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To participate in class discussions and activities it is essential to bring this learning guide to every
class. The first section of this guide is for your general information. The second part is the study
component which should be used as a workbook. Each section will guide you regarding what
you should know and which activities you should complete. The class notes as set out in this
guide are just a basic outline and you will be required to make supplementary notes during class
discussions as well as additional readings. Please ensure that all the skills are signed off in your
logbook or lecturer’s register. Learners who are not in class will not be able to sign off on the
skills and will therefore forfeit the opportunity to do their practical examination.
2.4 STUDY MATERIALS
Your workbook will form basis for this module. Throughout the workbook you will be led in terms of self-
study and additional readings. All activities should be reviewed when preparing for tests and exams.
2.5 GENERAL BEHAVIOUR
You are expected to act in a professional manner and act ethically responsible at all times. This
includes, but is not limited to:
Conduct in class: Behave appropriately during lectures, respecting Professional, Departmental and
University regulations. Please participate in class discussions. This will help you to form your
thoughts and facilitate learning. Punctuality is of utmost importance and also shows your respect
for both me and your classmates. Unless you make special arrangements you will not be allowed
to join scheduled periods if you arrive late for class. If you missed class, make sure that you catch
up with colleagues and any assessment done in class cannot be completed after the scheduled
session (unless a medical certificate is presented).
Grievance procedures: All complaints to be directed to me personally during the course of this
module.
Academic dishonesty: Please familiarize yourself with the University Rules (G 14, 15, 17 & 21)
regarding supplementary assessment, special summative assessment and assessment fraud. Any
academic dishonesty will be reflected in your academic records.
Only an original medical certificate will be accepted when you are absent from scheduled activities
and has to be submitted within 7 days.
It is your responsibility to check the notice board and Blackboard regularly for notices concerning this
module. Any information presented in this study guide may be changed if necessary.
Students have to wear identification cards at all times.
No eating and drinking is allowed in class in the Skills Centre.
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3. STUDY / LEARNING COMPONENT
Reviewing the outcomes specified for this module will direct you in terms of what we are aiming for i.e. where are we going. You will be able to identify your own part in the learning process. The outcomes also indicate what evidence is needed to prove that certain knowledge and skills have been acquired.
Module name: PRIMARY EMERGENCY CARE (PEC) Contact hours: 16 hours
Lectures per week Clinicals per week Tutorials per week Semester Venue
4 per week per subgroup Practicals Week 1,2 & 3
Practica incorporated
6 subgroups per year Skills Centre
Pre-requisites: learning assumed to be in place
Grade 12, Life Orientation
Must have basic understanding of the definition of First Aid
Co-requisites: units of learning contributing during the current year
Units covering Microbiology, Anatomy, Vital signs and communication as applicable in various departments
Module facilitator Facilitator details provided on page 1
Purpose of the module
To assist the students to:
develop the ability to identify problems and find solutions through critical thinking
be able to render Primary Emergency Care (PEC) to victims of trauma, sudden illness and environmental emergencies.
