Description
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This unit of competency describes the skills and knowledge required to identify and respond to clinical emergencies and to initiate and perform basic or advanced life support
The unit includes the skills and knowledge required to assist the anaesthetist during an anaesthetic emergency |
Pre/Co-Requisites
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This unit can be assessed independently, however holistic assessment practice with other health services units of competency is encouraged |
Application
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Work is performed under the direction of the anaesthetist and requires broad knowledge, a range of well-developed skills and the ability to develop and apply solutions to a range of predictable and unpredictable problems. Individuals use discretion and judgement and take responsibility for the quality of their outputs
The unit includes assisting the anaesthetist in the management of the client’s airway, including the removal of artificial airways, and assisting in the preparation and administration of a limited range of drugs (in accordance with national and state/territory legislation and organisation policies) which have been prescribed by the anaesthetist. It also includes providing assistance to the anaesthetist in monitoring and responding to changes or lack of changes in the client’s
condition during emergence phase of anaesthesia
All activities are carried out in accordance with relevant Australian and New Zealand College of Anaesthetists Policy Documents, organisation policies and procedures, and infection control guidelines |
Performance Criteria
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1. Identify and respond to clinical emergencies
1.1 Correctly interpret client’s symptoms, respond to abnormalities and immediately report to theappropriate clinician
1.2 Monitor and interpret equipment readings and immediately report any to the clinician
1.3 Utilise personal protective equipment in accordance with standard and additional precautions
1.4 Promptly obtain emergency equipment and make ready for the clinician
1.5 Maintain client’s vital functions pending attendance of medical staff
1.6 Undertake emergency procedures as directed by the anaesthetist/medical officer
1.7 Identify calls for assistance and ensure they are acted upon by attending staff member
2. Identify the need for and perform cardiopulmonary resuscitation (CPR)
2.1 Correctly identify the need for and initiate CPR and summon medical assistance
2.2 Establish and maintain client’s airway
2.3 Position client to facilitate CPR
2.4 Perform external cardiac compression and ventilation of the lungs correctly
2.5 Assess client’s physiological parameters continually and report variations/abnormalities immediately to the clinician
2.6 Ensure administration of defibrillation occurs rapidly and safely under the supervision of a medical practitioner and/or according to organisation policy and procedure and Australian Resuscitation Council Guidelines
2.7 Document actions in accordance with organisation policies and procedures
3. Prepare drugs and fluids for administration in emergency situations under the direction of the anaesthetist/medical officer
3.1 Ensure required drugs, diluents and fluids are to hand
3.2 Ensure expiry date has not been exceeded for each drug, diluent or fluids
3.3 Ensure prepared drug corresponds accurately to medical practitioners requirements in nature, quantity and dilution
3.4 Check drugs with an authorised person prior to and after mixing
3.5 Use correct equipment and maintain sterility of drug and dilutent
3.6 Check final drug dilution with anaesthetist/medical office
3.7 Undertake emergency procedures as directed by the anaesthetist/medical officer
3.8 Complete documentation in accordance with organisation policies and procedures
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Required Skills & Knowledge
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Essential Knowledge:
- Anatomy and physiology relevant to providing assistance in an emergency
- Altered physiology related to emergencies
- Levels of consciousness
- Maintenance of vital functions
- Principles of defibrillation/cardioversion
- Electrical safety requirements
- National legislation and local protocols for the administration of drugs relevant to providing assistance in an emergency
- Drug administration, including routes and equipment used relevant to providing assistance in an emergency
- Types, properties, function and effect of drug groups related to resuscitation in accordance with Australian and New Zealand College of Anaesthetists’ policy documents
- Knowledge of boundaries of responsibilities and ability to refer problems to supervisor, anaesthetist or other appropriate health professional
- Methods and procedures for dealing with emergencies
Essential Skills:
- Locate and use emergency equipment
- Comply with organisation policies and procedures including those of OHS and infection control, and current standards
- Identify various emergency conditions
- Respond to emergencies and maintain client’s vital functions
- Understand and implement of current techniques for CPR and advanced life support in accordance with Australian Resuscitation Council guidelines
- Recognise current beliefs regarding rapid defibrillation/cardioversion
- Maintain a client’s vital functions
- Recognise emergency conditions
- Prepare equipment for the administration of drugs relevant to providing assistance in an emergency
- Perform defibrillation/cardioversion under supervision if directed by medical practitioner
- Reading and writing skills-literacy competence required to fulfil job roles in a safe manner and as specified by the organisation. The level of skill required involves reading and documenting clinical information and understanding complex policy and procedure manuals.
