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 8: Management of injuries to head and face by autonomous practitioners in a minor
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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to the head.
6.2 Provide aftercare advice to individuals with injuries:
to the face
to the head.
7. Be able to evidence the clinical
management of injuries to the face and head.
7.1 Produce clinical case management records for injuries to the face and head.
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 to the head must include:
determining the degree of head injury and
further management.
Red flag - is defined as a condition, sign or symptom considered to be urgent and should not be missed.
Minor injuries to the face must include:
FACE # le fort; # zygoma, # mandible, # orbit rim, # orbit floor (blow out), tripod #
JAW: #; dislocated mandible
MOUTH: dental abscess, loss of teeth, lip wounds, tongue wounds, piercing to cheek/lips/tongue; broken teeth.
NB Minor injuries to the NOSE are not included in this unit. They are assessed in the Ear, Nose, Mouth and Throat unit: nasal.
Treat minor injuries must include evidence of:
pain management
wound closure
referral to other healthcare professionals.
LO 3 - LO 6 Evidence must be given for a minimum of six cases which must include:
child
adult and
older person.
If not specifically stated in the assessment information, a plural statement in any assessment criteria means a minimum of two.
For Health and Social Care, Clinical Care, early years Care and the care of Children and Young People:
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:
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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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:
Code 2015.
RCEM CC12, CC6, CC3.4, CC1, CC2, CC3, CAP23, CC16, CC4, CC5, CC17, CC18, CC19, CC21, CC24, PAP6, CAP18, CAP38, HAP34, HAP11, C3AP1E, CAP13, HAP13, PAP15.
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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Adult Head Injury [RCEM CAP18]
The EP will be able to evaluate the patient who presents with a traumatic head injury, stabilize, assess, appropriate investigate and implement a management plan.
Knowledge Assessment
Methods
NMC
Know the anatomy of the scalp, skull and brain, the pathophysiology of head injury (primary and secondary brain injury) and the symptoms and signs
C, Mi, PE, A
Know the indications for urgent CT scanning (national guidelines for CT imaging in head injury).
C, Mi, PE, A
Know the indications for admission/red flags following head injury including bleeding or clotting disorders or anticoagulation
C, Mi, PE, A
Know which patients can be safely discharged C, Mi, PE, A
Understands the additional considerations that need to be made for patients over age of 65y, DH: anticoagulant PMH: coagulopathies, previous significant head trauma
Skills
Be able to use the ABC approach to the management of a head injury patient, with cervical spine stabilization
D PE, A
Be able to demonstrate to use of the GCS Mi, PE, A
Elicit the important facts from the history and undertake an appropriate neurological exam to elicit signs of head injury and neurological deficit
Mi, C PE, A
Recognise and act/refer appropriately secondary consequences of head injury (e.g. loss of airway patency, seizures, raised ICP)
Mi, D PE, PS, A
Behaviour
Know when to make a referral for further management/tertiary centre C PE, PS, A
Know when to make a referral for further management C PE, PS
Optimise team working between facilities including safe transfer C PE, PS, PPT
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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Maxillofacial injuries, ENT & dental emergencies [RCEM C3AP1d HAP9]
The EP will be able to evaluate the patient who presents with facial, aural and oral injuries, identify the life-threatening presentations, produce valid differential diagnosis, appropriate investigation and implement a management plan.
Knowledge Assessment
Methods
NMC
Know the anatomy of the facial structures Mi, C, PE
Be able to identify life threatening & serious facial trauma e.g. Le Fort fractures, substantial epistaxis and refer appropriately in a timely manner
Mi, C, PE, A
Understand the principles for x-ray interpretation of the face and jaw.
Understand epistaxis and it’s appropriate treatment
Be able to identify and initially manage mandibular, orbital and zygomatic fractures.
Mi, C, PE, A
Know when underlying structures may be at risk from facial lacerations- specifically parotid duct, facial nerve and lacrimal duct
Mi, C, PE, A
Be able to recognise hyphaema, lens dislocation, orbital floor fractures, penetrating injuries of the eye and eyelid lacerations
Mi, C, PE, A
Skills
Be able to systematically assess the facial structures and recognise when the airway is threatened
Mi, C, D PS, A
Be able to interpret facial x-rays and orthopantomographs (OPT) Behaviour
Know when to refer to maxillofacial specialists in a timely fashion Mi. C PE, A
Ensure appropriate follow-up Mi, C
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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