1 (b
)•
••
3
(b) P
rovi
des
Pre-
hosp
ital E
mer
genc
y M
edic
al C
are
UK
1 (b
)•
••
1
(c) U
ses
Pre-
hosp
ital E
quip
men
tU
K1
(b)
••
•1
(d) S
uppo
rts
Resc
ue a
nd E
xtri
catio
nU
K1
(b)
••
•1
(e) S
uppo
rts
safe
pati
ent t
rans
fer
UK
1 (b
)•
••
1
(f) S
uppo
rts
emer
genc
y pr
epar
edne
ss a
nd re
spon
seU
K1
(b)
••
•2
A.1
.2
Des
crib
e th
e pr
ovis
ions
wit
hin
your
loca
l PH
EM
oper
ation
for:
(a) T
eam
reso
urce
man
agem
ent
UK
DR,
LT,
CL
1 (b
)•
••
3
(b) C
linic
al g
over
nanc
eU
K1
(b)
••
•2
A.1
.3
Des
crib
e th
e di
sting
uish
ing
feat
ures
of y
our
loca
l PH
EM o
pera
tion
wit
h re
spec
t to
:
(a) E
pide
mio
logy
UK
DR,
LT,
CL
1 (b
)•
••
1
(b) T
he E
MS
syst
emU
K1
(b)
••
•1
(c) C
once
pt o
f ope
ratio
nsU
K1
(b)
••
•1
(d) O
pera
tiona
l env
ironm
ent
UK
1 (b
)•
••
1
(e) S
taffi
ng a
nd s
kill
mix
UK
1 (b
)•
••
3
(f) T
rans
port
pla
tfor
ms
UK
1 (b
)•
••
1
CROSS-CUTTING THEME A 77
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
A. O
pera
tion
al p
racti
ce
A.2
Res
pond
to
inci
dent
s by
road
A.2
.1Ev
alua
te th
e ri
sks
and
bene
fits
of re
spon
ding
by
road
UK
DR,
LT,
SL
1 (b
)•
••
•2
A.2
.2Cr
itiqu
e th
e ro
le o
f the
co-
driv
er w
hen
usin
g em
erge
ncy
driv
ing
proc
edur
eU
K1
(b)
••
••
2
A.2
.3Ev
alua
te th
e be
nefit
s an
d lim
itatio
ns o
f diff
erin
g ro
ad
tran
spor
t pla
tfor
ms
with
in th
e EM
S sy
stem
UK
1 (b
)•
••
•1
A.2
.4D
emon
stra
te th
e ab
ility
to a
ct a
s an
effe
ctive
co-
driv
er w
hen
resp
ondi
ng b
y ro
adTS
1 (b
)•
•2
A.2
.5D
emon
stra
te th
e ab
ility
to u
nder
take
a r
isk
asse
ssm
ent r
elat
ed to
resp
ondi
ng b
y ro
adTS
1 (b
)•
•2
A.3
Res
pond
to
inci
dent
s by
air
A.3
.1Ev
alua
te th
e ri
sks
and
bene
fits
of re
spon
ding
by
air
UK
DR,
LT,
SL
1 (b
)•
••
•2
A.3
.2
Criti
que
the
role
and
resp
onsi
biliti
es o
f:
(a) A
ircre
wU
K
DR,
LT,
SL
1 (b
)•
••
1
(b) H
EMS
Crew
Mem
ber
UK
1 (b
)•
••
1
(c) M
edic
al P
asse
nger
UK
1 (b
)•
••
1
A.3
.3D
efine
com
mon
term
s us
ed in
avi
ation
in c
onte
xt o
f ac
ting
as a
med
ical
pas
seng
erU
K1
(b)
••
1
A.3
.4D
escr
ibe
the
crite
ria
for
a he
licop
ter
land
ing
site
UK
1 (b
)•
•2
A.3
.5D
iffer
entia
te th
e te
rms
‘Air
Am
bula
nce’
and
‘HEM
S’U
K1
(b)
••
1
A.3
.6D
escr
ibe
the
regu
latio
ns p
erta
inin
g to
HEM
S an
d ai
r am
bula
nce
depl
oym
ent
UK
1 (b
)•
•2
A.3
.7A
ppra
ise
the
evid
ence
rega
rdin
g th
e ro
le o
f he
licop
ters
with
in E
MS
syst
ems
UK
2•
••
1
A.3
.8Ev
alua
te th
e be
nefit
s an
d lim
itatio
ns o
f diff
erin
g ai
r tr
ansp
ort p
latf
orm
s w
ithin
the
EMS
syst
emU
K1
(b)
••
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
CROSS-CUTTING THEME A 78
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
A. O
pera
tion
al p
racti
ce
A.3
Res
pond
to
inci
dent
s by
air
(con
t.)
A.3
.9D
escr
ibe
the
cont
ent o
f a p
re-d
eplo
ymen
t bri
ef to
a
med
ical
pas
seng
erU
KD
R, L
T,
SL1
(b)
••
•2
A.3
.10
Dem
onst
rate
the
safe
em
bark
ation
and
di
sem
bark
ation
of a
n ai
rcra
ft
TSSL
, RM
1 (b
)•
•2
A.3
.11
Dem
onst
rate
the
abili
ty to
act
as
an e
ffecti
ve a
nd s
afe
med
ical
pas
seng
er w
hen
resp
ondi
ng b
y ai
rTS
1 (b
)•
••
2
A.4
Util
ise
tele
com
mun
icati
ons
and
voic
e pr
oced
ure
A.4
.1Re
call
the
phon
etic
alph
abet
UK
DR,
LT,
D
P, S
L
1 (b
)•
1
A.4
.2Cr
itiqu
e th
e uti
lity
of fo
rmal
voi
ce p
roce
dure
with
in
effec
tive
tele
com
mun
icati
ons
UK
2•
•3
A.4
.3Cr
itiqu
e th
e ch
alle
nges
to e
ffecti
ve
tele
com
mun
icati
ons
in th
e pr
e-ho
spita
l env
ironm
ent
UK
2•
•3
A.4
.4Cr
itiqu
e th
e in
fras
truc
ture
for
tele
com
mun
icati
ons
with
in th
e EM
S sy
stem
UK
2•
•3
A.4
.5D
emon
stra
te th
e eff
ectiv
e us
e of
com
mon
sta
ndar
d te
leco
mm
unic
ation
pro
cedu
res
with
in th
e EM
S sy
stem
TSD
P, S
L,
RM, E
L
1 (b
)•
•3
A.4
.6D
emon
stra
te th
e ab
ility
to p
ass
com
plex
mes
sage
s in
a
clea
r an
d effi
cien
t man
ner
TS1
(b)
••
3
A.5
App
ly p
rinc
iple
s of
dyn
amic
ris
k as
sess
men
t at
inci
dent
sce
nes
A.5
.1Ex
plai
n th
e co
ncep
t of g
ener
ic r
isk
asse
ssm
ent
UK
DR,
LT
2•
••
2
A.5
.2D
escr
ibe
the
prin
cipl
es o
f dyn
amic
ris
k as
sess
men
tU
K2
••
•2
A.5
.3D
escr
ibe
the
rela
tions
hip
betw
een
gene
ric
and
dyna
mic
ris
k as
sess
men
tU
K2
••
2
A.5
.4D
escr
ibe
how
dyn
amic
ris
k as
sess
men
t may
influ
ence
de
cisi
on m
akin
g re
late
d to
pati
ent c
are
UK
2•
•1
A.5
.5D
emon
stra
te th
e ap
plic
ation
of d
ynam
ic r
isk
asse
ssm
ent t
o a
rang
e of
inci
dent
sTS
DR,
LT,
SL
, EL
2•
•2
A.5
.6D
emon
stra
te th
e m
enta
l agi
lity
to p
erfo
rm d
ynam
ic
risk
ass
essm
ent
TSD
P, R
P2
••
2
CROSS-CUTTING THEME A 79
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
A. O
pera
tion
al p
racti
ce
A.6
Pro
vide
sce
ne
man
agem
ent
A.6
.1D
escr
ibe
the
stag
es o
f sce
ne m
anag
emen
tU
K1
(b)
••
••
2
A.6
.2
Des
crib
e th
e ro
les
and
resp
onsi
biliti
es o
f the
fo
llow
ing
orga
nisa
tion
s in
rela
tion
to s
cene
m
anag
emen
t:
