PARA303 - Paramedic Practice: Obstetric and Paediatric Emergencies

Year

Credit points

Campus offering

Prerequisites

Teaching organisation

Unit rationale, description and aim

While the number of pre-hospital gynaecological, obstetric and birth emergencies are small, the acuity in such cases can be high. It is therefore necessary that paramedics possess the knowledge and skills to manage gynaecological, obstetric and birth emergencies. Similarly, paediatric emergencies require specialist knowledge and skills. Children are not small adults; paediatric physiology is very different to that of adults. Therefore an advanced knowledge of pregnancy, birth and paediatric emergencies is required to ensure the optimal outcomes for women and children and enhances the professional practice of paramedics.

In this unit, paramedic students will develop knowledge and practical skills in birthing and the care of the neonate, and pre- and post-partum mother. There will be opportunity to develop competence in caring for the paediatric client and their family in the pre-hospital setting. This unit will also build on concepts introduced in previous units, including assessment of children of various ages and management of common health problems. Students will be provided with the opportunity to demonstrate broad and coherent theoretical and technical knowledge and skills to manage obstetric and paediatric emergencies. Student will also explore the role of the paramedic in delivering person-centred, culturally sensitive and globally informed health care in the setting of paediatric and obstetric emergencies.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Explain the physical and psychological stages of pregnancy and childbirth; (GA1, 5)

LO2 - Describe selected principles of safe, evidence-based child bearing care to women and their families during uncomplicated pre, peri & post-natal care; (GA2, 4)

LO3 - Describe the components of effective neonatal and paediatric resuscitation in the pre-hospital environment; (GA1, 5)

LO4 - Critically reflect on principles of cultural awareness in recognising diversity in stages of pregnancy and childbirth, including birthing practices of culturally diverse groups and Aboriginal and Torres Strait Islander peoples; (GA1, 2, 3, 6)

LO5 - Demonstrate the assessment and management of gynaecological, obstetric and paediatric emergencies in the pre-hospital environment; (GA1, 5)

LO6 - Apply emergency care assessment and management skills and strategies for infants, children, and adolescents in the pre-hospital environment. (GA3, 6)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

The Council of Ambulance Authorities Paramedic Professional Competency Standards developed in this unit are:

CAA Competency Standards:

Content

Topics will include:

Anatomy and physiology of reproductive system

Gynaecological emergencies

• Ectopic pregnancy
• Pelvic Inflammatory disease
• Ruptured ovarian cyst
• Vaginal bleeding
• Other gynaecological aetiologies

Obstetrics 

• Assessment of pregnant woman
• Anatomical and physiological changes in pregnancy
• Trauma and the pregnant woman
• Normal birthing
• Complicated obstetric presentations
• Placenta Previa, Abrupto Placenta
• Inversion of the uterus
• Cord prolapsed
• Breech presentation
• Shoulder dystocia
• Preeclampsia / eclampsia
• Post-partum haemorrhage
• Multiple births
• Abortion / miscarriage / stillbirth 
• APGAR assessment
• Care of the newborn
• Neonatal resuscitation

Paediatrics

• Common injury/illness management 
• Paediatric medical emergencies
• Sudden Infant Death Syndrome
• Paediatric trauma 
• Child abuse
• Paediatric  resuscitation 
• Management
• Associated pharmacology 

Assessment and management of gynaecological and obstetric emergencies for patients from diverse backgrounds and locations, including Aboriginal and Torres Strait Islander peoples

Specific Skills

Neonatal Assessment

• Values (vital signs)
• APGAR

Paediatric Assessment

• Values (vital signs)
• Perfusion Status Assessment
• Respiratory Status Assessment
• Conscious State Assessment
• Pain assessment 
• Burns assessment

Pain assessment and management 

Non-pharmacological interventions 

Airway management

• Neonatal
• Paediatric 
• Oxygen therapy and ventilation
• Nebulised medications

Resuscitation and defibrillation

• Neonatal 
• Paediatric

Burn management, assessment tools, fluid therapy

Drug dose calculation and administration in gynaecological, obstetric and paediatric emergencies

Learning and teaching strategy and rationale

This unit is delivered to practising paramedics who generally work rotating shifts. Thus, the unit is delivered fully online to allow the flexibility required by students who may not be able to attend on campus or in synchronous mode. As students are currently paramedic practitioners, a teaching and learning strategy which places them at the centre by drawing upon their own experiences best meets the learning needs of this cohort. This unit requires students to undertake 150 hours of focused learning to achieve the unit learning outcomes.

Flexible asynchronous online learner-centred lessons are used to support student learning. Students are able to co-construct knowledge using online discussions. Case study methodology is utilized within this unit to further draw upon student experience and to apply knowledge in context.

Assessment strategy and rationale

A range of assessment procedures will be used to meet the unit learning outcomes and develop graduate attributes consistent with University assessment requirements. Assessments are sequenced and timed to support progress from assessment of lower level learning outcomes to higher as the semester progresses. Assessments are weighted accordingly.

The quiz assesses the student’s knowledge of physiological stages of pregnancy, birth and gynaecological and obstetric emergencies. The discussion portfolio enables students to discuss, explore and articulate their thoughts and opinions to demonstrate their depth of knowledge to foster effective advanced decision making. The case study enables students to apply values, knowledge, skills and attitudes in the area of gynaecological and obstetric emergencies. The case study provides the opportunity for students to consolidate knowledge developed throughout the unit and to provide a management plan for an obstetric or gynaecological emergency in the pre-hospital setting.

Overview of assessments

Representative texts and references

Bates, K., & Crozier, K. (2015). Managing childbirth emergencies in the community and low-tech settings. Basingstoke, Hampshire: Palgrave Macmillan.

Burbank, V. K. (2011). An ethnography of stress: The social determinants of health in Aboriginal Australia.

Bainstoke, UK: Palgrave Macmillan.

Dudgeon, P., Purdie, N., Walker, R., Australia. (2010). Department of Health Ageing, Australian Council for Educational Research, & Kulunga Research Network. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. Canberra, A.C.T.: Department of Health and Ageing.

Hampton, R. & Toombs, M. (Eds.). (2013). Indigenous Australians and health: The wombat in the room. South Melbourne, Victoria: Oxford University Press.

Jenkins, G., & Tortora, G. (2013). Anatomy and physiology; From Science to Life. (3rd Ed.). United States of America: Wiley.

Marshall J.E. and Raynor M.(Eds). (2014) Myles’ textbook for midwives. (16th ed.). St Louis, MO, USA. Churchill Livingstone Elsevier. 

McLelland, G., Morgans, A., & McKenna, L. (2015). Victorian paramedics' encounters and management of women in labour: an epidemiological study. BMC pregnancy & childbirth, 15(1), 1-7. doi:10.1186/s12884-015-0430-6

Marx, J.A., Hockberger, R. S., Walls, R. M., …... (2014). Rosen’s emergency medicine concepts & clinical practice. (8th Ed.). Philadelphia PA: Elsevier.

Medical Journal of Australia accessed at https://www.mja.com.au/

Pairman, S., Thorogood, C., Pincombe, J., & Tracy, S. (2015). Midwifery: Preparation for practice. (3rd Ed.). New South Wales, Australia: Elsevier.