The internal verifier is not expected to review student work per se – this is the responsibility of the clinical/educational supervisor. Support the learner on a day-to-day basis by providing the level of supervision required by the learner's expertise during their training.
Autonomous practice and clinical assessment of adults in minor injuries setting
Understand the importance of the patient's background, culture, education and prejudices (ideas, concerns, expectations) to the consultation process. Counseling patients on the need to distribute information among members of the immediate health care team.
Autonomous practice and clinical assessment of children and young people in minor
As a consequence, GPs will need to improve their knowledge base and change their consultation and assessment skills in order to deal with children and young people appropriately. Be able to interact with children at different stages of development to elicit the story and conduct a careful, sensitive and flexible examination. EP will identify the child suffering from anaphylaxis and implement appropriate interventions and treatment Assessment methods Knowledge Understand the presentation and management of anaphylaxis in children AA, C, Mi, L Skills Be able to initiate appropriate treatment for anaphylaxis (APLS . guideline).
The EP will be able to identify and assess children with safeguarding concerns and refer them appropriately. Be able to recognize patterns of injury or illness that may indicate NAI C, Mi Sexual Abuse. Understand and be able to identify the ways in which children may exhibit neglect.
Be able to initiate child protection procedures according to local policy in the event of sexual abuse, physical. The EP is able to evaluate pain in children and implement an appropriate and effective pain management plan and intervention.
Anatomy and physiology for diagnosis and management of musculoskeletal injury
The EP will be able to evaluate the patient presenting with a traumatic limb or joint injury considering non-traumatic causes of limb/joint swelling to produce a valid differential diagnosis, appropriate investigation and implement a management. Outline the treatment options for common fractures and joint injuries E, C, Mi, PE, A, E Understand the pathophysiology behind complications such as compartment. Know how to safely prescribe/administer under PGD for traumatic limb pain E, C, Mi, PE, A, E Remember the different causes, pathophysiology and distinguish the characteristics of limb.
Perform a thorough and appropriate examination, including assessment of limb and joint stability and perfusion, and differentiate pitting edema; cellulite; Know when to seek senior/specialist advice in the management of limb and joint trauma. The PE will be able to assess the child presenting with a limb injury and plan the implementation of an appropriate assessment management plan.
Able to interpret radiographs of children taking into account epiphyseal variance and ossification time and use tools such as CRITOL for elbow injuries. Understand the differential diagnosis of lameness and how it can manifest as impairment of AA, C, Mi, skills. Know how to examine the gait, posture and hip and knee joints of children to enable a differential diagnosis of a limping and severely injured child.
Management of injuries distal to knee and distal to elbow by autonomous practitioners
Any learner who has not achieved a health and safety practice unit can be assessed for this as they complete the occupation specific unit. The EP will be able to evaluate the patient presenting with a traumatic limb or joint injury, to make a valid differential diagnosis, appropriate investigation and implement a management plan. To assess autonomous practitioners working in minor injury settings in the management of injuries from the knee to the pelvis.
Detect neurological and vascular compromise. Be able to demonstrate assessment of limb function. Be able to safely splint and cast injured limbs Behavior. Know when to seek senior/specialist advice in the management of limb and joint trauma Ensure appropriate follow-up including physiotherapy.
Management of injuries shoulder girdle to elbow by autonomous practitioners in a
Unless specifically stated in the assessment information, a plural statement in any assessment criterion means at least two. Be able to demonstrate common joint and fracture reduction techniques, particularly reduction of a dislocated shoulder.
Management of wounds, burns, bites, stings and inoculation injuries by autonomous
The EP will be able to assess the patient with complex growing wounds, providing analgesia, wound exploration, identification of underlying damaged structures, repair where appropriate, and closure. Know how to evaluate a wound in terms of mechanism of injury, underlying structures and complications. Know the indications for delayed wound closure and antibiotic treatment know when to refer for wound exploration eg.
The EP will be able to assess a child with a wound, develop a treatment plan and implement appropriate interventions. The EP will be able to evaluate the patient with minor burns and identify and refer life-threatening presentations, make a valid differential diagnosis, perform an appropriate investigation and implement a treatment plan. Burns - to assess the burn patient, initiate resuscitation, relieve pain and refer appropriately.
