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 11: Management of injuries to neck and back by autonomous practitioners in 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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management of injuries to the neck and back.
and back.
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 back must include:
muscle strain
fractures to spine
nerve entrapment.
Red flag is defined as a condition, sign or symptom considered to be urgent and should not be missed.
Minor injuries to the neck must include:
muscle strain
fracture c/spine & Odontoid peg
wounds
nerve entrapment.
Treat minor injuries must include evidence of:
pain management
stabilising and supporting
referral to other healthcare professionals.
LO 3 - LO 6 Evidence must be given for a minimum of four 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:
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, PAP15, CAP31,
CAP37, CAP13, HAP13.
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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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.
Page 96 Spinal injury [developed from RCEM CAP 21, CAP37 Weakness and Paralysis ]
The EP will be able to evaluate the patient who presents with minor neck and back injuries, request appropriate
investigations determine an appropriate management plan for a valid actual or potential diagnosis and discharge or they will also recognise those patients who have suffered a spinal cord, peripheral nerve or plexus injury by appropriate history examination and investigation and refer as appropriate
Knowledge Assessment
Methods
NMC Know the anatomy and physiology of the spinal column including bones,
ligaments, meninges spinal cord, brachial and sacral plexus and dermatones Broadly outline the physiology and neuro-anatomy of the components of the motor system
C, Mi, PE, A
Recall the myotomal distribution of nerve roots, peripheral nerves, and tendon reflexes
C, Mi, PE, A
Recall the clinical features of upper and lower motor neuron, neuromuscular junction and muscular lesions
C, Mi, PE, A
Know the patho-physiology of the different mechanisms of spinal trauma Mi, C, PE, A
Know how to interpret x-rays for the whole length of the spine Mi, C, PE,A
Know how to care for the spinal-injured patient Mi, C, PE, A
Know the red flags when assessing patients with neck and back injuries
Outline the common and serious causes of neck pain including meningeal irritation, musculoskeletal inflammation, local infection and vascular causes
Skills
Take a pertinent history
Identify patients with red flag features outside of scope of practice and refer immediately
Be able to perform a neurological examination of the peripheral nervous system Mi, C, D, L PE, A Be able to identify the sensory distribution associated with dermatomes
Be able to assess the reflexes of the lower limb which include knee, ankle & plantar
& identify deficits
Be able to identify signs of neurological dysfunction and identify associated deficits Describe likely site of lesion in motor system and produce differential diagnosis Be able to perform a PR examination to determine anal tone
Be able to immobilise a patient with spinal injury Mi, C, D, L PE, A
Be able to log roll and transfer a patient Mi, C, D, L PE, A
Provide discharge advice to patients with minor neck injury or
refer patients with serious causes of neck pain for further management as appropriate
C PE, A
Behaviour
Communicate effectively with a senior ED Doctor, neurosurgical /orthopaedic team in a timely fashion
Mi, C PE, A
Recognise importance of timely assessment and treatment of patients presenting with acute motor weakness
C
Recognise limitations of practice and refer to senior when appropriate PE, A
Recognise patients and carers distress when presenting with acute motor weakness
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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