Diploma in Emergency Medical Care

Purpose

This qualification is a mid-level health worker qualification which recognises the key competencies required of Emergency Care Technician (ECT) who can work independently and under supervision in a variety of contexts.

This qualification will be particularly useful for graduates to be able to

• Demonstrate an understanding of the South African Health Care system.
• Applaud principles of occupational health and wellness.
• Apply knowledge and understanding of human anatomy, physiology and bioprocesses relevant to the ECT.
• Render emergency care within the scope of practice of an ECT by means of care for and operating equipment and resources.
• Perform appropriate clinical assessments and diagnostic skills.
• Perform clinical, procedures, skills, and treatment interventions within the ECT scope of practice.
• Integrate and apply knowledge and understanding of pathology to make informed decisions and clinical judgments relating to treatment (HPCSA, 2017:3-4).

The Exit Level Outcomes and Assessment Criteria will be interpreted and applied within the context of the current scope of practice of ECTs as defined by the HPCSA.

Rationale

This qualification, developed by the Health Professional Council of South Africa (HPCSA) in 2017, is designed to produce mid-level emergency care professionals capable of delivering essential services across the diverse South African context. It emphasises adaptability, preparing individuals to operate effectively in rural, underserved areas as well as in advanced, high-tech urban environments. Designed to reflect South Africa's unique history and social landscape, this qualification highlights the importance of equity in health care and addresses critical needs, such as reducing the national burden of disease.

This qualification outlines core competencies required of paramedics and established foundation in emergency care that can support further study and professional growth. By aligning with the Higher Education Qualifications Sub-Framework (HEQSF), it replaces the previous National Certificate in Emergency Care, offering a better educational pathway.

For Individual Holders: This qualification provides a clear entry point into the field of emergency services, facilitating employment opportunities and enabling career mobility across various emergency care sectors. Additionally, it fosters comprehensive personal and professional development, equipping individuals with the holistic skills needed for effective emergency care practice.

For the Medical Profession: By enhancing the skill set and knowledge base of mid-level emergency care workers, this qualification supports the broader goals of the healthcare system, contributing to a well-prepared workforce capable of responding to diverse medical emergencies across South Africa.

This qualification will benefit the emergency care profession in the following ways

• Provide a consistent and coherent foundation for practice at an entry level and progression within the profession in the context of a national qualification's framework.
• Provide a means for the critical function of formal certification and registration within the profession, thus ensuring society is served by competent ECTs.
• Help to legitimise this level of practice as well as the profession..
• Provide a comparable benchmark within the health profession.
• Reduce the burden on other health structures and practitioners.
• Reduce the number of disciplinary occurrences that take place due to inadequate or inappropriate training.
• Promote emergency care as a preferred career option.
• Encourage individuals to enhance and develop the profession itself through their own innovation.
• Assist in the planning, implementation and monitoring of continuing professional development.
• Provide a more equitable basis for remuneration.
• Enhance the societal image of the profession through improved quality of emergency care services.

In addition, employers of ECTs will benefit through enhanced efficiency, effectiveness and productivity (e.g. reduced accidents).

The key benefits to society are

• Patients are served by competent ECTs, thus increasing their chances of survival and recovery.
• There will be a reduction in the cost of health care and hospitalization through the more efficient use of resources.
• Society will be served by more efficient and effective service delivery.
• The country will be served by a broad reserve of competent individuals.
• Given South Africa's role as one of five developing nations, this qualification will provide a benchmark for the continent.
• The qualification provides a step towards world-leading practice in EMS.

With a decreased burden on health structures, there are resultant benefits to allied services that are trying to meet EMS needs due to current inadequacies in competencies e.g. reduced contamination of crime scenes, how to give evidence in court; issues related to child abuse etc.

Holders of this qualification will operate mainly in and around the ambulance, within wide ranging contexts, including rural, urban, military, coastal, corporate, mass gatherings, homes and workplaces. In general, the ECT will provide an independent service within the pre-hospital context.

Recognition of Prior Learning (RPL)

RPL is applicable for entry selection within the context of the institutional policies and guidelines. The RPL process will incorporate a holistic approach and comply with the current regulations of HPCSA, SAQA and CHE. The learner has the right to have previous experience and qualifications taken into consideration when applying to do further qualifications.

RPL for access

Learners may be granted access through RPL. Evidence of prior learning must be provided by employing a portfolio and other appropriate evidence challenging theoretical and clinical examinations. Clinical and work-based experience must be relevant to the qualification the learner is applying for. The assessment(s) will be done by a registered assessor,and a registered moderator will validate the assessment process.

