New PHECC Education and Training Standards

A suite of four education and training standards have been developed to support a learning continuum ranging from a one day cardiac first response standard to the education programme for registered pre-hospital emergency care practitioners. Each standard is competency based with specific knowledge, attitudinal and skills objectives to be covered in each training programme. These objectives guide both the student and the instructor through the requirements of the standards. They are currently in draft format and are in circulation to relevant persons and bodies in industry for feedback prior to publication.

Anyone interested in reviewing the standards in full may access them via PHECC's web site www.phecc.ie or contacting the office directly for hard copies. We welcome all feedback and recommendation for change. Please reply per email to pauline@phecc.ie or per post.

Scene size up, standard infection control precautions, patient assessment and communication, medico-legal considerations and the well being of the responder/professional are fundamental and central to every standard.

The standard outlines the level of competence of a cardiac first responder, including lay persons and registered healthcare professionals and takes a notional 6 hours. It details the knowledge and skills for adult, infant and child cardiopulmonary resuscitation and advisory external defibrillator use, relief of foreign body airway obstruction as well as the administration of aspirin for cardiac chest pain. General skills include airway, breathing and circulatory care; additional skills such as paediatric defibrillation and discontinuation of resuscitation efforts are included for registered healthcare professionals. This Standard is a core unit on each of the PHECC standards and the Health and Safety Authority's new Occupational First Aid Standard.

Emergency First Response

The Emergency First Response Standard is designed for those working or aspiring to work pre-hospital as a non transporting Emergency First Responder [EFR). A person who is successful in a notional five day training programme will have the competencies to assist patients and practitioners with general medical and trauma emergencies including the administration of oxygen, suctioning and use of oropharyngeal airway. Assisting with the self administration of prescribed Salbutamol, GTN and Glucose gel are medications approved for use by the EFR. Skills to assist with a delivery and the pre-hospital assessment of children are also included. For the trauma patient, the EFRs scope of practice extends to manual stabilisation of the   cervical spine and collar application. Log rolling, placing a patient on a spinal board or use of an extrication device is under the direct supervision of a registered pre-hospital emergency care practitioner.
 

Emergency Medical First Response

This standard will take a notional four weeks theory and one week clinical instruction to cover all units. It is designed to provide the knowledge and skills required for the transporting prehospital emergency care practitioners to successfully complete the NQEMT - Emergency Medical First Responder (EMFR) assessment. Accession to the PHECC register for the NQEMT-EMFR is under consideration as control and access to medication approved for use by EMFR's will be limited to persons who are PHECC registered. For example, Entonox and Morphine intra muscular (IM) for pain relief and Salbutamol aerosol and Adrenaline (IM) for anaphylaxis. The additional skills of using a bag valve mask and a nasopharyngeal airway for airway and breathing emergencies are incorporated. Trauma skills building on those of the EFR include the application of approved splinting and immobilisation devices. The unit on Ambulance Operations outlines the competencies required for radio communications, lifting and moving, gaining
access, incidents with hazardous materials, civil disorders and management of Major Emergencies.

Paramedic

This standard will replace the current National Ambulance Standards published by the Department of Health and the NAAC in 1995. There is a focus on delivering patient care by assessing the needs of the patient, making informed clinical decisions, planning and administering procedures and monitoring the patient's response. Skil ls such as laryngeal mask airway insertion, 12 lead ECG transmission and rhythm recognition are examples of the Paramedic's scope of practice. This standard supports the competent practitioner in caring for the pregnant patient as well as child birth prehospital. Access to a broad range of medications is included at this level and includes Glucagon (lM) for hypoglycaemia, Diazepam (Per Rectum) for seizures and Hartmann's Solution infusion for hypovolaemic shock. Medication supply and administration is controlled by CPGs and under medical practitioner's instructions.

The student paramedic will take the NQEMT - Paramedic assessment; one of the academic qualifications required to join the PHECC register at the division of Paramedic. It builds substantially on the knowledge and skills objectives of the EMFR standard and is reflected in the duration of theoretical and clinical instruction; a notional 10 weeks and 14 weeks respectively. A probationary period of one year prior to registration is proposed to enable the newly qualified Paramedic to consolidate their clinical knowledge and skills and become a competent pre-hospital emergency care
practitioner.