First Aid Draft 1

HLTAID015 Provide advanced resuscitation Draft 1 Aug 19

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Unit application and prerequisites

UNIT CODE

HLTAID015

UNIT TITLE

Provide advanced resuscitation

APPLICATION

This unit describes the skills and knowledge required to use specialised equipment in the provision of resuscitation in line with the Australian Resuscitation Council (ARC) Guidelines.

This unit applies to workers who may be required to use specialised equipment to provide resuscitation in a range of complex situations, include community and workplace settings.

Specific licensing/regulatory requirements relating to this competency, including requirements for refresher training should be obtained from the relevant national/state/territory Work Health and Safety Regulatory Authorities.

PREREQUISITE UNIT

HLTAID011 or its equivalent, must have been completed within the last 3 years, in line with first aid code of practice requirements

UNIT SECTOR

First Aid

4 Comments

Pre-req

"I totally support the need to hold Provide First Aid. No one should be attempting this unit unless they have a solid foundation in the basics of first aid and especially in CPR"

Adrian Date 22.08.2019 09.30AM

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Prequisite unit

"This is not required as a prerequisite, please do not do this as I have many areas where skill sets are currently 003/007. Until you address the problems with Advanced First Aid which is huge don’t do this, even 001 should not be a PR as it is embedded within the unit. No prerequisite. Industry particularly diving use this unit by itself and I train RN’s, who don’t hold 003, as well who are looking for O2 and BVM on top of of basic CPR. Out of all the Advanced First Aid units this is currently one of the best units that does what it is supposed to do, in fact in all the first aid units it is the best, do not muck it up by forcing people to do a unit that they don’t require. Change it back to no prerequisite."

Peter Allan 21.08.2019 09.56PM

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1 Reply

"Pete, great comment above , I keep agreeing with you this should be left stand alone. It really makes sense for the clients we teach this to. Its great to be able to practice the skills in the UOC and not have to include everything else. "

Debbie Thomas 19.09.2019 11.43PM

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Code change

"Same as my other comments to 009/010/011/012. Not significant enough to change code name change to “Provide Advanced Resuscitation and Oxygen Therapy” to better describe the unit."

Peter Allan 21.08.2019 09.50PM

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Elements and performance criteria

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

  1. Respond to an emergency situation.
    1. Recognise an emergency situation.
    2. Ensure safety for self, victim and bystanders.
    3. Assess the victim and recognise the need for advanced resuscitation response.
    4. Assess the situation and seek assistance from emergency response services.
  1. Perform resuscitation procedures.
    1. Perform resuscitation procedures in accordance with the ARC Guidelines.
    2. Provide supplemental oxygen.
    3. Display respectful behaviour towards victim.
    4. Obtain consent from victim where possible.
    5. Use available resources and equipment to make the victim as comfortable as possible.
    6. Monitor victim condition and rectify issues preventing adequate treatment.
  1. Communicate details of the incident.
    1. Accurately convey incident details to emergency response services.
    2. Report details of incident in line with workplace procedures.
    3. Complete relevant workplace documentation, including incident report form.
    4. Maintain privacy and confidentiality of information in line with statutory and/or organisational policies.
  1. Evaluate the incident and own performance.
    1. Recognise the possible psychological impacts on self and other rescuers and seek help when required.
    2. Review the first aid response provided.
    3. Check, maintain and clean equipment ready for future use.

9 Comments

Clear up the PC around oxygen therapy

"There needs a rewrite of PC’s to include the use of oxygen therapy outside of a Resuscitation scenario. PC2.2 needs to be rewritten or expanded into more PC’s this is where the pulse oximetry can come in"

Peter Allan 21.08.2019 10.10PM

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4 Replies

"trouble with this is that pulse oximetry is so inaccurate that in my opinion we should have a greater focus on recognition of hypoxia"

Adrian Date 22.08.2019 09.27AM

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"Hi, the research evidence is very clear that with the exception of sickle cell anaemia pulse oximetry is 97%+- accurate compared to direct gas probes. However, the clinical guidance from the Thoracic Society is that it is mandatory when administering oxygen and this clinical guidance cannot be ignored."