RPL for credits

Credit transfer may be granted according to current institutional policy and guidelines of the relevant statutory health council, the CHE, and SAQA. Credit accumulation transfer will only be considered for a learner with an accredited and registered qualification. The credits transferred must be on the same level as the module the credits are transferred towards; the content and outcomes of the module(s) correspond with the module(s) presented by the institution, and the learner passed the additional assessments if required. All credits transferred will be submitted as part of completing training/academic records. Thus, all transcripts will reflect exemptions achieved through CAT and the credit points.

Entry Requirements

The minimum admission requirement for entry is

• Senior Certificate, NQF Level 4 without endorsement.

Or

• National Senior Certificate, NQF Level 4, granting access to Diploma studies.

Or

• National Certificate (Vocational), NQF Level 4 granting access to Diploma studies.

Or

• Higher Certificate in Emergency Medical Care, NQF Level 5.

This qualification comprises compulsory modules at National Qualifications Framework Levels 5 and 6, totalling 240 Credits.

Compulsory Modules Level 5, 120 Credits

• Anatomy, 12 Credits.
• Physiology, 12 Credits.
• Foundations of Professional Practice 1 (End user computing), 6 Credits.
• Integrated Sciences: Physics, 6 Credits.
• Integrated Sciences: Chemistry, 6 Credits.
• Foundations of Professional Practice 1, 12 Credits.
• Mental Health and Wellness, 6 Credits.
• Emergency Medical Care 1 Theory, 12 Credits.
• Emergency Medical Care 1 Clinical Practical Skills, 24 Credits.
• Emergency Medical Care 1 Clinical Practice, 24 Credits.

Compulsory Modules Level 6, 120 Credits

• Primary Health Care, 12 Credits.
• Emergency Medical Care 2 Theory, 18 Credits.
• Emergency Medical Care 2 Clinical Skills, 36 Credits.
• Emergency Medical Care 2 Clinical Practice, 36 Credits.
• Rescue High (angle rescue, fire search and rescue, motor vehicle rescue), 18 Credits.

1. Articulate an understanding of the South African Healthcare system, including the role and placement of emergency services within the broader health sector.
2. Apply principles of occupational health and wellness, including the identification and management of stress and burnout in oneself and others.
3. Apply the knowledge and understanding of human anatomy relevant to Paramedics.
4. Apply an understanding of human physiology and bioprocesses relevant to Paramedics.
5. Apply principles and theories of basic health sciences underpinning emergency care and rescue services.
6. Care for and operate equipment as well as resources required to render emergency care and rescue services within the Paramedic scope of practice.
7. Perform appropriate clinical assessment and diagnostic skills.
8. Integrate and apply knowledge and understanding of pathology to make informed decisions and clinical judgements in relation to treatment.
9. Perform clinical procedures, skills, and treatment interventions within the Paramedic scope of practice.
10. Demonstrate an appropriate level of physical health and physical preparedness to render emergency care and rescue services.
11. Perform fire search and rescue, high-angle and light motor-vehicle rescue activities.
12. Document and communicate clinical information and patient care records.

Associated Assessment Criteria for Exit Level Outcome 1

• Describe and discuss the role, function, challenges, goals, and strategies of the National Department of Health correctly
• Describe different tiers and levels of health care delivery in the Republic of South Africa correctly
• Describe the EMS correctly in terms of structure, funding, role, and function, both public and private, within the South African (SA) context
• Explain the interdependence and interrelationships occurring between EMS and other Allied Health Care structures correctly
• Identify and explain members of the health care team correctly in terms of key roles and responsibilities and the interrelationships between them (HPCSA, 2017:10-11).

Associated Assessment Criteria for Exit Level Outcome 2

• Explain the need for mental wellness on the part of the emergency care provider correctly by highlighting its role and importance, with reference to the impact on job effectiveness
• Describe techniques to identify and manage own stress and stressful situations correctly
• Identify personal stress disorders and stress factors correctly based on an accurate reading of symptoms and patterns
• Demonstrate methods for dealing with medical waste, disinfection procedures, and infection control correctly and or explained in line with established protocols
• Identify possible hazards within the EMS environment correctly in terms of their resources, impacts, and means for preventing or minimising their negative impact
• Carry out scene hazard control correctly in line with established procedures
• Discuss strategies for dealing with bystanders and the crowd correctly and appropriately applied
• Identify and demonstrate methods for maintaining personal safety correctly through appropriate risk assessment, scene assessment, decision making, and option taking

Associated Assessment Criteria for Exit Level Outcome 3

• Explain the thorax correctly in terms of its composition, general form, spatial orientation, structures, and position of cavities
• Provide explanations of the normal abdominal anatomy correctly, with an ability to integrate surface topographical and clinical anatomy of the abdomen into patient assessment and care
• Explain the pelvis correctly in terms of its structures and contents, with particular attention to gender
• Explain the structures of the lower and upper extremity correctly in terms of composition and relative position
• Explain structures of neck and head correctly in terms of composition and relative position, which demonstrates an ability to integrate surface topographical and clinical anatomy
• Describe anatomical differences between adults and children correctly
• Explain anatomical adaptations to pregnancy correctly (HPCSA, 2017:12)