develop the affective and psychomotor skills when rendering PEC to the victims of trauma
Critical cross-field outcomes / Professional attributes to be developed as generic skills: o Critical thinking skills (reflection and evaluation) o Communication skills (patients, peers, lecturers both verbally and non-verbally-written formats) o Team work (small group work as well as with other professionals such lecturers) o Social responsiveness (responsive to needs of patients, reflect and adapt what is necessary based on the needs of the patient/community)
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Specific Outcomes Assessment Criteria Teaching strategy Assessment task/method
At the end of this module you should be able to :
be able to:
You should be able to answer the following questions :
following questions:
This is the method to study the material
material
This is how you will gain marks and monitor your progress
monitor your progress S01 Apply principles of Emergency
Scene Management (ESM)
AC1 Describe steps taken by the first
person to arrive at an emergency scene
TS1
Formal lecture
Directed Instruction
Demonstration
A AT1
Summative assessment
SO 2 Apply legal and ethical responsibilities of PEC giver
AC2 Describe legal and ethical
responsibilities of a primary emergency care giver
TS2
Formal lecture
Role play on ESM
Self- directed learning
AT2
Summative assessment
SO 3 Perform CPR on an Adult, Child and Infant casualties according to the latest guidelines
AC3 Define the following:
Asphyxia
CPR List signs of successful CPR
TS3
Formal lecture
Audio visual material
Demonstration
AT3
Summative assessment
OSCE
S04 Perform Heimlich
manoeuvre on an adult, child and infant casualties
AC4 Define the following:
Choking
Describe the emergency care to be rendered in a given scenario
TS4
Formal lecture
Directed Instruction
Demonstration
AT4
Summative assessment
OSCE
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S05 Use Automated External Defibrillation (AED) safely
AC5
Define AED
State indications for the use of AED
TS5
Directed Instruction
Demonstration
Self -directed learning
AT5
Summative assessment
OSCE
S06 Perform log roll on an adult
and child casualties
AC6
Describe the indications to perform log roll
TS6
Formal lecture
Direct Instruction
Demonstration
Self- directed learning
AT6
Summative assessment
OSCE
S07 Manage burns, wounds
and bleeding
AC7
Name different types of wounds
Describe methods of controlling bleeding
TS7
Formal lecture
Audio visual
Demonstration
Self-directed learning
AT7
Summative assessment
OSCE
S08 Recognise signs and
symptoms of fractures, sprains, strains and immobilise appropriately
AC8
List signs and symptoms of fractures
TS8
Formal lecture
Audio visual
Directed Instruction
Demonstration
Self -directed learning
AT8
Summative assessment
OSCE
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S09 Perform rapid trauma
assessment
AC9 Identify abnormal physical
findings
TS9
Directed Instruction
Demonstration
Self- directed learning
AT9
Summative assessment
OSCE
Critical cross-field outcomes Skills achieved for lifelong learning
Critical thinking skills
Teamwork
Leadership Skills
Communication skills
Resources (prescribed text that you need to read in order to learn what you need to know)
Learner guide
Additional information posted on Blackboard
First Aid books
American Heart Association (AHA) 2010 guidelines (Endorsed by the SA Resuscitation Council)
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Level of cognition Def n on Typical action ver s Skills demonstrated
The statements used to define and assess the outcomes are classified in terms of a series of lower to higher-order thinking skills (cognitive domains), in accordance with
Bloom's
Taxonomy of Educational Objectives (Bloom BS and Krathwohl DR, Taxonomy of educational objectives. Handbook 1. Cognitive domain, Addison-
Wesley, 1984): The characterization of the cognitive domain:
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4. CONTENT GUIDE
4.1 PRINCIPLES OF PRIMARY EMERGENCY CARE (PEC)
Learning outcomes
At the end of this block, the student must be able to:
-To preserve life by:
*Ensuring that the patient’s airway is open
*Ensuring that the patient has a heartbeat
*Ensuring that the patient is breathing
*Manage bleeding
-To prevent the illness or injury from becoming worse by:
*Controlling further bleeding
*Immobilizing the casualty’s fractures
*Treating casualty for shock
*Preventing infection
-To promote recovery by:
*Positioning the casualty correctly
*Protecting the casualty from extreme temperatures
4.2 LEGAL AND ETHICAL RESPONSIBILITIES OF A PEC GIVER
When a PEC giver goes to someone’s aid, s/he undertakes to provide any assistance s/he can give and
remain on the scene until the casualty can be handed over to medical assistance or some authority.
Once you give assistance, you should use reasonable skill and knowledge based on your level of
training. In this role of a Good Samaritan, the PEC giver is given certain protections under the law.
Therefore he should not be overly concerned about legal liability.
Identification
The PEC giver must always identify him /herself and indicate to the casualty that s/he is trained
in PEC before attempting to offer help to the casualty in order to gain cooperation and
confidence.
Consent
A person has the right to accept (consent) or to refuse help. A conscious adult or older child who
agrees or makes no objection to your offer or help gives his consent. If a person refuses help,
call for help, stay with him and keep a close eye on his condition until medical assistance arrives.
If he becomes unconscious and his life is threatened, do whatever is necessary to save his life.