Dr John Fahey 22.08.2019 11.13AM

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"Hi John, Using which Pulse Oximetry ? I would hazard to guess that most pulse oximetry devices being used pre-hospital would be straight from Ebay and would not be anywhere near 97% accurate "

Adrian Date 22.08.2019 11.24AM

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"Hi Adrian, In setting legal standards we have to address the use of legal medical devices. Pulse Oximeters imported into Australia must be registered in the ARTG before they can be used on a patient. The fines for selling or using a non ARTG listed device are massive, although people do buy them from eBay. Buying such a device is not illegal but using it therapeutically is. I have not yet come across any privately purchased meters anywhere. The other point is these devices, even the ones on eBay, are made in two plants, both in China. All of them are very good at present. The main failing lies in red/green LED displays which cannot be seen by colourblind staff. However, the issue is not that complex. The medical guidance is that they must be used and that guidance implies legally obtaining and using them. My main point about the need to include them in advanced resuscitation is that first aid is supposed to reflect scientifically confirmed clinical practice and that if the course doesn’t include the use of them then what use is it? I would argue that any training that results in harm being inflicted on a patient cannot be delivered and the science shows causation between high dose oxygen and extended damage and death. "

Dr John Fahey 22.08.2019 05.11PM

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Pulse oximetry

"There needs to be a step somewhere to assess the appropriate use of oxygen. Pulse oximetry needs to be addressed in this unit in PC, practical and knowledge evidence areas."

Peter Allan 21.08.2019 10.06PM

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ILLOGICAL FORMATTING OF PERFORMANCE CRITERIA

"In any approach to an incident the first thing that is conceptually addressed is the assessment of the situation which then provides the information that will or will not make it an emergency. Point 1.4 is actually 1.1. The next step is making the situation safe - something that cannot be 'ensured'. Then we assess the patient and 2.6 'monitor victim' becomes 1.3. Also, given that therapeutic oxygen is not administered to unshocked patients with SpO2 readings above 92%, 2.2 has to be moved to 2.6. Given that we are still using oral airways and IPPV using a bag/mask/valve, there needs to be a performance criterion for dealing with regurgitation which will surely occur because of gastric insufflation. On top of this, there is no addressing the need to rigorously control over inflation through fast rates or large volumes. This entire unit is dangerous and needs to be completely rewritten by medically qualified professionals."

Dr John Fahey 14.08.2019 02.12PM

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ADMINISTRATION OF OXYGEN

"Nowhere in this material is any reference to the ANZ Thoracic Society's recommendations on pulse oximetry being an essential requirement for safe oxygen administration in patients suffering ischaemia or hypoxia. The entire document requires a major rewrite by people who are medically qualified and more up-to-date than the current ARC guidelines. Therapeutic oxygen is a pharmacological intervention and within hospitals around Australia requires a written drug order from a medical practitioner or unsupervised use by especially trained RNs."

Dr John Fahey 14.08.2019 02.04PM

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1 Reply

"we seem to be going around in circles a few years ago it was manatory to be use when use Oxygen howevery there were a few RTO got ogether a complain about the introduction so it was Change to the wording we have ? They need to research from relieable bodies before making Changes form comment place by RTO who do not have the Medical background."

Wayne Christiansen 06.09.2019 03.52PM

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Foundation skills

FOUNDATION SKILLS

Foundation skills essential to performance are explicit in the performance criteria of this unit of competency.

UNIT MAPPING INFORMATION

No equivalent unit.

LINKS

Companion Volume Implementation Guide

1 Comments

007

"So what is 007? These are equivalent "

Peter Allan 21.08.2019 10.11PM

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Performance evidence

TITLE

Assessment Requirements for HLTAID015 Provide advanced resuscitation

PERFORMANCE EVIDENCE

Evidence of the ability to complete tasks outlined in elements and performance criteria of this unit in the context of the job role.