(a) A
mbu
lanc
e au
thor
ities
and
ser
vice
s U
K
DR,
LT,
D
P, S
L,
RP, R
M,
CL, E
L
1 (b
)•
••
3
(b) P
olic
e au
thor
ities
and
ser
vice
sU
K1
(b)
••
•3
(c) F
ire a
utho
ritie
s an
d se
rvic
es
UK
1 (b
)•
••
3
(d) R
escu
e au
thor
ities
and
ser
vice
sU
K1
(b)
••
•3
(e) S
peci
alis
t res
cue
serv
ices
U
K1
(b)
••
•3
(f) V
olun
tary
em
erge
ncy
serv
ices
UK
1 (b
)•
••
3
(g) O
ther
sta
tuto
ry o
rgan
isati
ons
UK
1 (b
)•
••
3
A.6
.3Ev
alua
te s
trat
egie
s fo
r eff
ectiv
e sc
ene
man
agem
ent
UK
1 (b
)•
•1
A.6
.4Ev
alua
te le
sson
s id
entifi
ed re
late
d to
sce
ne
man
agem
ent f
rom
his
tori
cal i
ncid
ents
UK
1 (b
)•
•2
A.6
.5D
emon
stra
te th
e ab
ility
to e
ffecti
vely
man
age
an
inci
dent
sce
neTS
DP,
SL,
RP,
RM
, CL,
EL
1 (b
)•
••
•1
A.7
Mai
ntai
n re
cord
s
A.7
.1D
escr
ibe
the
dutie
s an
d re
spon
sibi
lities
of t
he
clin
icia
n pe
rtai
ning
to p
re-h
ospi
tal m
edic
al re
cord
sU
K
DR,
LT,
RM
1 (b
)•
•1
A.7
.2Cr
itiqu
e di
ffere
nt m
etho
ds o
f med
ical
reco
rd k
eepi
ngU
K1
(b)
••
1
A.7
.3D
escr
ibe
min
imum
sta
ndar
ds fo
r go
od m
edic
al
reco
rds
UK
1 (b
)•
•1
A.7
.4D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r m
edic
al
reco
rds
man
agem
ent w
ithin
the
EMS
syst
emU
K1
(b)
••
1
A.7
.5D
emon
stra
te th
e ab
ility
to m
aint
ain
clea
r an
d ap
prop
riat
ely
deta
iled
med
ical
reco
rds
TSSL
, EL
1 (b
)•
••
1
A.7
.6D
emon
stra
te a
pro
fess
iona
l atti
tude
to c
ritiq
uing
m
edic
al re
cord
s cr
eate
d by
sel
f and
oth
ers
NTS
RM1
(b)
••
•4
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
CROSS-CUTTING THEME A 80
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
A. O
pera
tion
al p
racti
ce
A.8
App
ly in
fecti
on
prev
entio
n an
d co
ntro
l pri
ncip
les
and
proc
edur
es
A.8
.1Ev
alua
te th
e in
terp
lay
betw
een
the
requ
irem
ents
for
infe
ction
pre
venti
on a
nd c
ontr
ol a
nd th
e us
e of
per
sona
l pr
otec
tive
equi
pmen
tU
K
DR,
LT
2•
••
•2
A.8
.2Ev
alua
te in
fecti
on p
reve
ntion
and
con
trol
mea
sure
s in
the
pre-
hosp
ital e
nviro
nmen
tU
K2
••
•2
A.8
.3Co
ntra
st in
-hos
pita
l and
pre
-hos
pita
l inf
ectio
n pr
even
tion
and
cont
rol m
easu
res
UK
2•
•2
A.8
.4D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r in
fecti
on
prev
entio
n an
d co
ntro
l with
in th
e EM
S sy
stem
UK
2•
••
2
A.8
.5D
emon
stra
te b
est p
racti
ce in
infe
ction
pre
venti
on a
nd
cont
rol i
n th
e pr
e-ho
spita
l env
ironm
ent
TSD
P, S
L RM
, EL
2•
••
•2
A.8
.6D
emon
stra
te a
pro
fess
iona
l app
roac
h to
infe
ction
pr
even
tion
and
cont
rol
NTS
RM2
••
•2
A.9
App
ly m
ovin
g an
d ha
ndlin
g pr
inci
ples
and
pr
oced
ures
A.9
.1D
escr
ibe
chal
leng
es re
late
d to
saf
e pa
tient
mov
ing
and
hand
ling
in th
e pr
e-ho
spita
l env
ironm
ent
UK
LT, S
L,
EL
1 (b
)•
•2
A.9
.2Ev
alua
te m
etho
ds to
ove
rcom
e ch
alle
nges
to p
atien
t m
ovin
g an
d ha
ndlin
g in
the
pre-
hosp
ital e
nviro
nmen
tU
K1
(b)
•2
A.9
.3D
escr
ibe
equi
pmen
t use
d fo
r m
ovin
g an
d ha
ndlin
g in
the
pre-
hosp
ital e
nviro
nmen
tU
K1
(b)
••
1
A.9
.4D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r m
ovin
g an
d ha
ndlin
g w
ithin
the
EMS
syst
emU
K1
(b)
••
•2
A.9
.5D
emon
stra
te s
afe
mov
ing
and
hand
ling
in th
e pr
e-ho
spita
l env
ironm
ent
TS
LT, D
P,
SL, E
L
1 (b
)•
••
2
A.9
.6D
emon
stra
te s
afe
mov
ing
and
hand
ling
of e
quip
men
t in
the
pre-
hosp
ital e
nviro
nmen
tTS
1 (b
)•
••
2
A.9
.7D
emon
stra
te s
afe
use
of m
ovin
g an
d ha
ndlin
g eq
uipm
ent
TS1
(b)
••
2
A.9
.8D
emon
stra
te th
e ab
ility
to s
afel
y lo
ad a
nd u
nloa
d pa
tient
s on
to tr
ansp
ort p
latf
orm
sTS
1 (b
)•
•2
A.9
.9D
emon
stra
te a
pro
fess
iona
l atti
tude
to s
afe
mov
ing
and
hand
ling
NTS
RM1
(b)
••
•4
CROSS-CUTTING THEME A 81
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
A. O
pera
tion
al p
racti
ce
A.1
0 A
pply
pri
ncip
les
of e
qual
ity a
nd
dive
rsity
A.1
0.1
Defi
ne E
qual
ityU
K
DR,
LT,
RM
RK
2•
••
•4
A.1
0.2
Des
crib
e co
nsid
erati
ons
for
avoi
ding
dis
crim
inati
on in
pr
e-ho
spita
l pra
ctice
UK
2•
••
•4
A.1
0.3
Defi
ne D
iver
sity
UK
2•
••
•4
A.1
0.4
Des
crib
e co
nsid
erati
ons
rela
ting
to v
alui
ng d
iver
sity
in
pre-
hosp
ital p
racti
ceU
K2
••
••
4
A.1
0.5
Des
crib
e th
e po
licie
s an
d pr
oced
ures
for
Equa
lity
and
Div
ersi
ty w
ithin
the
EMS
syst
emU
K2
••
••
4
A.1
0.6
Dem
onst
rate
a p
rofe
ssio
nal a
ttitu
de to
equ
ality
and
di
vers
ity in
the
pre-
hosp
ital e
nviro
nmen
tN
TSRM
2•
••
4
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
83
CROSS-CUTTING THEME B. TEAM RESOURCE MANAGEMENTContributing to effective Team Resource Management is a generic or cross-cutting area of professional practice within PHEM. This theme concerns the knowledge, skills and non-technical skills required to work as part of a multi-disciplinary team in the high hazard, resource limited, environmentally challenging and time pressured pre-hospital environment.
