HLTAN403C
Provide assistance during induction and maintenance of anaesthesia

This unit of competency describes the skills and knowledge required to provide assistance to the anaesthetist with the induction and maintenance of anaesthesia

Application

Work is performed under the direction of the anaesthetist and requires broad knowledge, a range of well developed skills. Individuals use discretion and judgement and take responsibility for the quality of their outputs

Client's dignity and confidentiality is maintained, and reassurance provided throughout the induction and maintenance of anaesthesia. Equipment and materials required for the anaesthetic are monitored for correct functioning and assistance provided to the Anaesthetist in identifying changes to client condition and associated fluid levels

Administration of anaesthesia may occur in various locations within the hospital environment e.g. operating theatres, emergency department, intensive care unit (ICU), radiology department

All activities are carried out in accordance with relevant Australian and New Zealand College of Anaesthetists Policy Documents, organisation policies, procedures and infection control guidelines


Prerequisites

Not Applicable


Elements and Performance Criteria

ELEMENT

PERFORMANCE CRITERIA

1. Assist in establishing and maintaining client's airway

1.1 Check anaesthetist's requirements

1.2 Check individual needs of the client and ensure the appropriate anaesthetic equipment is provided for the anaesthetist

1.3 Provide assistance to the anaesthetist as directed to position the client for establishing the airway

1.4 Select equipment and prepare and handle correctly and safely and in accordance with infection control guidelines

1.5 Provide assistance to the anaesthetist throughout induction procedure

1.6 Maintain client's airway when directed by the anaesthetist

1.7 Take all necessary precautions to prevent cross-infection and minimise trauma

1.8 Secure airway into position

2. Monitor the performance of anaesthetic equipment used

2.1 Ensure anaesthetic equipment is in working order and service records are current

2.2 Ensure warning devices are working and alarm limits are set in accordance with relevant standards

2.3 Observe anaesthetic equipment whilst in use and take action if a fault develops as directed by Anaesthetist to avoid danger to clients and staff

2.4 Follow established procedures to rectify faulty equipment

3. Provide assistance in monitoring the client during induction and maintenance of anaesthesia

3.1 Check client's physiological parameters when as directed by anaesthetist

3.2 Identify deviations from acceptable limits of the client's physiological parameters, check equipment for true reading and report to the anaesthetist

3.3 Identify signs of client discomfort, distress or adverse reaction, check equipment for true reading and report to the anaesthetist

3.4 Inform and reassure client, as appropriate, throughout the procedure

4. Measure and record clients' fluid balance

4.1 Accurately measure client's fluid intake and output/loss and record as directed by the anaesthetist

4.2 Promptly and accurately report any abnormal findings to the anaesthetist

4.3 Utilise personal protective equipment in accordance with standard and additional precautions

4.4 Dispose of waste safely and in accordance with infection control policy

5. Perform clinical measurements when directed by the anaesthetist

5.1 Select and prepare required equipment

5.2 Utilise personal protective equipment in accordance with additional precautions

5.3 Prepare client as required for test

5.4 Take sample as required, conduct measurement in accordance with manufacturer's guidelines and organisation policies and procedures

5.5 Record findings promptly and accurately

5.6 Dispose of waste safely and in accordance with infection control policy

Required Skills

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

Anaesthetic procedures relevant to providing assistance in anaesthesia

Anatomy and physiology relevant to providing assistance in anaesthesia

Boundaries of responsibilities and ability to refer problems to supervisor, anaesthetist or other appropriate health professional

Clinical/operative procedures and the interrelationship with anaesthesia relevant to providing assistance in anaesthesia

Fluid and electrolyte balance relevant to providing assistance in anaesthesia maintenance

General knowledge of pathophysiology of disease relevant to providing assistance during anaesthesia

Manual handling and client positioning techniques relevant to providing assistance in anaesthesia

Medical terminology relevant to providing assistance in anaesthesia

Medico-legal requirements relevant to providing assistance during anaesthesia

Monitoring of clients' physiological systems relevant to providing assistance in anaesthesia

Normal physiological parameters, and implications of deviation from normal, for a range of physiological functions relevant to providing assistance in anaesthesia

Occupational health and safety and infection control procedures/regulations relevant to providing assistance during anaesthesia

Physiology of loss of airway, the signs and symptoms, the causes and the remedial actions, including maintenance of airway manually, insertion of nasal/oral airways

Pre-medications and their effects relevant to providing assistance in anaesthesia

Range of equipment in current use for anaesthetic/operative procedures, knowledge of manufacturers' operating guidelines and criteria for withdrawal of faulty equipment

Types and functions of anaesthetic equipment, their indications and limitations for use

Types of suction equipment, its indication for use and hazards associated with usage

Use of pain management equipment relevant to providing assistance during anaesthesia

Essential skills:

It is critical that the candidate demonstrate the ability to:

Comply with organisation policies and procedures including those of OHS and infection control, and current standards

Establish and maintain a client's airway manually

Identify and manage faults in anaesthetic and monitoring equipment

Identify the different methods of airway establishment

Monitor range of physiological parameters with reference to standard values of normal physiological function for each clients' usual parameters relevant to providing assistance in anaesthesia

Perform clinical measurements

Prepare anaesthetic and monitoring equipment for use

Prepare client sites correctly to interface with equipment

Recognise the signs and symptoms, causes and remedial actions in the event of loss of airway