 

There must be evidence that the candidate has completed the following tasks in line with state/territory regulations, first aid codes of practice, Australian Resuscitation Council (ARC) Guidelines and workplace procedures:

  • Followed DRSABCD in line with ARC guidelines, including:
    • managed the unconscious, breathing victim including positioning to reduce the risk of airway compromise
    • performed at least 2 minutes of uninterrupted single rescuer cardiopulmonary resuscitation (CPR) (5 cycles of both compressions and ventilations) on an adult or child resuscitation manikin placed on the floor
    • performed at least 2 minutes of uninterrupted single rescuer CPR (5 cycles both compressions and ventilations) on an infant resuscitation manikin placed on a firm surface
    • performed at least 2 minutes of bag-valve-mask ventilation and at least 2 minutes of compression during a two rescuer procedure on an adult resuscitation manikin placed on the floor
    • responded appropriately in the event of regurgitation or vomiting
    • demonstrated a rotation of operators with minimal interruptions to compressions
    • followed the prompts of an automated external defibrillator (AED) to deliver at least one shock
    • show respectful behaviour towards the victim
  • Applied first aid procedures for major haemorrhage control including use of tourniquets and haemostatic dressings
  • Conducted a secondary survey assessment of the victim
  • Assessed vital signs (respirations, pulse, temperature, oxygen saturation and level of consciousness)
  • Provide at least one accurate written report of the incident
  • selected and inserted an oropharyngeal airway adjunct
  • administered oxygen to an unconscious/conscious victim, including:
    • selected and prepared correct oxygen equipment
    • administered oxygen safely at correct flow rate
  • monitored and coordinated maintenance of resuscitation equipment
    • dismantling
    • storage
    • disposal
    • cleaning and decontamination
    • checking and diagnosis of faults
  • Responded to at least four simulated first aid scenarios contextualised to the candidate’s workplace/community setting, including:
    • one simulated scenario dealing with an unconscious, breathing victim
    • one simulated scenario dealing with an unconscious, non-breathing victim including the use of an AED.
    • One simulated scenario dealing with a breathing victim requiring supplementary oxygen including the use of standard infection control precautions
    • One simulated scenario taking part in a team resuscitation effort of an unconscious, non-breathing adult victim using advanced resuscitation techniques, including performing bag-valve-mask ventilations and compressions, using an AED and suction to clear the airway including the use of standard infection control precautions.

10 Comments

Advanced Resuscitation

"Hope this is a misprint "applied first aid procedure for major haemorrhage" A first aid skill ?"

John Aagten 19.09.2019 07.06PM

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1 Reply

"Lets hope John that it is a misprint : D"

Debbie Thomas 19.09.2019 11.56PM

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Where is choking and spinal injury?

"You add haemorrhage control but miss management of choking and spinal injuries? Come on if anything managing choking and spinal using suction devices and positioning is much more important to an airway unit then putting on a bandage."

Peter Allan 21.08.2019 10.20PM

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Haemorrhage control?

"Why are we doing haemorrhage control in an Oxygen Resus unit? Yes bleeding/trauma can be a cause of hypoxia, but so is burns, Asthma, Anaphylaxis, poisoning, etc so why is it just bleeding addressed? Remove this, by adding it, it makes the unit confusing and loses the point of what this unit is for. These procedures should be included in advanced first aid instead not advanced Resus."

Peter Allan 21.08.2019 10.16PM

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1 Reply

"Agree"

Janine Nicholas 21.09.2019 02.49AM

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resuscitation equipment

"The range of equipment should be updated in this unit or at least have the Flexibility to "contextualized to the work place" you are conducting this training at and not restricted by the name of the equipment. Most work places no longer use the OP (oropharyngeal) airways but use the I-gels instead, These are an updated version and much easier to use. But if something new comes out the Training unit should allow the newer equipment to be used. So maybe the Performance Evidence should read "Select and Insert an appropriate Airway". Simular to the Bag Valve Mask wording, again many Oxygen units have a MTVR included and these MTVR's deliver positive pressure (like a BVM) and could be used instead of a BVM or a patient could receive positive pressure Oxygen with a Pocket mask that has an Oxygen inlet. These are all pieces of equipment that the industry uses and we should be able to provide training for the staff on this equipment. When we are asked to simulate the First Aid scenarios contextualised to the work place we should not be restricted. AED's come in different versions (Auto or Semi Auto) Suction comes in different versions (Manual pump, electrical or Oxygen driven) so why does the Oxygen deliver get specified to BVM only? Just make it 'Positive pressure delivery of Oxygen" and "Inserting Airways" with out specific equipment choices."