UNITSB.1 Understand human factors and their role in patient and team safety
B.2 Maintain situational awareness
B.3 Understand and apply principles of decision making
B.4 Communicate effectively
B.5 Employ effective team working
B.6 Demonstrate leadership and followership
B.7 Manage stress and fatigue
B.8 Understand and apply principles of error investigation and management
Related GMP domains are assigned to each group of elements within units as follows:
1. Knowledge skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
CROSS-CUTTING THEME B
CROSS-CUTTING THEME B 84
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
B. T
eam
reso
urce
man
agem
ent
B.1
Und
erst
and
hum
an fa
ctor
s an
d th
eir
role
in p
atien
t an
d te
am s
afet
y
B.1.
1D
efine
the
conc
ept o
f hum
an fa
ctor
s U
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•3
B.1.
2D
escr
ibe
the
prin
cipl
es o
f hum
an e
rror
theo
ryU
K1
(b)
••
3
B.1.
3Ev
alua
te th
e pl
ace
of h
uman
fact
ors
with
in th
e co
ntex
t of h
uman
err
or th
eory
UK
1 (b
)•
•3
B.1.
4
Des
crib
e th
e po
tenti
al im
pact
on
pati
ent
and
team
sa
fety
of:
(a) h
uman
fact
ors
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•3
(b) s
yste
m fa
ctor
sU
K1
(b)
••
2
(c) o
rgan
isati
onal
fact
ors
UK
1 (b
)•
•2
(d) c
ultu
ral f
acto
rsU
K1
(b)
••
2
B.1.
5D
emon
stra
te th
e pr
actic
al a
pplic
ation
of h
uman
err
or
theo
ry to
pre
-hos
pita
l em
erge
ncy
med
ical
pra
ctice
TSLT
, SL,
RP,
RM
, CL,
EL
1 (b
)•
••
3
B.1.
6D
emon
stra
te a
pro
fess
iona
l atti
tude
to p
atien
t saf
ety
NTS
RM, S
L,
EL, R
P1
(a)
••
••
4
B.2
Mai
ntai
n si
tuati
onal
aw
aren
ess
B.2.
1D
efine
situ
ation
al a
war
enes
sU
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•3
B.2.
2Cr
itiqu
e m
odel
s of
situ
ation
al a
war
enes
sU
K2
••
3
B.2.
3Cr
itiqu
e st
rate
gies
to m
aint
ain
situ
ation
al a
war
enes
s in
the
pre-
hosp
ital e
nviro
nmen
tU
K2
••
3
B.2.
4
Dem
onst
rate
, in
the
cont
ext o
f PH
EM p
racti
ce, t
he
abili
ty to
:
(a) g
athe
r in
form
ation
TS
LT, S
L,
CL, E
L
1 (b
)•
••
1
(b) i
nter
pret
info
rmati
onTS
1 (b
)•
••
1
(c) a
ntici
pate
like
ly e
vent
sTS
1 (b
)•
••
1
CROSS-CUTTING THEME B 85
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
B. T
eam
reso
urce
man
agem
ent
B.2.
5Em
brac
e th
e co
ncep
t of s
ituati
onal
aw
aren
ess
NTS
RM, R
P,
CL, E
L1
(b)
••
3
B.3
Und
erst
and
and
appl
y pr
inci
ples
of
deci
sion
mak
ing
B.3.
1A
ppre
ciat
es th
at p
re-h
ospi
tal d
ecis
ion
mak
ing
is o
ften
on
the
basi
s of
an
inco
mpl
ete
data
set
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•1
B.3.
2Cr
itiqu
e di
ffere
nt d
ecis
ion
mak
ing
mod
els
rele
vant
to
pre-
hosp
ital p
racti
ceU
K2
•1
B.3.
3
Dem
onst
rate
app
licati
on o
f str
ateg
ies
to m
ake
corr
ect
deci
sion
s in
the
pre
-hos
pita
l env
iron
men
t re
late
d to
:
(a) t
eam
and
pati
ent s
afet
yTS
LT, S
L,
CL, E
L,
DP
1 (b
)•
••
2
(b) c
linic
al c
are
TS1
(b)
••
•1
(c) o
pera
tiona
l asp
ects
TS1
(b)
••
•1
(d) l
ogis
tics
TS1
(b)
••
•3
B.3.
4
Dem
onst
rate
the
abili
ty to
bal
ance
the
desi
rabi
lity
of o
btai
ning
all
rele
vant
info
rmati
on w
ith th
e re
quire
men
t to
mak
e de
cisi
ons
in a
n ap
prop
riat
e tim
e fr
ame
NTS
RM, R
P,
SL, C
L,
EL
1 (b
)•
••
•1
B.3.
5D
emon
stra
te w
illin
gnes
s to
util
ise
all s
ourc
es o
f in
form
ation
to a
id d
ecis
ion
mak
ing
NTS
1 (b
)•
••
•3
B.4
Com
mun
icat
e eff
ectiv
ely
B.4.
1D
escr
ibe
verb
al a
nd n
on-v
erba
l tec
hniq
ues
to
com
mun
icat
e eff
ectiv
ely
in th
e op
erati
onal
en
viro
nmen
tU
K
DR,
LT,
SL
, EL,
CL
1 (b
)•
•3
B.4.
2D
escr
ibe
tech
niqu
es to
com
mun
icat
e eff
ectiv
ely
in
the
teac
hing
and
lear
ning
env
ironm
ent
UK
1 (b
)•
•3
B.4.
3
Des
crib
e co
mm
unic
ation
tech
niqu
es to
:
(a) r
esol
ve c
onfli
ctU
K1
(b)
••
3
(b) c
onve
y as
serti
vene
ssU
K1
(b)
••
3
(c) h
ando
ver
clin
ical
info
rmati
onU
K1
(b)
••
3
(d) c
ritiq
ue p
erfo
rman
ceU
K1
(b)
••
3
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
CROSS-CUTTING THEME B 86
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
B. T
eam
reso
urce
man
agem
ent
B.4
Com
mun
icat
e eff
ectiv
ely
(con
t.)
