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Evidence Guide: HLTANA004 - Respond to anaesthesia related emergencies

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

HLTANA004 - Respond to anaesthesia related emergencies

What evidence can you provide to prove your understanding of each of the following citeria?

Elements define the essential outcomes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise clinical emergencies

  1. Recognise signs of deterioration in clients and immediately report to appropriate clinician
  2. Monitor, interpret and promptly recognise abnormal equipment readings and immediately report abnormal values to anaesthetist/medical staff
Recognise signs of deterioration in clients and immediately report to appropriate clinician

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Monitor, interpret and promptly recognise abnormal equipment readings and immediately report abnormal values to anaesthetist/medical staff

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Respond to clinical emergencies

  1. Maintain client’s vital functions pending attendance of medical staff
  2. Use communication escalation techniques according to organisation procedures
  3. Promptly obtain emergency equipment and make ready for relevant medical staff
  4. Assist the anaesthetist/medical staff to perform any emergency procedures under direction
  5. Assist with the medical management of the client and allocate work to other team members according to priority
Maintain client’s vital functions pending attendance of medical staff

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use communication escalation techniques according to organisation procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Promptly obtain emergency equipment and make ready for relevant medical staff

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the anaesthetist/medical staff to perform any emergency procedures under direction

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist with the medical management of the client and allocate work to other team members according to priority

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare drugs for administration in emergency situations

  1. Ensure required drugs, diluents and fluids are to hand
  2. Read expiry date for each drug, diluent or fluid and check it has not been exceeded
  3. Make accurate calculations to prepare drug to correct nature, quantity and dilution based on medical officer requirements
  4. Check drugs with an authorised person prior to and after mixing
  5. Use correct equipment and maintain sterility of drug and diluent
  6. Check final drug dilution with anaesthetist or medical officer
  7. Administer drugs under the direction and supervision of the anaesthetist
  8. Complete medication documentation in accordance with organisation policies and procedures
Ensure required drugs, diluents and fluids are to hand

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Read expiry date for each drug, diluent or fluid and check it has not been exceeded

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Make accurate calculations to prepare drug to correct nature, quantity and dilution based on medical officer requirements

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Check drugs with an authorised person prior to and after mixing

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use correct equipment and maintain sterility of drug and diluent

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Check final drug dilution with anaesthetist or medical officer

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Administer drugs under the direction and supervision of the anaesthetist

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Complete medication documentation in accordance with organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Finalise emergency procedures

  1. Document accurate and complete record of emergency situation and actions taken according to scope of own role
  2. Participate in emergency de-brief according to organisation procedures
  3. Review own role in emergency and identify potential actions to support future improvement
Document accurate and complete record of emergency situation and actions taken according to scope of own role

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Participate in emergency de-brief according to organisation procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Review own role in emergency and identify potential actions to support future improvement

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

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

1. Recognise clinical emergencies

1.1 Recognise signs of deterioration in clients and immediately report to appropriate clinician

2.1 Monitor, interpret and promptly recognise abnormal equipment readings and immediately report abnormal values to anaesthetist/medical staff

2. Respond to clinical emergencies

2.1 Maintain client’s vital functions pending attendance of medical staff

2.2 Use communication escalation techniques according to organisation procedures

2.3 Promptly obtain emergency equipment and make ready for relevant medical staff

2.4 Assist the anaesthetist/medical staff to perform any emergency procedures under direction

2.5 Assist with the medical management of the client and allocate work to other team members according to priority

3. Prepare drugs for administration in emergency situations

3.1 Ensure required drugs, diluents and fluids are to hand

3.2 Read expiry date for each drug, diluent or fluid and check it has not been exceeded

3.3 Make accurate calculations to prepare drug to correct nature, quantity and dilution based on medical officer requirements

3.4 Check drugs with an authorised person prior to and after mixing

3.5 Use correct equipment and maintain sterility of drug and diluent

3.6 Check final drug dilution with anaesthetist or medical officer

3.7 Administer drugs under the direction and supervision of the anaesthetist

3.8 Complete medication documentation in accordance with organisation policies and procedures

4. Finalise emergency procedures

4.1 Document accurate and complete record of emergency situation and actions taken according to scope of own role

4.2 Participate in emergency de-brief according to organisation procedures

4.3 Review own role in emergency and identify potential actions to support future improvement

Required Skills and Knowledge

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

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

1. Recognise clinical emergencies

1.1 Recognise signs of deterioration in clients and immediately report to appropriate clinician

2.1 Monitor, interpret and promptly recognise abnormal equipment readings and immediately report abnormal values to anaesthetist/medical staff