Alex van Welderen 20.08.2019 11.27AM

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3 Replies

"I like your ideas on this. I am totally against teaching BVM or any "mechanical" positive pressure delivery device for resuscitation to most students so changing the wording as you suggest would be a great move and allows for contextualisation to the clients equipment. "

Adrian Date 22.08.2019 09.37AM

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"Dis advantange with apocket mask is your only suppling 40 to 50% o2"

Wayne Christiansen 06.09.2019 04.17PM

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"Good points Alex agree with you here. "

Debbie Thomas 19.09.2019 11.55PM

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THE PERFORMANCE EVIDENCE

"The performance evidence here is irrelevant to the use of the equipment. There is no mention of fault finding under stress. Of reverting to triple airway manoeuvre if the oral airway fails, of proper techniques in compressing an IPPV bag, of IPPV for the cardiac arrest, pulmonary embolism and respiratory arrest patients. Of managing regurgitation using suction or any of the other problems associated with these techniques. Also, the range of scenarios is poor. Anyone undertaking this course should be able to demonstrate when they would abandon equipment and change to BLS techniques, how they would address problems like blown bodoc seals, empty cylinders or other equipment failures. I would not regard anyone who successfully passed this unit of competency as being proficient in any way to administer a gas to a patient or to use IPPV equipment."

Dr John Fahey 14.08.2019 02.18PM

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Knowledge evidence

KNOWLEDGE EVIDENCE

Demonstrated knowledge required to complete the tasks outlined in elements and performance criteria of this unit:

  • guidelines and procedures including:
    • ARC Guidelines relevant to managing the unconscious victim and provision of CPR and oxygen therapy
    • Identifying potential incident hazards and minimise risks when providing Oxygen Therapy and Advanced Resuscitation Techniques
    • infection control procedures, including use of standard precautions and resuscitation barrier devices
    • safe work practices to deal with oxygen cylinders and associated equipment
    • requirements for currency of skill and knowledge
    • first aid codes of practice
    • workplace procedures relevant to the provision of first aid
  • legal, workplace and community considerations, including:
    • duty of care requirements
    • own skills and limitations
    • consent and how it relates to the conscious and unconscious victim
    • privacy and confidentiality requirements
    • awareness of potential need for stress management techniques and available support for rescuers
    • legal requirements of administration of medication and the rights and responsibilities of the First Aider in the workplace regarding medication
  • considerations when providing resuscitation, including:
    • Upper airway and effect of positional change
    • appropriate duration and cessation of CPR
    • appropriate use of an AED
    • Safety and maintenance procedures for an AED
    • Use of suction devices
    • benefits, contraindications and complications with the use of an oropharyngeal airway
    • chain of survival
    • how to access emergency response services
  • assessment and interpretation of vital signs (respirations, temperature, pulse, oxygen saturation and level of consciousness), including normal clinical values
  • how to conduct a secondary survey assessment
  • how to use a suction device
  • techniques for providing CPR to adults, children and infants including:
    • How to recognise that a victim is unresponsive and not breathing normally
    • Rate, ratio and depth of compressions/ventilations
    • Correct hand positioning for compressions
    • Basic anatomy, physiology and the differences between adults, children and infants relating to CPR
  • signs, symptoms and management of major haemorrhage control including use of tourniquets and haemostatic dressings
  • considerations when providing supplementary oxygen, including:
    • benefits, contraindications and complications of providing oxygen to a victim and of providing suction during the application of advanced resuscitation techniques
    • complications with the use of a bag-valve-mask device and suitable strategies to minimise these
    • selection and operation of oxygen masks and other appropriate oxygen therapy devices
    • benefits, contraindications and complications of suction during advanced resuscitation
  • methods for cleaning, replenishing, recharging and maintaining resuscitation and oxygen equipment including:
    • actions to rectify problems
    • procedures to ensure operational readiness
    • storage, cleaning, decontamination and safe disposal of consumables
    • troubleshooting to identify minor and major faults.