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*Obtaining consent on an unconscious person and a young adult
It is assumed that an unconscious person or a young child, whose parents are not
available, would consent to your help if he could. A parent with a young child has a
right to refuse help given to her child. In this case, advise a parent to seek help or to
take the child for medical assistance. If the child’s life is in danger, call for help and
stay with the parent.
Standard of care
This is the manner in which the PEC giver must act or behave. It depends on the level of training,
experience and circumstances around the scene. One has a moral and legal responsibility to
respond to legitimate calls for help, but should not act improperly to give treatment that is beyond
his/her scope of practice.
Allegations of negligence
Assault and improper conduct form the basis of most legal actions brought against emergency
care personnel by the public. Make sure that your actions are in the casualty’s best interest.
There is no need to neither hesitate nor be concerned about legal liability provided that:
PEC is not forced on a conscious adult or older child who refuses such help.
You give the help you would hope to receive if you were in a similar circumstance.
You use caution when giving PEC so that you do not aggravate or increase injury.
A casualty is not abandoned. When the offer of help is accepted it must be given and
continued until the casualty can be handed over to a more qualified person.
A common sense approach is adopted when giving PEC, if/when the casualty’s life is not
in danger.
Suspected child abuse
Be on the alert for signs of child abuse when giving PEC to children.
Unusually shaped bruises or burns, injuries that would not be normal for a child and
fractures in children and infants, where the cause is not readily apparent or is suspicious
in nature, should alert you to look for other signs. The child’s apparent fear of a parent or
babysitter should reinforce suspicions of child abuse.
Insist on medical attention for the child’s injuries, no matter how minor they may be, to permit
a full medical assessment. If the parent or babysitter refuses medical assistance, you have
a duty to notify local child welfare agencies or authorities (e.g. Child line or FAMSA). Do not
accuse anyone of child abuse, but for the child’s welfare do not hesitate to report suspected
cases.
Child line: 080 005 5555
FAMSA: 082 231 0370
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Confidentiality and Privacy
PEC giver shall maintain all confidential matters entrusted to him by the casualty without
divulging them to any unauthorised persons. He shall also respect the casualty’s privacy and
avoid exposing the casualty unnecessary when giving treatment.
Abandonment
Never abandon (leave) a casualty who is in your care. Once the casualty accepts your offer of
help, stay with her/him until you hand him over to medical help, another PEC giver, or she/he
no longer wants your help. This is when the problem is no longer an emergency and further
care is not needed.
Declaration of death
Only a qualified authorized health care practitioner can certify death.
4.3 EMERGENCY SCENE MANAGEMENT (PRIORITY ACTION APPROACH)
PEC is given safely in a proper sequence according to life threatening conditions. At times the
sequence might be changed depending on the patient’s condition. This is also called Priority
Action Approach.
Below are the five steps and related actions taken in Emergency Scene Management (ESM)
Step 1. Scene survey
Calmly approach the scene
Identify all the possible risks and hazards
Take charge in the absence of a person senior to you, if there is someone ask if they
can help
Quickly assess the situation accurately and decide on the priorities of action
Call out for help to attract attention of by standers
Assess and remove all hazards to make area safe for self, casualty and bystanders
Find out the history of the accident (what happened), how many casualties there
are and determine the mechanism of injury (how & where the injury occurred)
Identify self as PEC giver and offer to help so as to obtain consent
Assess responsiveness to determine level of consciousness (LOC), [AVPU i.e. If
casualty is alert, responds by making noise when spoken to, responds to painful
stimulus, no eye, voice or motor response on painful stimuli]
In adults a GCS is used whilst in newborns an APGAR score is used to assess LOC
Send for medical help
Don gloves
N.B Priorities of action means start treating the casualties according to this sequence:
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i. Manage life threatening bleeding
ii. Unconsciousness – no pulse start CPR immediately
iii. Airway- open, protect and maintain
iv. Breathing – ensure adequacy
v. Circulation – control minor bleeding
vi. Deformities- manage fractures
vii. Evaluation - continuous patient evaluation
N.B Making the scene safe means: in case of:
i. Police officers- to control traffic, switch off the ignition, watch out for petrol spillage
and ask people not to smoke
ii. Body fluids -wear appropriate personnel protective clothing (PPC) i.e. head