2. Respond to clinical emergencies

2.1 Maintain client’s vital functions pending attendance of medical staff

2.2 Use communication escalation techniques according to organisation procedures

2.3 Promptly obtain emergency equipment and make ready for relevant medical staff

2.4 Assist the anaesthetist/medical staff to perform any emergency procedures under direction

2.5 Assist with the medical management of the client and allocate work to other team members according to priority

3. Prepare drugs for administration in emergency situations

3.1 Ensure required drugs, diluents and fluids are to hand

3.2 Read expiry date for each drug, diluent or fluid and check it has not been exceeded

3.3 Make accurate calculations to prepare drug to correct nature, quantity and dilution based on medical officer requirements

3.4 Check drugs with an authorised person prior to and after mixing

3.5 Use correct equipment and maintain sterility of drug and diluent

3.6 Check final drug dilution with anaesthetist or medical officer

3.7 Administer drugs under the direction and supervision of the anaesthetist

3.8 Complete medication documentation in accordance with organisation policies and procedures

4. Finalise emergency procedures

4.1 Document accurate and complete record of emergency situation and actions taken according to scope of own role

4.2 Participate in emergency de-brief according to organisation procedures

4.3 Review own role in emergency and identify potential actions to support future improvement

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:

determined and actioned response to diverse emergency situations, including:

respiratory/ airway emergencies:

difficult/compromised airway

can’t intubate can’t ventilate

bronchospasm

pneumothorax

laryngospasm

aspiration

suxamethonium apnoea

hypoxia/hypoxaemia

hypercarbia

cardiac emergencies:

ventricular fibrillation

ventricular tachycardia

pulseless electrical activity

asystole

third degree heart block

cardiac arrhythmias which pose threat to life for individual clients

perioperative myocardial infarcts

cardiac tamponade

malignant hyperthermia

hypothermia

hypovolaemic shock/massive blood loss

severe hypotension

severe hypertension

pulmonary hypertension

anaphylactic shock

thromboembolism or pulmonary embolism – fat, thrombus, air/gas, amniotic fluid

pulmonary oedema & negative pressure pulmonary oedema

local anaesthetic toxicity

total spinal

metabolic and endocrine abnormalities

drug administration error and adverse drug reaction

septic shower

followed established procedures for use of emergency equipment/ consumables, including:

difficult airway trolley and other airway and suction equipment

cardiac arrest trolley and defibrillator

heating/cooling equipment

infusion/transfusion equipment

monitoring equipment

medications

chest drains

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:

legal and ethical considerations (national, state/territory) for emergencies, and how these are applied in organisations:

codes of practice

duty of care

infection prevention and control

informed consent

mandatory reporting

privacy, confidentiality and disclosure

records management

rights and responsibilities of workers, employers and clients

work role boundaries – responsibilities and limitations in emergencies

work health and safety

the following anaesthetic emergencies, their signs, symptoms, physiological and non-physiological causes, treatment or resolution and prediction:

respiratory/ airway emergencies:

difficult/compromised airway

can’t intubate can’t ventilate

bronchospasm

pneumothorax

laryngospasm

aspiration

suxamethonium apnoea

hypoxia/hypoxaemia

hypercarbia

cardiac emergencies:

ventricular fibrillation

ventricular tachycardia

pulseless electrical activity

asystole

third degree heart block

cardiac arrhythmias which pose threat to life for individual clients

perioperative myocardial infarcts

cardiac tamponade

malignant hyperthermia

hypothermia

hypovolaemic shock/massive blood loss)

severe hypotension

severe hypertension

pulmonary hypertension

anaphylactic shock

thromboembolism or pulmonary embolism – fat, thrombus, air/gas, amniotic fluid

pulmonary oedema & negative pressure pulmonary oedema

local anaesthetic toxicity

total spinal

metabolic and endocrine abnormalities

drug administration error and adverse drug reaction

septic shower

external emergencies including equipment failure, equipment/consumable supply shortage, weather events, fire and power outage

algorithms used to de-escalate anaesthetic emergencies

crisis management basic principles including internal and external crisis sources

methods, principles and procedures for dealing with emergencies, including:

problem solving techniques

graded assertiveness

crisis communication principles

clinical handover

multidisciplinary team structure and functions

situation monitoring/situational awareness

massive transfusion protocol

Australian Resuscitation Council guidelines

Australian and New Zealand College of Anaesthetists (ANZCA) Anaphylaxis guidelines

ANZCA Malignant hyperthermia guidelines

features, functions and safe use of emergency equipment

emergency drug administration:

equipment

routes of administration in anaesthesia context

types, functions and effects of different drugs

legislation and protocols