4 Comments

Bleeding control?????

"I am bewildered to understand why the following is included in Advanced Resuscitation: ◾Applied first aid procedures for major haemorrhage control including use of tourniquets and haemostatic dressings Someone please explain what this has to do with advanced resuscitation? And who looked at this and thought " yep that would be a great addition to this unit". It is a sad reflection of the industry at present"

Jason Taylor 22.08.2019 03.17AM

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1 Reply

"I agree this is ridiculous please remove it. "

Debbie Thomas 20.09.2019 12.01AM

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Haemorrhage

"Why require knowledge of bleeding control to be included in this unit ? If we do this, then why not include spinal care as well as when resuscitating a query spinal patient it does require adjusted technique for head tilt etc ? "

Adrian Date 12.08.2019 01.30PM

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1 Reply

"Completely agree"

Peter Allan 21.08.2019 10.21PM

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Assessment conditions

ASSESSMENT CONDITIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Skills must be demonstrated working individually in an environment that provides realistic in-depth, industry-validated scenarios and simulations to assess candidates’ skills and knowledge.

 

Due to the nature of this type of training, it is acceptable for the performance evidence to be collected in a simulated environment.

Compression and ventilation skills must be demonstrated on resuscitation manikins in line with ARC guidelines for the purpose of assessment of CPR procedures.

 

Assessment must ensure access to:

  • Adult or child resuscitation manikins in line with ARC guidelines for the purpose of assessment of CPR procedures
  • Infant resuscitation manikins in line with ARC guidelines for the purpose of assessment of CPR procedures
  • Anatomical model for use with oropharyngeal airway adjunct
  • AED training device
  • bag-valve-mask
  • oropharyngeal airway adjunct
  • oxygen resuscitation system with oxygen cylinder and regulator
  • pulse oximeter
  • selection of oxygen masks with tubing; nasal cannula, therapy mask, resuscitation mask with oxygen port
  • thermometer
  • suction device
  • PPE including disposable gloves
  • Various variety of oxygen therapy
  • haemostatic dressings
  • haemostatic wound packing trainer
  • tourniquets
  • tourniquet trainer
  • workplace incident, injury, trauma or illness record or other appropriate workplace incident report form, which includes space for recording vital signs of victims.

 

Simulated assessment environments must simulate the real-life working environment where these skills and knowledge would be performed, with all the relevant equipment and resources of that working environment.

 

Assessors must satisfy the Standards for Registered Training Organisations’ requirements for assessors.

LINKS

Companion Volume Implementation Guide

5 Comments

haemostatic dressings haemostatic wound packing trainer tourniquets

"This should be removed from this unit of competency. The course should be focusing solely on Resuscitation. If the student needs to understand the application and management of haemostatic dressings haemostatic wound packing trainer tourniquets, the should complete the Advance First Aid course. Trainers and student should be solely focused, in the allotted time frame on building sound Adv Resus knowledge and skills."

STUART JAMESON 05.09.2019 12.18PM

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2 Replies

"Agree"

Wayne Christiansen 06.09.2019 04.24PM

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"Agree - Haemorrhage control should not form part of advanced resuscitation."

Janine Nicholas 21.09.2019 02.45AM

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Haemorrhage again

"These things should be in Advanced First Aid and not the advanced Resus unit. I would much prefer adding requirements for spinal management like collars then putting on another bandage."

Peter Allan 21.08.2019 10.22PM

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1 Reply

"Head blocks rather than Collars"

Wayne Christiansen 06.09.2019 04.24PM

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