Associated Assessment Criteria for Exit Level Outcome 4

• Explain the organisation of the body correctly with respect to the cellular physiology, tissue physiology, major systems, homeostasis, and feedback
• Explain the physiology of the human body correctly in terms of principles of support and movement
• Explain control systems of the body correctly in terms of nervous and endocrine components
• Explain special senses and systems correctly in terms of functioning
• Explain fluid, electrolyte, and acid-base dynamics correctly with reference to the impact on human physiology
• Explain key principles of microbiology correctly and apply them to the emergency medical care context in general, with reference to communicable diseases and infection control:
• Gross classification system of applicable micro-organisms
• Mode of transmission
• Applied basic hygiene and protection measures
• How micro-organisms are destroyed
• Infection control measures, incl. basic elements of epidemiology
• Describe physiological differences between adults and children correctly
• Explain physiological adaptations to pregnancy correctly (HPCSA, 2017: 12-13)

Associated Assessment Criteria for Exit Level Outcome 5

- Explain the following key principles of chemistry correctly and apply them to the emergency medical care context

• Foundational chemistry (matter, atomic structures, and chemical bonding)
• Chemical equations and reactions
• Acids, bases, and salt
• Radioactivity
• Properties of specific gases
• Water and solutions
• Organic chemistry
• Biochemistry
• Explain the following key principles of physics correctly and apply them to the emergency medical care context:
• Basic measurements
• Mechanics
• Fluids
• Heat
• Electricity and magnetism

Associated Assessment Criteria for Exit Level Outcome 6

• Identify emergency vehicles correctly according to specific tasks within the EMC environment
• Set up emergency vehicles ergonomically and maintain them in a state of constant readiness
• Identify and report vehicle problems according to local operational procedures
• Check emergency equipment correctly with required regularity and maintain it in a clean, disinfected, and ready state always, as per local procedures
• Identify troubleshooting of equipment failure and take appropriate actions to address identified problems according to local procedures
• Identify and describe emergency equipment correctly in terms of indications, contraindications, precautions, complications, use, and, where applicable, assembly thereof
• Operate vehicles with due respect for other road users in compliance with the Road Traffic Act and prevailing road conditions
• Control the vehicle under operational conditions, with effective use of warning devices and with due respect safety of other road users
• Explain correct procedures relating to registration, modification and marking emergency services vehicles as per regulations
• Describe relevant regulation as it relates to emergency vehicles responding to incidents, and transporting patients and or pressure cylinders
• Carry out navigation effectively using appropriate navigational tools
• Explain and demonstrate procedures, in line with relevant legislation, to follow should a responding vehicle become involved in an accident
• Utilise communication devices according to established protocols to ensure effective communication
• Compare a variety of communication devices to identify their functional components, principles of operation, advantages, and disadvantages
• Explain EMC equipment related to the care of ill or injured patients in terms of function, storage, maintenance, and use

Associated Assessment Criteria for Exit Level Outcome 7

• Assess patients correctly in a pre-hospital emergency context consistent with the scope of practice of a Paramedic
• Assess in a manner that is professional and consistent with principles of medical history taking
• Carry out assessments in accordance with accepted medical principles of physical examinations within the Paramedic scope of practice
• Identify successfully with clinical assessments of life-threatening symptoms/conditions

Associated Assessment Criteria for Exit Level Outcome 8

• Describe and explain the pathogenesis of disease applicable to the Paramedic correctly in relation to the anatomy and physiology of applicable systems
• Explain pathophysiology of disease processes correctly in terms of adult, obstetric and paediatric patients
• Demonstrate appropriate clinical decision-making for the presenting condition

Associated Assessment Criteria for Exit Level Outcome 9

• Demonstrate treatment supported by sound clinical decision making and applicable to identified disorders/conditions
• Provide transportation to the appropriate facility
• Manage patients in a pre-hospital context consistent with the scope of practice (SOP) of a Paramedic
• Detect acute life-threatening medical and/or trauma-related disorders properly based on applied understanding of the basic pathophysiology behind common medical and trauma-related disorders
• Take correct decisions regarding treatment, based on and validated by history taking and appropriate patient assessment
• Identify the need for a higher level of clinical competencies correctly
• Explain life support interventions and emergency care for adults, children, infants, and neonates, and apply them in line with currently accepted theory and principles, and the acceptable code of practice and protocols defined by the PBEC
• Execute sterility and infection prevention control correctly in line with requirements
• Demonstrate integrated patient care correctly in simulated patient scenarios
• Explain assessment and treatment of the patient correctly and demonstrate within the SOP of Paramedic with reference to the various body systems
• Explain all clinical interactions and practices in line with provisions of Paramedic SOP and ethical rules of the HPCSA and professional associations
• Carry out consultation with and referral to the health care team when necessary and appropriate. The patient and family are included as integral members so the health care team can as and when possible
• Describe principles of pharmacology as applied to the Paramedic in terms of:
• Mechanisms of drug actions
• Pharmacokinetics
• Routes of drug administration
• Drug interactions and adverse drug reactions
• Administer medications correctly within the SOP of the Paramedic
• Explain and demonstrate the treatment of obstetric cases, neonates, and paediatric patients correctly within the SOP of the Paramedic
• Explain and demonstrate the treatment of environmental emergencies within the SOP of the paramedic