- Oral communication skills-language competence required to fulfil job roles in a safe manner and as specified by the organisation. Assessors should look for skills in asking questions, providing clear information, listening to and understanding workplace instructions, and clarifying workplace instructions when necessary. Effective verbal and non verbal communication skills with a range of internal and external persons are essential. Organisation may require competence in English or a community language, depending on client group
- Numeracy skills may range from the ability to complete basic arithmetic calculations, recording stock levels and statistical information
- Problem solving skills required include an ability to use available resources
- Deal with conflict
- Work with others within a team
- Display empathy with client and relatives
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Range Statement
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Clinical emergencies must include:
- Respiratory emergency (e.g. failed airway, bronchospasm, tension pneumothorax)
- Laryngospasm
- Ventricular fibrillation/tachycardia and cardiac arrhythmias eg cardiac arrest, VFVT asystole
- Malignant hyperthermia
- Hypovolaemic shock (e.g. massive blood loss)
- Drug overdoses (e.g. convulsions, embolisms)
- Anaphylactic shock (including latex allergies)
- Aspiration
Clients requiring anaesthetic may include:
- Neonates
- Infants
- Children
- Adolescents
- Adult
- Elderly
- Pregnant women
Emergency equipment may include:
- Equipment for oxygen therapy
- Suction equipment
- Equipment for airway management
- Intravenous access/therapy
- Electro cardiograph monitor
- Defibrillator/cardioverter
- Blood pressure monitors, invasive and non-invasive
- Pulse oximeter monitor
- Gas monitor
- Temperature monitor
- Rapid infusion equipment
Physiological parameters
- Circulation
- Respiration
- Neuromuscular function
- Urine output
Drugs and dilutents and fluids may include:
- Drugs relevant to emergency situations in accordance with Australian and New Zealand College of Anaesthetists’ Policy Documents
- Water/saline solution
- Glucose
- Crystalloid, colloids and blood products
Infusion equipment may include:
- Standard syringes
- Pre-filled syringes
- Hypodermic needles and drawing up cannula/needles
- Ampoules
- Needleless systems
Providing assistance at the request of the anaesthetist may include:
- Siting venous cannula in accordance with state/territory and organisation guidelines ensuing:
- client is informed and reassured throughout theprocedure
- individual needs of the client are checked and action to meet those needs is completed
- optimum conditions to facilitate access are provided
- cannulation is completed in an aseptic manner
- cannula is adequately and safely secured and accessibility provided
- waste is disposed of in accordance with waste management policies
- Defibrillation
- Airway management
- Other assistance as requested by the anaesthetist/medical officer
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Evidence Guide
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Critical aspects for assessment and evidence required to demonstrate this competency unit:
- The assessee must provide evidence of specified essential knowledge as well as skills.
- Observation of workplace performance is essential for assessment of this unit.
- Consistency of performance should be demonstrated over the required range of situations relevant to the workplace.
- Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible.
- Assessment must include a written calculation test with 100% mastery
Context of and specific resources for assessment:
- Access to appropriate workplace where assessment can take place
- Simulation of realistic workplace setting for assessment
- Relevant organisation policy, guidelines, procedures and protocols
Access and equity considerations:
- All workers in the health industry should be aware of access and equity issues in relation to their own area of work
- All workers should develop their ability to work in a culturally diverse environment
- In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
- Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities
Method of assessment
- Observation in the workplace
- Evidence gathered from clinical work environment
- Written assignments/projects or questioning should be used to assess knowledge
- Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.
- Questioning – verbal and written
- Role play/simulation
- Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision
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