B.4.
3(e
) deb
rief
UK
DR,
LT,
SL
, EL,
CL
1 (b
)•
•3
B.4.
4Cr
itiqu
e ba
rrie
rs to
effe
ctive
com
mun
icati
on in
PH
EM
prac
tice
UK
3•
•3
B.4.
5D
emon
stra
te th
e ab
ility
to c
omm
unic
ate
in a
n ac
cura
te, b
rief
and
cle
ar m
anne
rTS
LT, S
L, E
L,
CL, R
P1
(b)
••
•3
B.4.
6
Dem
onst
rate
the
use
of c
omm
unic
ation
tech
niqu
es
to:
(a) r
esol
ve c
onfli
ctTS
LT, S
L, E
L,
CL, R
P
1 (b
)•
••
3
(b) c
onve
y as
serti
vene
ssTS
1 (b
)•
••
3
(c) h
ando
ver
clin
ical
info
rmati
onTS
1 (b
)•
••
3
(d) c
ritiq
ue p
erfo
rman
ceTS
1 (b
)•
••
3
(e) d
ebri
efTS
1 (b
)•
••
3
B.4.
7D
emon
stra
te th
e ab
ility
to a
dapt
com
mun
icati
on
met
hods
to th
e si
tuati
onTS
1 (b
)•
••
3
B.4.
8D
emon
stra
te th
e ab
ility
to c
omm
unic
ate
effec
tivel
y w
ith d
iffer
ent g
roup
s en
coun
tere
d in
the
pre-
hosp
ital
envi
ronm
ent
TS1
(b)
••
•3
B.4.
9Re
cogn
ises
the
impo
rtan
ce o
f effe
ctive
co
mm
unic
ation
to s
afe
and
effici
ent d
eliv
ery
of
patie
nt c
are
in th
e pr
e-ho
spita
l env
ironm
ent
NTS
RM, R
P,
CL, E
L1
(b)
••
••
3
B.5
Empl
oy e
ffecti
ve
team
wor
king
B.5.
1D
escr
ibe
the
attri
bute
s of
an
effec
tive
team
UK
DR,
SL,
CL
, EL
1 (b
)•
•3
B.5.
2Co
ntra
st m
odel
s of
team
wor
kU
K2
••
3
B.5.
3D
escr
ibe
stra
tegi
es to
sup
port
effe
ctive
team
wor
k U
K2
••
3
B.5.
4Cr
itiqu
e th
e fa
ctor
s th
at in
fluen
ce te
am w
orki
ng in
th
e pr
e-ho
spita
l env
ironm
ent
UK
2•
•3
CROSS-CUTTING THEME B 87
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
B. T
eam
reso
urce
man
agem
ent
B.5
Empl
oy e
ffecti
ve
team
wor
king
(con
t.)
B.5.
5D
emon
stra
te th
e ab
ility
to w
ork
in m
ulti-
disc
iplin
ary
and
unfa
mili
ar te
ams
TS
LT, S
L,
RP, R
M,
CL, E
L
2•
••
•3
B.5.
6D
emon
stra
te a
will
ingn
ess
to a
ssum
e th
e m
ost
appr
opri
ate
role
in a
team
NTS
1 (b
)•
••
•3
B.5.
7D
emon
stra
te a
n ap
prec
iatio
n fo
r al
l tea
m m
embe
rs
and
thei
r co
ntri
butio
nsN
TS1
(b)
••
••
3
B.6
Dem
onst
rate
le
ader
ship
and
fo
llow
ersh
ip
B.6.
1D
iffer
entia
te c
linic
al, m
edic
al a
nd o
pera
tiona
l le
ader
ship
UK
DR,
LT,
SL
, CL,
EL
2•
••
3
B.6.
2D
escr
ibe
the
attri
bute
s of
an
effec
tive
lead
erU
K2
••
3
B.6.
3D
escr
ibe
the
attri
bute
s of
an
effec
tive
follo
wer
UK
2•
•3
B.6.
4Co
ntra
st d
iffer
ent m
odel
s of
lead
ersh
ipU
K2
•3
B.6.
5Cr
itiqu
e th
e cl
inic
al a
nd n
on-c
linic
al le
ader
ship
role
s of
the
PHEM
pra
ctitio
ner
UK
2•
3
B.6.
6D
emon
stra
te th
e ab
ility
to b
e an
effe
ctive
lead
er
TS
SL, D
P,
RP, R
M,
EL
2•
••
3
B.6.
7D
emon
stra
te th
e ab
ility
to b
e an
effe
ctive
follo
wer
TS1
(b)
••
•3
B.6.
8D
emon
stra
te a
will
ingn
ess
to a
ssum
e an
d m
aint
ain
a le
ader
ship
role
in a
dver
se c
ircum
stan
ces
NTS
2•
••
•3
B.7
Man
age
stre
ss
and
fatig
ue
B.7.
1Re
call
the
defin
ition
and
cau
se o
f str
ess
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
•3
B.7.
2Re
call
the
defin
ition
and
cau
ses
of fa
tigue
UK
1 (b
)•
•3
B.7.
3D
escr
ibe
the
effec
ts o
f str
ess
and
fatig
ue o
n cl
inic
al
and
oper
ation
al p
erfo
rman
ceU
K1
(b)
••
3
B.7.
4Cr
itiqu
e fa
ctor
s th
at re
duce
abi
lity
to m
anag
e st
ress
an
d fa
tigue
UK
2•
•3
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
CROSS-CUTTING THEME B 88
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
B. T
eam
reso
urce
man
agem
ent
B.7
Man
age
stre
ss
and
fatig
ue(c
ont.
)
B.7.
5Cr
itiqu
e w
ays
in w
hich
str
ess
and
fatig
ue m
ay b
e m
inim
ised
U
KD
R, L
T, S
L,
EL, C
L2
••
3
B.7.
6D
emon
stra
te th
e ab
ility
to re
cogn
ise
the
effec
ts o
f st
ress
and
fatig
ue o
n se
lf an
d ot
hers
TSLT
, SL,
RP
, CL,
EL
1 (b
)•
••
3
B.7.
7D
emon
stra
te a
bilit
y to
insti
tute
str
ateg
ies
to m
inim
ise
the
effec
ts o
f str
ess
and
fatig
ue o
n se
lf an
d ot
hers
TS1
(b)
••
•3
B.7.
8D
emon
stra
te a
n op
en a
nd h
ones
t app
roac
h to
de
clar
ing
whe
n st
ress
and
/or
fatig
ue m
ay im
pact
on
own
prac
tice
NTS
RM, R
P,
EL, S
L
1 (b
)•
••
4
B.7.
9D
emon
stra
te a
n op
en a
nd h
ones
t app
roac
h to
di
scus
sing
with
col
leag
ues
whe
n st
ress
and
/or
fatig
ue
may
impa
ct o
n th
eir
prac
tice
NTS
1 (b
)•
••
4
B.8
Und
erst
and
and
appl
y pr
inci
ples
of
erro
r in
vesti
gatio
n an
d m
anag
emen
t
B.8.
