Run by School of Medical and Health Sciences

20.000 Credits or 10.000 ECTS Credits

Semester 1 & 2

Organiser: Mrs Heather Bloodworth

The aim of this module is to provide the healthcare professional working in the pre-hospital environment with the essential core academic and clinical knowledge to formalize and develop their practice within credible work settings. Practitioners are required to work effectively within challenging environments, this bespoke module will provide students with the required underpinnings to stimulate critical thinking and promote advanced practice skills in prehospital care/transfer and HEMS.This module as part of a Masters pathway offers an exciting opportunity to advance pre-hospital and paramedical practice.

HEMS Medical Passenger Knowledge Air law as it applies to Air Ambulance Operations Flight Safety Communications Basic Navigation Basic Meteorology Aviation physics and physiology Landing site safety Multiagency working HEMS Air Crew Key Skills - In-flight emergencies -Fire safety
HEMS Medical Passenger Skills -Stretcher loading -Radio use Airpersonship Crew Resource Management History in prehospital care: mechanisms of injury, reading the wreckage, and witness reports. Assessment: primary and secondary survey, point of care diagnostics Treatment: key advanced prehospital interventions and triage to definitive care

Pre-hospital anaesthesia

Pathophysiology underlying injury; integrating injury mechanisms with anatomy.

Trauma management; Management of thoracic injury -Thoracic ultrasound assessment -Needle chest decompression Intravenous access -Intraosseous access -Umbilical venous access in neonates Management and termination of fitting Spinal injury stabilisation and management.

Management of pregnancy and labour -Managing emergency childbirth -Perimortem caesarean section Management of pregnancy and labour -Intrauterine resuscitation -Management of hypertensive diseases of pregnancy -Management of peripartum haemorrhage -Medical and traumatic resuscitation of the pregnant patient -Management of pregnancy and labour -Managing fitting in labour

Neonatal Care-understanding of key differences between neonate and older children/adults -Newborn resuscitation -Management of neonatal hypoglycaemia -Management of fitting -Neonatal temperature control

Wound management -Basic wound care and management -Burns care -Immobilisation of fractures -Fracture and disclocation reduction Limb amputation Sepsis management Contaminated wound management

Cardiovascular support -Fluid management in all settings (medical and trauma) -Post cardiac arrest management -Management of catastrophic haemorrhage, including: use of tourniquets; pelvic and femoral stabilisation; clam shell thoracotomy. -Management of cardiac arrest: traumatic and medical

Neurological support -Balancing neuroprotection versus haemodynamic support in the multiply injured

excellent

Excellent understanding of the facts and principles specific to the topics covered in this module and evidence of additional evidence gained by the student. Very good understanding of professional accountability issues. This equates to a minimum mark of Grade A- in the Grading Criteria

good

Very good understanding of the facts and principles specific to the topics covered in this module. Good understanding of professional accountability issues. This equates to a minimum mark of Grade B- in the Grading Criteria.

threshold

Basic understanding of the facts and principles specific to the topics covered in this module. Basic understanding of professional accountability issues. Students will be required to achieve a minimum of C- grade in the assignment to in order to pass the theory component of the module.

1. Manage a complex pre-hospital scene where multiple patients require triage treatment and transportation.

2. Identify and critically analyse supportive evidence in relation to professional judgement when making complex transport decisions including geography, weather and patient characteristics.

3. Develop a management plan for a critically ill or injured patient, and critically evaluate a variety of sources of information to support the plan.

4. Critically assess the extent to which Ergonomics and Human Factors (including AKA Non-Technical Skills or ;Crew Resource Management) can influence patient safety in the pre-hospital environment.

Type	Name	Description	Weight
ORAL	Viva Voce	Viva Voce - a structured oral examination which is 45 min. The viva voce assessess: Professional judgement (utilising evidence based medicine) when making complex transport decisions including geography, weather and patient characteristics. Critically assess the extent to which Ergonomics and Human Factors (including AKA Non-Technical Skills or Crew Resource Management) can influence patient safety in the pre-hospital environment. Demonstrate a full understanding of the considerations to be taken into account when managing a complex pre-hospital scene involving multiple patients.	100.00
CLINICAL PRACTICAL ASSESSMENT	Practical Assessment - competencies	• A selection of Essential and Desirable Work based competency assessments that demonstrate proficiency in: trauma management; care in special populations; cardiovascular support and neurological support which will allow the practitioner to competently: Manage a complex pre-hospital scene Develop a management plan for a critically ill or injured patient	0.00

		Hours
Private study	Directed learning via Blackboard, students will be given directed learning in order that they can complete the module learning outcomes. 20 hours - working towards assessments/online working 50 hours - directed reading and appropriate workbooks (Computer based exercises) 30 hours - developing personal knowledge	100
Practical classes and workshops	Practical workshops and face to face lectures 7 x 7 days ( 7 hours per day)	49
Fieldwork	students will be required to work with a mentor in relation to developing knowledge regarding transport to scene and hospital, weather and geography etc	51

