HLTAMB004
Conduct advanced clinical assessment


Application

This unit describes the skills and knowledge required to apply the specialised knowledge of pathophysiology and pharmacology that is required to use advanced techniques to clinically assess a patient.

The worker is expected to apply underpinning skills and knowledge in clinical assessment and to function independently providing intensive clinical care within established clinical guidelines/protocols.

This unit applies to pre-hospital/out-of-hospital health care workers.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand Standards and industry codes of practice.


Elements and Performance Criteria

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

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

1. Apply pathophysiological concepts to assess patient’s body system function

1.1 Apply specialised knowledge of fluid and electrolyte imbalance to determine the patient’s health status

1.2 Demonstrate a specialised knowledge of acid base imbalance impacting the patient’s health status

2. Identify any variations from homeostasis when assessing a patient’s physical health status

2.1 Use specialised knowledge of homeostasis imbalance to recognise signs and symptoms indicating abnormal functioning of body systems

2.2 Update specialised knowledge of variations to cellular metabolism and apply when assessing patient for poor states of perfusion

3. Conduct assessment of patients with specific conditions, disorders and injuries using advanced techniques

3.1 Integrate comprehensive knowledge of pathophysiological concepts with assessment data and principles of management for specific conditions, disorders and injuries

3.2 Evaluate the need for advanced assessment techniques and potential impact on patient’s health status

3.3 Analyse assessment data and establish the need for and potential impact of pharmacological and/or fluid therapies on patient’s health status

3.4 Employ a process of critical analysis and diagnostic reasoning to make links between patients illness and/or injury and information found at the scene to facilitate treatment strategies

Evidence of Performance

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

• performed the activities outlined in the performance criteria of this unit during 80 hours under clinical supervision in the workplace

• conducted 5 comprehensive advanced clinical assessments and applied skills necessary to stabilise healthy functioning body systems for each of the following incidents and situations across the lifespan of the incident and situation (must include at least 1 adult, 1 paediatric patient and 1 older person):

- emergency

- non-emergency

- medical

- surgical

- trauma

• used appropriate medical terminology in 1 consultation with medical and/or multidisciplinary teams about variations from normal healthy functioning body systems and advanced assessment procedures performed on patient.


Evidence of Knowledge

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

• advanced concepts underpinning pharmacology and pharmacokinetics including:

- therapeutic effects, indications and contraindications

- physiological and psychological effects associated with pain and pain management

• specialised knowledge of anatomy and physiology, and variations from normal functioning of body systems, in relation to potential impact on advanced patient assessment procedures practised including:

- internal and external thoracic structures and respiratory conditions including:

o pneumothorax and haemothorax

o mechanics of ventilation, inspiration and expiration, respiratory control and impact of gas laws

- abdominal conditions including:

o visceral wounds

o internal bleeding

- specialised knowledge of cardiovascular structures, heart conditions, cardiac conduction, electrocardiograph (ECG) rhythm variations and analysis

- urogenital and reproductive and pelvic structures and conditions

- obstetrics and gynaecology including:

o pregnancy

o foetal development

o normal and abnormal presentations

o labour and post-partum haemorrhage

o assessment of the newborn

- fluid and electrolyte balance and imbalance including:

o mechanisms of fluid movement through the body

o states of fluid and acid imbalance

- cellular injury and immune responses

- assessment of blunt versus penetrating trauma

- environmental factors related to the cause of a patient’s illness, injury or trauma.


Assessment Conditions

Skills must have been demonstrated in the workplace with the addition of simulations and scenarios where the full range of contexts and situations cannot be provided in the workplace. The following conditions must be met for this unit:

use of suitable facilities resources and equipment as per local governing body including:

adult, child, infant and obstetric manikins suitable for simulation of advanced clinical skills

vital signs monitoring devices

sample medications used in emergency treatment

oxygen resuscitation system with oxygen cylinder and oximeter

selection of oxygen masks with tubing

airway model suitable for simulation insertion of an oropharyngeal airway

ECG recording device

communication protocols

organisation policies and procedures and/or established clinical guidelines and protocols on which the candidate bases the planning process

documentation for recording clinical assessment

modelling of industry operating conditions, including contingencies should be included in simulations and scenarios that reflect pre-hospital/out-of-hospital clinical care work.

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.


Foundation Skills

The Foundation Skills describe those required skills (language, literacy, numeracy and employment skills) that are essential to performance.

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