1D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r er
ror
inve
stiga
tion
and
man
agem
ent w
ithin
the
EMS
syst
emU
K
DR,
LT,
EL
, CL,
SL
2•
•2
B.8.
2D
escr
ibe
the
attri
bute
s of
a s
afet
y cu
lture
UK
2•
•2
B.8.
3D
escr
ibe
the
attri
bute
s of
a h
igh
relia
bilit
y or
gani
satio
nU
K2
••
2
B.8.
4D
escr
ibe
the
tech
niqu
es fo
r eff
ectiv
e er
ror
repo
rting
an
d in
vesti
gatio
nU
K2
••
2
B.8.
5Co
mpa
re le
sson
s id
entifi
ed fr
om s
afet
y cr
itica
l in
dust
ries
oth
er th
an h
ealth
care
UK
2•
•2
B.8.
6D
emon
stra
te th
e ab
ility
to c
ompl
ete
an in
vesti
gatio
n in
to a
pot
entia
l err
orTS
LT, S
L,
CL, E
L2
••
2
B.8.
7D
emon
stra
te a
n op
en a
nd h
ones
t app
roac
h to
err
or
inve
stiga
tion
and
man
agem
ent
NTS
RM, R
P,
SL, E
L
2•
•2
B.8.
8Pr
omot
es a
saf
ety
cultu
reN
TS2
••
2
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
CROSS-CUTTING THEME C 89
CROSS-CUTTING THEME C. CLINICAL GOVERNANCEApplication of clinical governance principles and techniques is a generic or cross-cutting area of professional practice within PHEM. This theme concerns the knowledge, skills and non-technical skills required to ensure that clinical governance principles and mechanisms are applied to clinical practice.
Units
C.1 Understand and apply principles of clinical governance as applied to pre-hospital practice
C.2 Manage and support continuous professional development
C.3 Utilise clinical evidence to support clinical practice
C.4 Utilise and prepare documents that guide practice
C.5 Support and apply clinical audit
C.6 Understand and apply organisational risk management processes
C.7 Support training and development
C.8 Understand and apply quality management processes
Related GMP domains are assigned to each group of elements within units as follows:
1. Knowledge skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust
Good Medical Practice
Working in Emergency
Medical Systems
Providing pre-hospital
Emergency Medical Care
Using pre-hospital
equipment
Supporting rescue and extrication
Supporting safe patient
transfer
Supporting emergency
preparedness and response
CROSS-CUTTING THEME C 90
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
C. C
linic
al g
over
nanc
e
C.1
Und
erst
and
and
appl
y pr
inci
ples
of
clin
ical
gov
erna
nce
as a
pplie
d to
pre
-ho
spita
l pra
ctice
C.1.
1D
escr
ibe
how
the
mec
hani
sms
unde
rpin
ning
clin
ical
go
vern
ance
are
app
lied
to p
re-h
ospi
tal p
racti
ce.
UK
DR,
LT,
SL,
CL
, EL
1 (b
)•
••
2
C.1.
2.
Eval
uate
the
chal
leng
es to
goo
d cl
inic
al g
over
nanc
e po
sed
by:
(a) S
mal
l tea
m w
orki
ngU
K
DR,
LT,
SL,
CL
, EL
1 (b
)•
•2
(b) L
one-
doct
or w
orki
ngU
K1
(b)
••
2
(c) H
igh-
risk
clin
ical
inte
rven
tions
UK
1 (b
)•
•2
(d) R
emot
e an
d ru
ral p
racti
ceU
K1
(b)
••
2
C.1.
3D
escr
ibe
the
polic
ies
and
proc
edur
es fo
r cl
inic
al
gove
rnan
ce w
ithin
the
EMS
syst
emU
K1
(b)
••
2
C.1.
4Co
ntra
st lo
cal,
regi
onal
, nati
onal
and
inte
rnati
onal
re
gula
tory
fram
ewor
ks fo
r en
suri
ng q
ualit
y an
d sa
fety
w
ithin
the
EMS
syst
em
UK
2•
•2
C.1.
5D
emon
stra
te a
pro
fess
iona
l atti
tude
to c
linic
al
gove
rnan
ceN
TSRM
, RP,
CL
, EL
1 (b
)•
••
•2
C.2
Man
age
and
supp
ort c
ontin
uous
pr
ofes
sion
al
deve
lopm
ent
C.2.
1Li
st m
etho
ds to
sup
port
con
tinuo
us p
rofe
ssio
nal
deve
lopm
ent (
CPD
) in
PHEM
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
1
C.2.
2A
naly
se s
trat
egie
s by
whi
ch g
roup
s of
sm
all n
umbe
rs
of b
usy
prof
essi
onal
s ar
e ab
le to
mai
ntai
n eff
ectiv
e CP
DU
K2
•1
C.2.
3Ev
alua
te th
e ch
alle
nges
in d
eliv
erin
g re
leva
nt m
ulti-
prof
essi
onal
CPD
UK
2•
•1
C.2.
4D
emon
stra
te th
e ab
ility
to fa
cilit
ate
CPD
for
self
and
othe
rsTS
LT, D
P, S
L,
RP, R
M,
CL, E
L2
••
1
C.2.
5D
emon
stra
te a
pro
fess
iona
l atti
tude
to C
PDN
TSRM
, RP,
CL
, EL
2•
•1
CROSS-CUTTING THEME C 91
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
C. C
linic
al g
over
nanc
e
C.3
Util
ise
clin
ical
ev
iden
ce to
sup
port
cl
inic
al p
racti
ce
C.3.
1Li
st p
ossi
ble
sour
ces
of c
linic
al e
vide
nce
in th
e pr
e-ho
spita
l env
ironm
ent
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
••
1
C.3.
2A
ppra
ise
the
rang
e an
d de
pth
of re
sear
ch e
vide
nce
unde
rpin
ning
PH
EM c
linic
al p
racti
ceU
K1
(b)
••
•1
C.3.
3D
escr
ibe
the
chal
leng
es o
f per
form
ing
rese
arch
in th
e pr
e-ho
spita
l env
ironm
ent
UK
2•
••
1
C.3.
4D
emon
stra
te th
e ab
ility
to in
tegr
ate
the
late
st a
vaila
ble
evid
ence
to p
rovi
de h
igh
qual
ity c
are
to in
divi
dual
pa
tient
s TS
DP,
SL,
RP,
CL
, EL
2•
••
•1
C.3.
5D
emon
stra
te a
will
ingn
ess
to c
hang
e pr
actic
e on
the
basi
s of
app
ropr
iate
rese
arch
evi
denc
eN
TSRM
, RP,
SL
, CL,
EL
2•
••
•1
C.4
Util
ise
and
prep
are
docu
men
ts th
at g
uide
pr
actic
e
C.4.
1
Des
crib
e th
e ro
le, i
n th
e pr
e-ho
spit
al e
nvir
onm
ent o
f:
(a) S
tand
ard
oper
ating
pro
cedu
res
UK
DR,
LT,
SL
, CL,
EL
1 (b
)•
••
2
(b) R
outin
e ch
eckl
ists
UK
1 (b
)•
••
2
(c) E
mer
genc
y ac
tion
chec
klis
tsU
K1
(b)
••
•2
(d) P
roce
dura
l aid
e m
emoi
res
UK
1 (b
)•
••
2
(e) P
atien
t gro
up d
irecti
ves
UK
1 (b
)•
••
2
(f) C
linic
al g
uide
lines
UK
1 (b
)•
••
2
(g) P
atien
t inf
orm
ation
leafl
ets
UK
1 (b
)•
••
2
C.4.