To remember the importance of burns in special areas (face, joints, perineum) and the management of these burns is different. To be able to diagnose the depth and manage minor burns Mi, C, D PE, A Behavior appropriately. The EP will be able to evaluate the patient presenting with a needlestick injury and be able to risk injury and initiate initial appropriate investigation and management plan.
Management of injuries to head and face by autonomous practitioners in a minor
The EP will be able to assess the patient presenting with a traumatic head injury, stabilize, assess, investigate and implement a management plan. Know the anatomy of the head, skull and brain, the pathophysiology of head injury (primary and secondary brain injury) and the symptoms and signs. Know the indications for admission/red flags after head injury, including bleeding or coagulation disorders or anticoagulation.
Be able to use the ABC approach to treating a head injury patient with cervical spine stabilization. Elicit the important facts from the history and perform an appropriate neurologic examination to elicit evidence of head injury and neurologic deficit. Recognize and act/refer appropriately secondary consequences of head injury (eg, loss of airway patency, seizures, elevated ICP).
The EP will be able to evaluate the patient presenting with facial, hearing and oral injuries, identify the life-threatening presentations, make valid differential diagnosis, perform appropriate investigation and implement a management plan. Be able to recognize hyphema, lens dislocation, orbital floor fractures, penetrating eye injuries and eyelid lacerations. Be able to systematically assess the facial structures and recognize when the airway is threatened.
Management of injuries to ear, nose and throat by autonomous practitioners in a minor
Be able to treat minor injuries to the ear, nose, mouth and throat. For standardization purposes, assessment of this unit should be performed by the emergency nurse/paramedic. The EP will be able to evaluate the child with an ENT injury and develop an appropriate treatment plan.
Be able to perform otoscopy correctly; In young children, use the proper technique to remove FB from the nose and ear.
Management of injuries to eye by autonomous practitioners in a minor injuries setting
The EP will be able to evaluate a patient with an eye injury, make a valid differential diagnosis, perform the appropriate investigation, and implement a treatment plan. Knows the basic anatomy and physiology of the eye and visual pathways C, Mi, PE, A Knows the principles of eye examination. Knows potential wound complications associated with eye injuries, including hyphema, eyelid, tear duct, and penetrating injuries.
Knows the potential complications and need for prioritization of ocular chemicals, including RCEment. Understands how the signs and symptoms of eye infections such as conjunctivitis (bacterial and viral) can mimic the symptoms of FB. Know the warning signs of red eyes, including orbital cellulitis and the need for urgent referral to Welsh Eye Care Services (WECS) or ophthalmology.
Demonstrates ability to perform an eye wash using a Morgan lens or saline solution, including inverting the eyelid. The EP will be able to evaluate a child presenting with an eye injury and formulate a management plan and implement any appropriate intervention. Able to insert LA topically into the eye Able to remove FB/chemical from the eye.
Management of injuries to neck and back by autonomous practitioners in a minor
The assessments used must be fit for purpose for the unit and learners and generate evidence of achievement for all assessment criteria. For standardization purposes, assessment of this unit should be carried out using the Emergency Nurse/Paramedic Development Program for Self-Management of Minor Injuries, commissioned by the Chief Executives of University Health Boards Wales, Welsh Ambulance Services Trust (WAST) ) and the University of Wales Council of Deans for Health (CYNGOR). A red flag is defined as a condition, sign or symptom that is considered urgent and should not be missed.
The EP will be able to evaluate the patient presenting with minor neck and back injuries, requesting appropriate. Outline the common and serious causes of neck pain, including meningeal irritation, musculoskeletal inflammation, local infection, and vascular causes. Be able to perform a neurological examination of the peripheral nervous system Mi, C, D, L PE, A Can identify the sensory distribution associated with dermatomes.
Be able to assess the reflexes of the lower extremities including knee, ankle and sole of the foot. Be able to identify signs of neurological dysfunction and identify associated deficits. Describe the likely site of lesion in the motor system and make a differential diagnosis. Be able to perform a PR examination to determine anal tone.
Management of injuries to chest by autonomous practitioners in a minor injuries setting
The EP will be able to evaluate a patient with a minor chest injury and is able to make a valid differential diagnosis, appropriate investigation, and implement a management plan. Be able to systematically approach and identify rib fractures and soft tissue injuries of the chest wall. Be able to recognize when medications and age can alter the normal physiological signs of shock.
Knows when chest injury is outside the ENP scope of practice and can refer Mi, C PE, A.