• Literacy - Proficiency in reading and writing through a variety of media
• Computer Literacy - Proficiency in using a varied range of computer software
• Self-Management - Able to work unsupervised in an efficient, punctual and structured manner. To examine the outcomes of tasks and events, and judge levels of quality and importance
• Exploring - Able to investigate, research and consider alternatives
• Information retrieval - Able to access different and multiple sources of information
• Inter-personal - Able to question, actively listen, examine given answers and interact sensitevely with others
• Critical analysis & Problem Solving - Able to deconstruct and analyse problems or complex situations. To find solutions to problems through analyses and exploration of all possibilities using appropriate methods, rescources and creativity.
• Safety-Consciousness - Having an awareness of your immediate environment, and confidence in adhering to health and safety regulations
• Presentation - Able to clearly present information and explanations to an audience. Through the written or oral mode of communication accurately and concisely.
• Teamwork - Able to constructively cooperate with others on a common task, and/or be part of a day-to-day working team
• Mentoring - Able to support, help, guide, inspire and/or coach others
• Caring - Showing concern for others; caring for children, people with disabilities and/or the elderly
• Management - Able to utilise, coordinate and control resources (human, physical and/or financial)
• Argument - Able to put forward, debate and justify an opinion or a course of action, with an individual or in a wider group setting
• Self-awareness & Reflectivity - Having an awareness of your own strengths, weaknesses, aims and objectives. Able to regularly review, evaluate and reflect upon the performance of yourself and others
• Leadership - Able to lead and manage, develop action plans and objectives, offer guidance and direction to others, and cope with the related pressures such authority can result in

Resource implications for students

None apart from funding for the module and access to IT and word processing equipment.

Reading list

Allman, K., Wilson, I. O'Donnell, A. (2016). Oxford handbook of anesthesia. Oxford: OUP Oxford.

Anders, Jennifer; Brown, Kathleen; Simpson, Joelle; Gausche-Hill, Marianne. (2014) Evidence and Controversies in Paediatric Prehospital Airway Management Clinical Paediatric Emergency Medicine; Maryland Heights Vol. 15, Iss. 1: 28-37.

Black, JM. Ward, M,E. Lockey, D,J.(2004) Appropriate use of helicopters to transport trauma patients from incident scene to hospital in the United Kingdom: an algorithm. Emergency Medical Journal;21:355–361.

Bernard, Stephen ; Nguyen, Vina; Cameron, Peter; Masci, Kevin; Fitzgerald, Mark; Cooper, David J; Walker, Tony; Std, B Paramed; Myles, Paul; Murray, Lynne; David; Taylor; Smith, Karen; Patrick, Ian; Edington, John; Bacon, Andrew; Rosenfeld, Jeffrey V; Judson, Rodney. (2014) Prehospital rapid sequence intubation improves functional outcome for patients with severe traumatic brain injury: a randomized controlled trial. Annals of surgery Vol. 252, Iss. 6: 959-965.

Crewdson, Kate; Nolan, Jerry P.(2011) Management of the trauma airway. Trauma; London Vol. 13, Iss. 3: 221-232.

Easby, J; Dodds, C. 2004) Emergency induction of anaesthesia in the prehospital setting: a review of the anaesthetic induction agents. Trauma; London Vol. 6, Iss. 3 : 217-224.

Fevang, Espen; Perkins, Zane; Lockey, David; Jeppesen, Elisabeth; Lossius, Hans Morten. (2017) A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients Critical care (London, England) Vol. 21, Iss. 1: 192.

Griesdale, Donald E; G; Henderson, William R; Green, Robert S. (2011) Airway Management in Critically Ill Patients. New York Vol. 189, Iss. 3 : 181-92.

Hossfeld, Bjoern; Bein, Bertold; Boettiger, Bernd W; Bohn, Andreas; Fischer, Matthias. (2016) Recommended practice for out-of-hospital emergency anaesthesia in adults: Statement from the Out-of-Hospital Emergency Anaesthesia Working Group of the Emergency Medicine Research Group of the German Society of Anaesthesiology and Intensive Care.European journal of anaesthesiology Vol. 33, Iss. 12: 881-897.

Hickman, J. (2006) Prehospital advanced airway management for trauma in the United Kingdom: how, when and by whom? Trauma; London Vol. 8, Iss. 3: 169-178.

Lackey, D J; Crewdson, K; Davies, G; Jenkins, B; Klein, J; Laird, C; Mahoney, P F; Nolan, J; Pountney, A; Shinde, S; Tighe, S; Russell, M Q; Price, J; Wright, C. (2017) AAGBI: Safer pre-hospital anaesthesia. Anaesthesia; Oxford Vol. 72, Iss. 3: 379-390.

Lockey, David J; Avery, Pascale; Harris, Timothy; Davies, Gareth E; Lossius, Hans Morten.(2013) A prospective study of physician pre-hospital anaesthesia in trauma patients: oesophageal intubation, gross airway contamination and the 'quick look' airway assessment. BMC Anesthesiology; London Vol. 13.

Nakstad, Anders Rostrup; Heimdal, Hans-Julius; Strand, Terje; Sandberg, Mårten. (2011) Incidence of desaturation during prehospital rapid sequence intubation in a physician-based helicopter emergency service. The American Journal of Emergency Medicine; Philadelphia Vol. 29, Iss. 6: 639-44.

Peck, T. (2014). Pharmacology for anaesthesia and intensive care. Cambridge: University Press.

Ricard-Hibon, Agnes; Chollet, Charlotte; Belpomme, Vanessa; Duchateau, FranÇois-Xavier; Marty, Jean. (2003) Epidemiology of adverse effects of prehospital sedation analgesia. The American Journal of Emergency Medicine; Philadelphia Vol. 21, Iss. 6: 461-6.

Sunde, Geir Arne; Sandberg, Marten; Lyon, Richard; Fredriksen, Knut; Burns, Brian. (2017) Hypoxia and hypotension in patients intubated by physician staffed helicopter emergency medical services - a prospective observational multi-centre study. BMC Emergency Medicine; London Vol. 17.

Scarth, E., Smith, S. (2016). Drugs in anesthesia and intensive care. Oxford: OUP Oxford.

The Association of Anaesthetists of Great Britain & Ireland (2015). Recommendations for standards of monitoring during anaesthesia and recovery. London, AAGBI.