Secure an arterial/venous cannula

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

Deal with conflict

Display empathy with client and relatives

Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues

Use basic computer skills relevant to providing assistance during anaesthesia

Use numeracy skills including the ability to complete basic arithmetic calculations, recording stock levels and statistical information

Use oral communication skills-language competence required to fulfil job roles in a safe manner and as specified by the organisation. Assessors should look for skills in asking questions, providing clear information, listening to and understanding workplace instructions, and clarifying workplace instructions when necessary. Effective verbal and non verbal communication skills with a range of personnel within and outside of the organisation are essential. An ability to recognise and manage barriers to effective communication is also essential. Organisation may require competence in English or a community language, depending on client group

Use problem solving skills required including an ability to use available resources

Use reading and writing skills-literacy competence required to fulfil job roles in a safe manner and as specified by the organisation. The level of skill required involves reading and documenting clinical information and understanding complex policy and procedure manuals.

Work with others within a team

Evidence Required

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Observation of workplace performance is essential for assessment of this unit

Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Context of and specific resources for assessment:

Resources essential for assessment include:

Access to appropriate workplace where assessment can take place

Simulation of realistic workplace setting for assessment

Relevant organisation policy, guidelines, procedures and protocols

Access and equity considerations:

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Method of assessment

Observation in the workplace

Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision.

Written assignments/projects

Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.

Questioning verbal and written

Role play/simulation

Related units:

This unit can be assessed independently, however holistic assessment practice with other health services units of competency is encouraged


Range Statement

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Clinical procedures covers the surgical procedure and the type of anaesthetic which may include:

General/regional/local anaesthetic and sedation

Fibreoptic intubation

Radiology/radiotherapy anaesthesia

General surgery

Gastro-intestinal surgery

Ear, nose and throat surgery

Gynaecological surgery

Obstetric surgery

Orthopaedic surgery

Vascular surgery

Urological surgery

Oral/dental/maxillofacial surgery

Cardiothoracic surgery

Neurosurgery

Plastic surgery

Trauma/emergency surgery

Ophthalmic surgery

Clients requiring anaesthetics include:

Neonates

Infants

Children

Adolescents

Adults

Elderly

Pregnant women

Impaired

Traumatised

Unconscious

Immuno-compromised

Male

Female

Anaesthetist's requirements may include:

Procedure to be undertaken

Equipment and materials for procedure

Airway equipment must include:

Range of nasal and oral endotracheal tubes

Tracheostomy tubes

Range of laryngoscopes

Fibreoptic bronchoscopes

Difficult intubation equipment

Intubation aids

Oropharyngeal/nasal/laryngeal airways

Suction equipment for oesophageal and tracheal suction

Throat packs

Self inflating bag

Anaesthetic circuits

Face masks

Connectors

Filters

Video equipment

Assistance provided during induction procedure must include:

Cricoid pressure

Laryngeal manipulation

Types of induction procedures must include:

Rapid sequence induction

Oral and nasal route

Tracheostomy

Equipment may include:

Anaesthetic machine and components, including alarms and scavenger

Ventilator and components

Vaporisers or other systems designed for delivery of inhalation anaesthetic agents

Breathing systems and attachments

Oxygen masks

Laryngoscopes

Fibreoptic bronchoscopes

Intubation aids, including difficult intubation equipment

Artificial airways

Suction equipment for oesophageal and tracheal suction

Monitoring equipment includes:

Electrocardiography (ECG)

Pulse oximetry

Non-invasive and invasive blood pressure monitoring

Temperature monitoring

Central venous pressure (CVP) monitoring

Intravascular monitoring

Gas analysers, including oxygen, carbon dioxide and anaesthetic agent

Expired/inspired volume/pressure

Neuromuscular transmission

Cardiac output monitoring

Cerebral activity monitoring

Stethoscopes, including oesophageal

Doppler

Other equipment includes:

Infusion equipment, including rapid infusion equipment

Warming/cooling equipment for client and intravenous fluids

Equipment to minimise heat loss

Tourniquets and exsanguinators

Neuromuscular function monitor

Calf stimulators/compression devices

Humidifiers

Materials for subarachnoid epidural or regional nerve blocks

Physiological parameters must include:

Blood pressure and pulse

Temperature

Circulation

Respiration

Oxygenation

Inspired/expired gases

Airway pressure

Neuro-muscular function

Level of consciousness

Fluids may include:

Blood

Urine

Gastro-intestinal fluids

Irrigation

Intravenous

Intra arterial

Personal protective equipment may include:

Gown

Gloves

Mask

Protective eyewear

Apron

Clinical measurements may include:

Arterial blood gas measurement

Blood sugar level measurement

Haemoglobin measurement

12 lead electrocardiograph

Coagulation times

Manual blood pressure and pulse

Client positions may include:

Supine

Prone

Lithotomy/Lloyd Davis

Trendelenberg/reverse

Lateral

Jack knife

Sitting

Specific positioning related to the operative/clinical procedure

Protecting client from injury may include:

Support/padding

Careful movement of joints

Avoiding sudden and abnormal movements

Protection from excessive heat loss


Sectors

Not Applicable


Employability Skills

This unit contains Employability Skills


Licensing Information

Not Applicable