2Ev
alua
te th
e w
ays
in w
hich
the
docu
men
ts (a
) to
(g)
abov
e co
ntri
bute
to g
ood
clin
ical
gov
erna
nce
UK
1 (b
)•
••
••
2
C.4.
3D
emon
stra
te th
e ab
ility
to u
se a
ppro
pria
te d
ocum
ents
th
at g
uide
pra
ctice
in c
linic
al s
ituati
ons
TSSL
, RP,
CL,
EL
, DP
1 (b
)•
••
•1
C.4.
4D
emon
stra
te th
e ab
ility
con
stru
ct d
ocum
ents
that
gui
de
prac
tice
TS1
(b)
••
2
C.4.
5D
emon
stra
te a
pro
fess
iona
l atti
tude
to d
ocum
ents
that
ai
de b
est p
racti
ceN
TSRM
, RP,
SL
, EL
1 (b
)•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
CROSS-CUTTING THEME C 92
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
C. C
linic
al g
over
nanc
e
C.5
Supp
ort a
nd a
pply
cl
inic
al a
udit
C.5.
1D
escr
ibe
the
impo
rtan
ce o
f and
cha
lleng
es to
clin
ical
in
form
ation
sha
ring
acr
oss
an E
MS
syst
emU
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•3
C.5.
2D
escr
ibe
the
polic
ies
and
proc
edur
es re
late
d to
cl
inic
al a
udit
with
in th
e EM
S sy
stem
UK
1 (b
)•
•2
C.5.
3Ev
alua
te th
e re
quire
men
t to
prio
ritis
e lim
ited
audi
t re
sour
ces
to a
reas
of g
reat
est n
eed
UK
2•
••
2
C.5.
4D
emon
stra
te th
e ab
ility
to p
erfo
rm a
clin
ical
aud
it in
PH
EMTS
SL, C
L, E
L1
(b)
••
•2
C.5.
5D
emon
stra
te a
will
ingn
ess
to p
artic
ipat
e in
and
re
spon
d to
clin
ical
aud
itN
TSRM
, RP,
CL
, EL
1 (b
)•
•2
C.6
Und
erst
and
and
appl
y or
gani
satio
nal
risk
man
agem
ent
proc
esse
s
C.6.
1D
iffer
entia
te h
azar
d an
d ri
skU
K
DR,
LT,
SL
, CL,
EL
1 (b
)•
•2
C.6.
2D
escr
ibe
risk
man
agem
ent a
nd it
s co
mpo
nent
s in
the
cont
ext o
f PH
EM
UK
1 (b
)•
••
•2
C.6.
3D
escr
ibe
loca
l, re
gion
al a
nd in
tern
ation
al p
roce
sses
fo
r m
anag
ing
risk
with
in th
e EM
S sy
stem
U
K2
••
2
C.6.
4D
emon
stra
te th
e ap
plic
ation
of r
isk
man
agem
ent
stra
tegi
esTS
LT, S
L,
CL, E
L
2•
••
•2
C.6.
5D
emon
stra
te th
e ab
ility
to c
onst
ruct
a r
isk
asse
ssm
ent
TS2
•2
C.6.
6D
emon
stra
te th
e ab
ility
to le
ad a
n in
vesti
gatio
n in
to
an in
cide
ntTS
2•
2
C.6.
7D
emon
stra
te th
e ab
ility
to a
pply
the
less
ons
iden
tified
dur
ing
an in
vesti
gatio
nTS
1 (b
)•
•2
C.6.
8D
emon
stra
te a
pro
fess
iona
l atti
tude
to r
isk
man
agem
ent
NTS
RM, R
P,
CL, E
L, S
L1
(b)
••
2
CROSS-CUTTING THEME C 93
Uni
tEl
emen
ts
LearningMethods
AA
sses
smen
t Met
hods
GMP
KTCE
XCb
DSI
MD
OPS
MSF
ACAT
LOG
PSTO
Cros
s-cu
tting
The
me
C. C
linic
al g
over
nanc
e
C.7
Supp
ort t
rain
ing
and
deve
lopm
ent
C.7.
1Su
mm
aris
e th
e pr
inci
ples
of a
dult
lear
ning
UK
DR,
LT,
SL
, CL,
E
L
2•
•3
C.7.
2A
naly
se te
achi
ng m
etho
ds s
uita
ble
for
maj
or le
arni
ng
styl
es
UK
2•
•3
C.7.
3D
emon
stra
te th
e ab
ility
to a
pply
the
prin
cipl
es o
f ad
ult l
earn
ing
to th
e te
achi
ng a
nd tr
aini
ng o
f a
mul
ti-pr
ofes
sion
al a
udie
nce
TSSL
, CL,
EL
2•
•3
C.7.
4A
ppro
ache
s th
e tr
aine
e w
ith d
ifficu
lties
in a
sen
sitiv
e an
d co
nstr
uctiv
e w
ayN
TSRM
, RP,
SL
, CL,
EL
2•
•3
C.7.
5D
emon
stra
tes
a pr
ofes
sion
al a
ppro
ach
to s
uppo
rting
tr
aini
ng a
nd d
evel
opm
ent
NTS
2•
•3
C.8
Und
erst
and
and
appl
y qu
ality
m
anag
emen
t pr
oces
ses
C.8.
1Su
mm
aris
e th
e pr
inci
ples
of q
ualit
y m
anag
emen
tU
K
DR,
LT,
SL
, CL,
EL
2•
•1
C.8.
2Ev
alua
te th
e ch
alle
nges
to q
ualit
y m
anag
emen
t pr
esen
ted
by P
HEM
UK
2•
••
1
C.8.
3Cr
itiqu
es s
trat
egie
s to
impl
emen
t qua
lity
man
agem
ent p
roce
sses
in p
re-h
ospi
tal p
racti
ceU
K2
••
1
C.8.
4D
emon
stra
te th
e ab
ility
to u
tilis
e qu
ality
man
agem
ent
proc
esse
s in
pre
-hos
pita
l pra
ctice
TSSL
, RP,
CL
, EL
2•
•1
DR
Dire
cted
Rea
ding
LTLe
ctur
es a
nd T
utor
ials
DP
Del
iber
ate
Prac
tice
SLSi
mul
ation
Lea
rnin
g
RPRe
flecti
ve P
racti
ceRM
Role
Mod
elin
gCL
Colla
bora
tive
Lear
ning
ELEx
peri
entia
l Lea
rnin
g
95ANNEXES
ANNEX D. PHEM TRAINEE ASSESSMENT TOOLSExamples of the assessment tools recommended in section 4 are provided in this appendix along with guidance notes for rating satisfactory or unsatisfactory performance.
