Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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UNIT 4: Management of injuries distal to knee and distal to elbow by autonomous
Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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6. Be able to evidence the clinical
management of injuries distal to the knee and elbow.
6.1 Produce clinical case management records for injuries distal to the knee and elbow.
Assessment Methods:
There is no assessment information available for this unit. Assessments used should be fit for purpose for the unit and learners, and generate evidence of achievement for all the assessment criteria.
Assessment Information:
For standardisation purposes, assessment of this unit must be conducted using the Emergency Nurse/Paramedic Development Programme for Autonomously Managing Minor Injuries, commissioned by the Chief Executive Officers of University Health Boards Wales, the Wales Ambulance Services Trust (WAST) and Wales University Council of Deans for Health (CYNGOR).
Minor injuries distal to the elbow must include:
FINGER: Mallet deformity, # phalanx, spiral, oblique or intra-articular #, tendon rupture, nerve damage, pulp infections/paronychia, tendon sheath infections, crush #s, subungual haematomas, degloving injury from ring, nail avulsions, nail bed wounds, boutonniere deformity, dislocations, fractures, traumatic trigger finger, collateral ligament injuries
THUMB: as finger plus Rolando #, Bennetts #, dislocations.
HAND: # MCs, Fighters bite, head/neck MC fracture, street fighters fracture, dislocated base MCs (carpo-MC dislocations), tendon ruptures or incisional wounds, crush injury, penetrating wounds.
WRIST: Scaphoid, hamate, trapezium, trapezoid, triquetral, capitate, lunate & pisiform #, Colles #, Smith’s #,
# ulna or radial styloid, Barton’s #, perilunate dislocation, lunate dislocation, carpal subluxations, triangular cartilage injuries.
FOREARM: # radius or ulna, Monteggia #/dislocation, Galeazzi #/dislocation, compartment syndrome;
bowing
Red flag is defined as a condition, sign or symptom considered to be urgent and should not be missed.
Minor injuries distal to the knee must include:
ANKLE: LM or MM Sprain grade 1 to 3, # talus, talar dome osteochondral injury, # LM or # MM, # dislocation, posterior malleoli #.
FOOT: Lisfrac #, 5th MT #, # MTs, Jones #, MT stress #, navicular, cuboid, calcaneum or other tarsal bone.
Ligament sprain. Muscular strain, # hallux, dislocation phalanx. # 2 to 5 toes, dislocation toes.
LOWER LEG: Achilles tendon strain or rupture, avulsion # Achilles, gastrocnemius & quadriceps sprain/ tear/
haematoma, # fibular or tibia shaft, compartment syndrome, DVT, Maisonneuve #.
Treat minor injuries must include evidence of:
pain management
reduction
casting
splinting
stabilising and supporting
wound closure, including suturing
referral to other healthcare professionals.
LO 3 - LO 6 Evidence must be given for a minimum of twelve cases and must include:
child
adult and
older adult.
Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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If not specifically stated in the assessment information, a plural statement in any assessment criteria means a minimum of two.
For ALL SECTORS OTHER THAN Health and Social Care, Clinical Care, Early Years Care and the Care of Children and Young People:
For Health and Safety within units; unless otherwise stated in the assessment criteria:
Learners undertaking this unit are expected to implement safe practices in accordance with the relevant settings.
Any learner who has not achieved a unit for health and safety practices can be assessed for this as they complete the vocationally specific unit.
The areas of H&S that must be evidenced as incorporated into the achievement of this unit are:
selection and wearing of the relevant protective clothing for the task
selection of the relevant safety equipment for the task
complying with all work station / safety signs
ensuring a tidy work area at all times
lifting and carrying of materials and tools in accordance with institutional code of safe working practices
selection and using of correct tools for the task
cleaning and storing of tools in accordance with institutional code of safe working practices
identification, and where relevant the reporting, of potential hazards relating to tools and materials
demonstration of due regard for the health and safety of self and others
disposal of waste materials in line with legislative and local expectations.
To meet standards for clinical governance, organisational liability, professional and regulatory requirements, all new units containing assessments that are competence based and are for learners who are employed in, or volunteering in, health and social care, clinical care or childcare settings:
learners must have completed any mandatory H&S training or education required for their job role
context-specific health and safety must be explicitly stated WITHIN individual units.
Other Mappings:
NOS EUSC 34, EUSC 36EUSC 21.