Associated Assessment Criteria for Exit Level Outcome 10

• Perform strength tests, cardiorespiratory exercises, flexibility assessments and muscle endurance > tests relevant to the emergency care and rescue environment
• Demonstrate a complete physical fitness assessment applicable to the emergency care rescue environment successfully
• Demonstrate a level of swimming proficiency applicable to the emergency care and rescue environment
• Describe the implications of a healthy lifestyle, diet, and adequate level of exercise in relation to the emergency care and rescue environment correctly
• Describe the risks of a sedentary and physically inactive lifestyle in the context of emergency care and rescue correctly

Associated Assessment Criteria for Exit Level Outcome 11

• Discuss the legislative context and role of rescue in the South African environment
• Demonstrate effective functioning as part of a high-angle team using the appropriate equipment and techniques
• Describe the phases of light motor vehicle rescue correctly
• Demonstrate effective functioning as part of a light motor-vehicle rescue team using the appropriate equipment and techniques
• Discuss the principles of fire dynamics and behaviour
• Demonstrate fire search and rescue techniques using the appropriate equipment and techniques
• Demonstrate effective functioning as part of a fire search and rescue team

Associated Assessment Criteria for Exit Level Outcome 12

• Describe medical legal implications and the importance of accurate record keeping correctly
• Demonstrate that report writing and administration are comprehensive, comprehensible, accurate, relevant, up to date, and compliant with organisational requirements
• Demonstrate language conventions, textual features, and styles of recording are appropriate for specific and workplace purposes
• Demonstrate patient handover to other professionals. / Services are correctly carried out in line with local protocols and procedures
• Records provide accurate details of the patient information, assessment, and treatment

Integrated Assessment

The institution will adhere to qualification and subject policies to assess learners effectively. The goal is to create an interactive learning environment that supports learners in achieving the desired outcomes. Through this approach, learners will demonstrate competence in a practical context, meeting the specific outcomes in the exit-level outcomes and their associated assessment criteria, theoretical knowledge, and critical cross-field outcomes.

Assessment and evaluation during the qualification takes place through a process of continuous evaluation, based on a comprehensive and integrated approach. The criteria for assessing learners are based on the learning outcomes and the strategies that will be used to ensure that all the critical cross-field outcomes are achieved.

Assessment will include formative and summative methods aligned with work-based integrated learning objectives. Various assessment forms will be employed, with an integrated assessment approach that includes cognitive, psychomotor, and affective aspects.

A variety of formative assessment strategies and/or approaches will be used, including but not limited to

• Case presentations
• Assignments
• Clinical simulations
• Workbooks/Portfolio of Evidence (POE)
• Practical demonstrations
• Clinical assessments
• Questioning
• Tests (written and electronically)
• Oral presentations
• Clinical assessments
• Direct observation in simulation and/or controlled work environment
• Physical fitness and swimming assessments
• Journal article reviews.

Work-integrated learning (WIL) is fundamental to the teaching and learning process, seamlessly incorporating workplace relevance into the classroom, simulation laboratory, and on-site workplace training. Learners will spend designated WIL hours in the workplace settings, where they will complete a portfolio of evidence (PoE), and an essential component of the assessment process. Formative assessment of all clinical procedures is conducted to monitor student progress, identify areas needing improvement, and evaluate the standard of their work. Progress is documented in student records through monthly reports from unit managers or clinical mentors to monitor competence, affective skills, and professional characteristics such as honesty, integrity, reliability, and caring.

Summative evaluation may be conducted through

• Portfolio of Evidence/workbooks
• Written and oral examinations
• OSCE
• Clinical examination

To gain examination entry, learners must achieve at least a mark of 50% in continuous theoretical assessments conducted by the educators and at least 70% in clinical assessments. A minimum score of 50% is required to pass the theory examination and 50% for the clinical examination. Quality assurance will adhere to Mediclinic Private Higher Education policies, with marks recorded following institutional protocols. If learners have concerns regarding assessment results, they can address these through established institutional procedures. Educators conduct regular follow-ups with learners in the clinical setting to assess progress and ensure that learners rotate through the various disciplines or areas as outlined in the rotation schedule.