1. Mini-Clinical Evaluation Exercise (CEX)• Initial operational approach• Initial clinical approach• History and information gathering• Examination• Clinical decision making and judgment• Communication with patient, relatives, staff• Overall plan• Adherence to Good Medical Practice
2. Case Based Discussion (CBD)• Underpinning principles• Safety issues• Record keeping• Team management • Diagnosis• Treatment• Planning for subsequent care • Clinical reasoning• Overall clinical care• Adherence to Good Medical Practice
3. Direct Observation of Procedural Skill (DOPS)• Clinical indication• Appropriately deals with issues related to consent• Appropriate preparation • Technical skills • Situational awareness and clinical judgement• Safety, including prevention and management of complications• Post procedure management• Professionalism, communication and consideration for patient, relatives and colleagues• Documentation • Adherence to Good Medical Practice
4. Acute Care Assessment Tool (ACAT-PHEM)• Clinical Assessment• Medical record keeping• Clinical management• Time management• Management of the team• Medical leadership• Equipment and resource management• Patient safety• Handover• Overall Clinical Judgment• Adherence to Good Medical Practice
5. Teaching Observation (TO)
6. Audit Assessment (AA)
7. Multi-source Feedback (MSF)
ANNEXES 96
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEMINI-CLINICAL EVALUATION EXERCISE (CEX)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Clinical scenario observed Curriculum elements covered
Formative? Summative?
Please TICK to indicate the standard of the trainee’s
performance in each area
Not observed
Unsatisfactory for current level of
training Satisfactory for current level of
training
Achievement above current level of
trainingMust
addressShould address
Initial operational approach
Initial clinical approach
History and information gathering
Examination
Clinical decision making and judgment
Communication with patient, relatives, staff
Overall plan
Adherence to Good Medical Practice
ANNEXES 97
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEMINI-CLINICAL EVALUATION EXERCISE (CEX) (CONT.)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Areas of strength
Areas for improvement
Action plan
If summative: Fail Pass Good pass
Assessor Signature: Trainee Signature:
ANNEXES 98
GUIDANCE NOTES FOR RATING SATISFACTORY OR UNSATISFACTORY PERFORMANCE MINI-CLINICAL EVALUATION EXERCISE (CEX)
The following table provides descriptors of unsatisfactory performance in a CEX which can be used for providing feed back to the trainee.
Domain Descriptors of unsatisfactory performance
Initial approachScene safety, personal safety and/or dynamic risk assessment were omitted or undertaken haphazardly
Scene survey, history & information gathering
Scene survey was omitted or haphazardHistory taking was not focusedCritical symptoms or symptom patterns were not recognizedFailure to gather all the important information from the patient or other sources, missing important pointsNon-engagement with the patient or inappropriate delegationUnable to elicit history in difficult circumstances – busy, noisy, multiple demands
ExaminationFailure to detect/elicit and interpret important physical signs Failure to maintain dignity and privacy when possible
Monitoring & investigationsFailure to use appropriate monitoring and/or diagnostic tests with recognition of need for reassessment
Clinical decision making & judgement
Failure to identify the most likely diagnosis in a given situationFailure to construct a likely differential diagnosisFailure to identify patients who require hospitalisation or notFailure to recognise atypical presentationFailure to recognise urgency of caseFailure to select the most effective treatmentsFailure to make decisions in a timely fashionDecisions made which do not reflect clear understanding of underlying principlesFailure to reassess patientLack of anticipation for need of interventions and slow to respond to changes in patient’s conditionFailure to review effect of interventions
Communication with crew, patient, relatives, other staff
Communication skills with colleagues• Failure to listen to other views• Failure to discuss issues with the team• Failure to follow the lead of others when appropriate• Rude behaviour• Failure to give clear and timely instructions• Failure to seek advice
Communication with patients• Failure to elicit concerns, understanding or expectations of the patient, • Failure to inform patient and educate when appropriate• Failure to protect patient’s dignity when possible• Insensitivity to patient’s opinions, hopes or fears• Failure to explain plans and risks of treatment when appropriate in a way
the patient could understand
Overall care
Failure to ensure that the patient is in a safe monitored environmentFailure to anticipate or recognise complicationsFailure to focus sufficinertl on safe practiceFailure to follow published standard guidelines or protocolsFailure to follow infection control measuresFailure to safely administer medication
ANNEXES 99
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINE CASE BASED DISCUSSION (CBD)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Clinical scenario observed Curriculum elements covered
Formative? Summative?
Please TICK to indicate the standard of the trainee’s
performance in each area
Not observed
Unsatisfactory for current level of
training Satisfactory for current level of
training
Achievement above current level of
trainingMust
addressShould address
Underpinning principles
Safety issues
Record keeping
Team management
Diagnosis
Treatment
Planning for subsequent care
Clinical reasoning
Overall clinical care
Adherence to Good Medical Practice
ANNEXES 100
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINE CASE BASED DISCUSSION (CBD) (CONT.)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Areas of strength
Areas for improvement
Action plan
If summative: Fail Pass Good pass
Assessor Signature: Trainee Signature:
ANNEXES 101
GUIDANCE NOTES FOR RATING SATISFACTORY OR UNSATISFACTORY PERFORMANCE
CASE BASED DISCUSSIONS (CBD)
The following table provides descriptors of expected or satisfactory behaviour
The following table provides descriptors of unsatisfactory behaviour
Domain Expected behaviour
Record keeping Records should be legible and signed and dated. Should be structured and include provisional and differential diagnoses, initial clinical findings & monitoring data.
Review of clinical findings & monitoring
Undertook appropriate clinical examination & monitoring. Results are recorded and correctly interpreted with appropriate reassessments.
Diagnosis The correct provisional diagnosis was achieved with an appropriate differential diagnosis. Were any important conditions omitted?
Treatment Emergency treatment on scene and during transfer was correct, thoroughly documented and response recorded including adverse events.
Planning for subsequent care & handover of care
Clear plan demonstrating expected clinical course, recognition of and planning for possible complications and instructions to team and patient (if appropriate). Evidence of thorough handover to the provider of ongoing care.
Clinical reasoning Able to integrate the history, examination and investigative data to arrive at a logical diagnosis and appropriate treatment plan taking into account the patient’s co-morbidities and any special considerations for the relevant patient group
Patient safety issues Able to recognize effects of systems, process, environment and staffing on patient safety issues
Overall clinical care The case records and the trainees discussion should demonstrate that this episode of clinical care was conducted in accordance with good clinical practice and to a good overall standard
Incident debrief There should be evidence that the incident has been debriefed
Observed behaviour
Did not understand the indications and contraindications to the procedure
Did not properly explain the procedure to the patient
Did not understand relevant anatomy
Failed to prepare properly for the procedure
Did not communicate appropriately with patient, crew or staff
Aseptic precautions were inadequate
Did not perform the technical aspect of the procedure correctly
Failed to adapt to unexpected problems in the procedure
Failed to demonstrate adequate skill and practical fluency
Was unable to complete the procedure
Did not complete relevant documentation
Did not issue clear post procedural instructions to patient, crew or staff
Did not maintain an appropriate professional demeanour
ANNEXES 102
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEDIRECT OBSERVATION OF PROCEDURAL SKILLS (DOPS)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Clinical scenario observed Curriculum elements covered
Formative? Summative?