Code 2015.
RCEM: CC12, CC6, CC1, CC2, CC3, CAP23, CC16, CC4, CC5, CC17, CC18 CC19, CC21, CC22, CC24, CC34, CAP 33, CAP 20, HAP 18, HAP 19, C3AP2A, C3AP2B, CAP38, HAP34, HAP11, CAP30, CAP13, HAP30, PAP6, PAP15, PAP16, PAP17.
Assessor Requirements:
Registered practitioners with a minimum of two years experience of working in minor injuries settings as:
an emergency nurse/paramedic/advanced care practitioner
Consultant nurse or
Consultants in emergency medicine.
© 2016 Agored Cymru
Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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Traumatic limb and joint injuries - Upper limb [RCEM C3AP2b]
The EP will be able to evaluate the patient who presents with a traumatic limb or joint injury, to produce a valid differential diagnosis, appropriate investigation and implement a management plan
Knowledge Assessment
Methods
NMC Be able to recognise, including plain radiology appearances, and initiate
treatment for fracture of:
radius and ulna including proximal, shaft & distal
scaphoid
other carpals
metacarpals
phalanges
Mi, C, PE, A
Dislocations of the:
lunate and perilunate
finger/thumb
Mi, C, PE, A
Musculotendinous injuries: tendon injuries of the hand/phalanges Mi, C. PE, A
Other injuries: subungual haematoma PE, A
Infection - paronychia, pulp space, flexor sheath Mi, C, PE, A
Skills
Be able to examine each joint Mi, C, D PE, A
Be able to demonstrate assessment of limb function, detect neurological and vascular compromise
Mi, C, D PE, A
Be able to demonstrate the common techniques for joint and fracture reduction Mi, C, D PE, A
Be able to splint and cast injured limbs safely Mi, C, D PE, A
Behaviour
Know when to seek senior/specialist advice in the management of limb and joint trauma
Mi, C PE, A
Ensure appropriate follow-up including physiotherapy Mi, C PE, A
Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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Traumatic limb and joint injuries - Lower limb [RCEMC3AP2a]
The EP will be able to evaluate the patient who presents with a traumatic limb or joint injury, to produce a valid differential diagnosis, appropriate investigation and implement a management plan
Knowledge Assessment
Methods
NMC Be able to recognise, including plain radiology appearances, and initiate
treatment for fracture of:
Tibia and fibula
Ankle
Calcaneum
Tarsals
Metatarsals
Phalanges
Mi, C, PE
Musculotendinous injuries: gastrocnemius tears, ligamentous injury to ankle, Achilles tendon rupture
Mi, C, PE, A
Vascular: compartment syndrome Mi, C, PE, A
Common techniques for joint and fracture reduction, specifically reduction of dislocated ankle Skills
Detect neurological and vascular compromise Mi, C, D PE, A
Be able to demonstrate assessment of limb function Mi, C, D PE, A
Be able to splint and cast injured limbs safely Mi, C, D PE, A
Behaviour
Know when to seek senior/specialist advice in the management of limb and joint trauma
Mi, C PE, A
Ensure appropriate follow-up, including physiotherapy Mi, C PE, A
Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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UNIT 5: Management of injuries pelvic girdle to knee by autonomous practitioners in a minor injuries setting
Purpose and Aim:
To assess autonomous practitioners working in minor injuries settings in the management of injuries from knee to pelvis.
LEARNING OUTCOMES ASSESSMENT CRITERIA
The learner will: The learner can:
1. Understand how autonomous practitioners manage the treatment of minor injuries from knee to pelvis.
1.1 Explain the presenting features of minor injuries from knee to pelvis.
1.2 Explain how minor injuries from knee to pelvis are assessed.
1.3 Explain non-injury complaints from knee to pelvis that affect examination, diagnosis and treatment decisions.
1.4 Explain ‘red flag’ injuries from knee to pelvis.
1.5 Explain how minor injuries from knee to pelvis are managed.
1.6 Explain the aftercare advice for minor injuries from knee to pelvis.
2. Be able to conduct a clinical consultation for minor injuries from knee to pelvis.
2.1 Take histories from individuals presenting with minor injuries from knee to pelvis.
2.2 Conduct physical examinations of individuals presenting with injuries from knee to pelvis.
2.3 Use radiological and biochemical information to inform clinical consultations in injuries from knee to pelvis.
3. Be able to diagnose minor injuries from knee to pelvis.
3.1 Interpret evidence from a clinical consultation to produce a differential diagnosis for minor injuries from knee to pelvis.