Please TICK to indicate the standard of the trainee’s
performance in each area
Not observed
Unsatisfactory for current level of
trainingSatisfactory for current level of
training
Achievement above current level of
trainingMust
addressShould address
Clinical indication
Appropriately deals with issues related to consent
Appropriate preparationtion
Technical skills
Situational awareness and clinical judgement
Safety, including prevention and management of complications
Post procedure management
Professionalism, communication and consideration for patient, relatives and colleagues
Documentation
Adherence to Good Medical Practice
ANNEXES 103
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEDIRECT OBSERVATION OF PROCEDURAL SKILLS (DOPS) (CONT.)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Areas of strength
Areas for improvement
Action plan
If summative: Fail Pass Good pass
Assessor Signature: Trainee Signature:
ANNEXES 104
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEACUTE CARE ASSESSMENT TOOL ACAT-PHEM
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Procedure assessed Curriculum elements covered
Please TICK to indicate the standard of the trainee’s
performance in each area
Not observed
Unsatisfactory for current level of
trainingSatisfactory for current level of
training
Achievement above current level of
trainingMust address
Should address
Clinical Assessment
Medical record keeping
Clinical management
Time management
Management of the team
Medical leadership
Equipment and resource management
Patient safety
Handover
Overall Clinical Judgement
Adherence to Good Medical Practice
ANNEXES 105
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEACUTE CARE ASSESSMENT TOOL ACAT-PHEM (CONT.)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Areas of strength
Areas for improvement
Action plan
If summative: Fail Pass Good pass
Assessor Signature: Trainee Signature:
ANNEXES 106
GUIDANCE NOTES FOR RATING SATISFACTORY OR UNSATISFACTORY PERFORMANCE ACUTE CARE ASSESSMENT TOOL (ACAT)
The following table provides descriptors of expected or satisfactory behaviour
Assessment domains Descriptors
Clinical assessment and clinical cases covered
Quality of focused history and examination to arrive at appropriate diagnosis – made by direct observation and note review of no more than 5 cases
Medical record keepingQuality of recording of patient encounters including documentation of drug administration
Investigations and triageQuality of trainee’s choice of investigations & appropriateness of triage to next level of care
Management of patients Quality of treatment given to patients (assessment, investigation and treatment)
Time management Prioritisation of patients
Management of the shift & team working
Appropriate relationship with and involvement of other pre-hospital care providers and emergency services
Clinical leadershipAppropriate delegation and supervision to colleagues within the multidisciplinary team
HandoverQuality of handover of care of patients in the receiving Emergency department or specialty ward
Patient safetyRecognises effects of systems, process, environment and crew composition on patient safety issues
Overall clinical judgement
Quality of trainee’s clinical thinking based on clinical assessment, interpretation of monitoring with appropriate prediction of anticipated clinical course; safe and appropriate management including triage to appropriate level of ongoing clinical care; use of resources sensibly
ANNEXES 107
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINETEACHING OBSERVATION (TO)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Teaching topic/title Curriculum elements covered
Number of learners
Teaching environment
Length of teaching session
Please TICK to indicate the standard of the trainee’s
performance in each area
Not observed
Unsatisfactory for current level of
trainingSatisfactory for current level of
training
Achievement above current level of
trainingMust
addressShould address
Introduction of self
Gained attention of group
Gave expected learning outcomes
Key points emphasised
Good knowledge of subject
Logical sequence
Well paced
Clear concise delivery
Good use of tone/voice
Appropriate use of resources
Encouraged group participation
Effective use of questioning
Appropriate use of teaching methods
Encouraged questions from group
Dealt with questions appropriately
Summarised key points at end
ANNEXES 108
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINETEACHING OBSERVATION (TO) (CONT.)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Please TICK to indicate the standard of the trainee’s
performance in each areaNot observed
Unsatisfactory for current level of
trainingSatisfactory for current level of
training
Achievement above current level of
trainingMust address
Should address
Met learning outcomes
Kept to time limit
Overall performance
Areas of strength
Areas for improvement
Action plan
If summative: Fail Pass Good pass
Assessor Signature: Trainee Signature:
ANNEXES 109
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEAUDIT ASSESSMENT (AA)
Trainee name: Training Phase:
Assessor name: Registration no:
Grade of assessor: Date
Audit Title Curriculum elements covered
Please TICK to indicate the standard of the trainee’s
performance in each areaNot observed
Unsatisfactory for current level of
trainingSatisfactory for current level of
training
Achievement above current level of
trainingMust address
Should address
Criteria Chosen
Standard chosen
Audit methodology
Results and interpretation
Conclusions
Presentation of audit findings
Recommendations made as a result
Plan for implementation of change
Actions undertaken to implement change
Overall performance
Adherence to Good Medical Practice
Areas of strength
Areas for improvement
Action plan
Assessor Signature: Trainee Signature:
ANNEXES 110
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEMULTI-SOURCE FEEDBACK (MSF)
Trainee name: Training Phase:
Grading System
UNKNOWN 1 2 3 4 5
Not ObservedPerformance
Does Not Meet Expectations
Performance Partially Meets
Expectations
PerformanceMeets
Expectations
Performance Exceeds
Expectations
Performance Consistently
Exceeds Expectations
Good Clinical Care1-5 or
UKComment
1 Medical knowledge and clinical skills
2 Problem-solving skills
3 Note-keeping – clarity; legibility and completeness
4 Emergency Care skills
Additional comments on this doctor’s clinical care
Relationships with patients1-5 or
UKComment
1 Empathy and sensitivity
2 Communicates well with all patient groups
3 Treats patients and relatives with respect
4Appreciates the pyscho-social aspects of patient care
5 Offers explanations
Additional comments on this doctor’s relationships with patients
ANNEXES 111
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEMULTI-SOURCE FEEDBACK (MSF) (CONT.)
Trainee name: Training Phase:
Grading System
UNKNOWN 1 2 3 4 5
Not ObservedPerformance
Does Not Meet Expectations
Performance Partially Meets
Expectations
PerformanceMeets
Expectations
Performance Exceeds
Expectations
Performance Consistently
Exceeds Expectations
Relationship with colleagues1-5 or
UKComment
1 Is a team-player
2 Asks for others’ point of view and advice
3 Encourages discussion Empathy and sensitivity
4 Is clear and precise with instructions
5 Treats colleagues with respect
6 Communicates well (incl. non-vernal communication)
7 Is reliable
8 Can lead a team well
9 Takes responsibility
10 “I like working with this doctor”
Additional comments on this doctor’s clinical care
ANNEXES 112
INTER-COLLEGIATE BOARD FOR TRAINING IN PRE-HOSPITAL EMERGENCY MEDICINEMULTI-SOURCE FEEDBACK (MSF) (CONT.)
Trainee name: Training Phase:
Grading System
UNKNOWN 1 2 3 4 5
Not ObservedPerformance
Does Not Meet Expectations
Performance Partially Meets
Expectations
PerformanceMeets
Expectations
Performance Exceeds
Expectations
Performance Consistently
Exceeds Expectations
Teaching and training1-5 or
UKComment
1 Teaching is structured
2 Is enthusiastic about teaching
3 This doctor’s teaching sessions are beneficial
4 Teaching is presented well
5 Uses varied teaching skills
Additional comments on this doctor’s clinical care
Global ratings on this door1-5 or
UKComment
1Overall how do you rate this Dr compared to other Sub-specialist PHEM Trainees
2How would you rate this trainees performance at this stage of training
3Do you have any concerns over this Drs probity or health?
Additional comments on this doctor’s relationships with patients