3.2 Justify the diagnosis and treatment plan for injuries that are from knee to pelvis.
4. Be able to manage the treatment of minor injuries from knee to pelvis.
4.1 Treat minor injuries from knee to pelvis.
4.2 Provide aftercare advice to individuals with injuries from knee to pelvis.
5. Be able to evidence the clinical management of injuries from knee to pelvis.
5.1 Produce clinical case management records for injuries from knee to pelvis.
Assessment Methods:
There is no assessment information available for this unit. Assessments used should be fit for purpose for the unit and learners, and generate evidence of achievement for all the assessment criteria.
Assessment Information:
For standardisation purposes, assessment of this unit must be conducted using the Emergency Nurse/Paramedic Development Programme for Autonomously Managing Minor Injuries, commissioned by the Chief Executive Officers of University Health Boards Wales, the Wales Ambulance Services Trust (WAST) and Wales University Council of Deans for Health (CYNGOR).
Minor injuries from knee to pelvis must include:
HIP: Bursitis, # neck or great tuberosity femur, strain to gluteal muscles, dislocation, # acetabulum, # pelvis, apophysistis
GROIN: # pelvis, avulsion #, muscle strain, traumatic hernia
THIGH: # femur, muscular strain or rupture, haematoma, DVT
KNEE: femur, tibial plateau #, fibular head or neck #, patella #: body/avulsion, segond #, reverse segond #,
MCL/LCL ligamental sprain grade 1 to 3, meniscal tear, patella tendon rupture, ruptured bakers cyst. Bone
Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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bruising, avulsion #s of ACL & PLC, patella dislocation.
Red flag is defined as a condition, sign or symptom considered to be urgent and should not be missed.
Treat minor injuries must include evidence of:
pain management
casting
splinting
wound closure
referral to other healthcare professionals.
LO 2 – LO 5 Evidence must be given for a minimum of five cases and include:
child
adult and
older adult.
If not specifically stated in the assessment information, a plural statement in any assessment criteria means a minimum of two.
To meet standards for clinical governance, organisational liability, professional and regulatory requirements, all new units containing assessments that are competence based and are for learners who are employed in, or volunteering in, health and social care, clinical care or childcare settings:
learners must have completed any mandatory H&S training or education required for their job role
context-specific health and safety must be explicitly stated WITHIN individual units.
Other Mappings:
NOS EUSC 34, EUSC 36EUSC 21.
Code 2015.
RCEM: CC12, CC6, CC1, CC2, CC3, CAP23, CC16, CC4, CC5, CC17, CC18 CC19, CC21, CC22, CC24, CC34, CAP 33, CAP 20, HAP 18, HAP 19, C3AP2A, CAP38, HAP34, HAP11, CAP30, CAP13, HAP30, PAP6, PAP15, PAP16, PAP17.
Assessor Requirements:
Registered practitioners with a minimum of two years experience of working in minor injuries settings as:
an emergency nurse/paramedic/advanced care practitioner
Consultant nurse or
Consultants in emergency medicine.
© 2016 Agored Cymru
Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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Traumatic limb and joint injuries - Lower limb [RCEMC3AP2a]
The EP will be able to evaluate the patient who presents with a traumatic limb or joint injury, to produce a valid differential diagnosis, appropriate investigation and implement a management plan
Knowledge
Be able to recognise, including plain radiology appearances, and initiate treatment for fracture of:
Hip and pelvis
Femur
knee
Tibial plateau
Patella
Dislocation - hip (including prosthetic)patella
Musculotendinous injuries: quadriceps and patellar tendon rupture, meniscal and ligamentous injury to knee Vascular: compartment syndrome
Skills
Detect neurological and vascular compromise Be able to demonstrate assessment of limb function Be able to splint and cast injured limbs safely Behaviour
Know when to seek senior/specialist advice in the management of limb and joint trauma Ensure appropriate follow-up, including physiotherapy
Abbreviations: mi: mini-cex; C/CbD: case based discussion; MSF/M: multisource feedback, D/DOPS: direct observations procedural skill, PS: patient survey, AA: Audit assessment tool.
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