Diploma in Emergency Medical Care

Purpose

The purpose of this qualification is to produce healthcare professionals with the focused knowledge, skills, applied competence, and professional attributes needed to provide quality emergency medical care and rescue services independently to diverse communities in South Africa.

The qualification will allow for career paths, lifelong learning, professional development in the health sciences and related domains, and mobility and progression within emergency care education and training. Learners are eligible to register as paramedics with the Health Professions Council of South Africa to practice within a pre- defined scope with capabilities determined by the Professional Board for Emergency Care.

Rationale

The Diploma in Emergency Medical Care qualification includes professional, vocational, and industry-specific knowledge that provides a sound understanding of general theoretical principles and a combination of general and specific procedures and their application. The Diploma in Emergency Medical Care qualification is an advanced life support qualification in the three-tier Emergency Care Qualification Framework proposed by the National Department of Health in the NECET policy. The qualification, therefore, benefits the emergency care profession as it provides a means for formal qualification and professional registration with the Health Professions Council of South Africa.

The qualification is designed to produce healthcare professionals with the knowledge, skills and professional attributes required for rendering advanced life support emergency medical care and rescue services to diverse communities in South Africa. The qualification is intended for learners who can work independently and make decisions according to their scope and capabilities when the situation requires it. A Diploma in Emergency Medical Care learner will be able to work in various contexts.

This qualification will be particularly useful for

• Learners who wish to enter the emergency care profession.
• Existing Basic Ambulance Assistants.
• Existing Ambulance Emergency Assistants.
• Existing Operational Emergency Care Orderlies.
• Emergency Care Technicians.
• Staff with other allied science qualifications levels.
• School leavers.

Learners in this program will be able to implement effective communication systems within emergency care and rescue services. In addition, they will be able to apply the principles of medical ethics, professional conduct, and the legal framework to their operational context while maintaining their health, physical preparedness, wellness, and safety. Moreover, Diploma in Emergency Medical Care learners will be able to provide advanced life support and basic rescue services that are appropriate and contextually relevant for all community sectors while understanding the role of EMS within the broader health system.

In various settings, including rural, urban, military, coastal, corporate, mass gatherings, homes, and workplaces, holders of this qualification will primarily work in EMS.

The depth and specialisation of knowledge, together with practical skills and experience in the workplace, will enable successful learners to enter several career paths and apply their learning to employment contexts from the outset. Diploma programmes typically include an appropriate experiential learning component.

Recognition of Prior Learning (RPL)

RPL for access

RPL for access is applicable to applicants who do not meet the minimum requirements for the Diploma in Emergency Medical Care qualification but can provide evidence of relevant prior formal, informal, and non-formal learning may access the Diploma in Emergency Medical Care qualification through the Recognition of Prior Learning (RPL) route. Prior learning will be assessed for each RPL applicant against the qualifications' outcomes based on the judgement of the equivalence against learning outcomes. The College will apply the 10% intake RPL clause as determined by the CHE RPL policy, which will also apply to emergency medical services staff. The College RPL policy will govern the RPL process, which will involve the following stages:

• Identifying what the learner knows and can do
• Matching the learners' skills, knowledge and experience to specific standards and the associated assessment criteria of the Diploma in Emergency Medical Care qualification.
• Assessing the learners against those standards.
• Crediting the candidate for skills, knowledge and experience built up through formal, informal and non-formal learning that occurred in the past.
• In the case of non-award RPL credits, the learner may appeal the decision as per the College's Appeals and Grievance policy
• Dedicated qualification academic and administrative staff will serve in the RPL assessors, moderators and RPL facilitator roles to ensure consistency and reliability of the process.
• Each RPL assessment will be internally moderated by an academic staff member other than the RPL assessor, based on the same principles of reliability and validity outlined for formative and summative assessments.
• Final RPL decision will be ratified by the Academic Board.

Entry Requirements

The minimum entry requirement for this qualification is

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

Or

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

Or

• Senior Certificate, NQF Level 4 without endorsement.

This qualification consists of the following compulsory modules at National Qualifications Framework Levels 5 and 6, totalling 368 Credits.

Compulsory Modules, Level 5, 124 Credits

• Foundations of Professional Practice, 12 Credits.
• Mental Health and Wellness, 8 Credits.
• End User Computing, 8 Credits.
• Anatomy and Physiology, 20 Credits.
• Applied Physics, 8 Credits.
• Applied Chemistry, 8 Credits.
• Emergency Medical Care I: Theory, 18 Credits.
• Emergency Medical Care II: Practical, 18 Credits.
• Workplace Clinical Practice I, 24 Credits.

Compulsory Modules, Level 6, 264 Credits

• Emergency Medical Care II: Theory, 22 Credits.
• Emergency Medical Care II: Practical, 22 Credits.
• Workplace Clinical Practice II, 44 Credits.
• Physiology II, 20 Credits.
• Primary Health Care, 12 Credits.
• Medical Rescue, 24 Credits.
• Emergency Medical Care III: Theory, 20 Credits.
• Emergency Medical Care III: Practical, 20 Credits.
• Workplace Clinical Practice III, 60 Credits.

1. Communicate and engage ethically, legally, and professionally with colleagues and other stakeholders.
2. Articulate an understanding of the South African Health Care System, including the role and placement of emergency services within the larger health sector.
3. Understand the significance of mental health and wellness, including the recognition and management of stress and burnout in oneself and others.
4. Utilise paramedic-relevant knowledge and understanding of human anatomy.
5. Apply knowledge of relevant physiology and bio-processes to paramedic practice.
6. Maintain, inspect, and utilise the equipment and resources required for providing emergency care and rescue.
7. Demonstrate clinical assessment and diagnostic expertise.
8. Conduct emergency medical rescue in specific contexts.
9. Provide support and assistance for specialized transport patients.

Associated Assessment criteria for Exit Level Outcome 1

• Communication with patients, colleagues, and other services is efficient, transparent, direct, and accurate, with suitable use of media and vocabulary that is consistent with professional practice.
• Discuss comments or responses during discussions, demonstrate a mature understanding of the subjects in one-on-one and group settings.
• Clarify and expand through discussions, one's understanding and opportunities for clarification of one another's understanding are presented.
• Mutual respect, cooperation, accountability, rapport, and good communication characterize professional relationships.
• Correctly apply in all settings, the ethical principles of beneficence, autonomy, fairness, truth-telling, promise-keeping, and confidentiality.
• Hold confidentiality in accordance with medical ethical principles. Justify and handle when legal authority supersedes the concept of confidentiality, the obligation to overcome it is appropriately in accordance with accepted regulations.
• Correctly explain the legal framework under which an emergency care provider and/or practitioner operates.

Associated Assessment Criteria for Exit Level Outcome 2

• Accurately describe and discuss the National Department of Health's role, function, goals, strategies, and associated challenges.
• Correctly describe within the South African context, the EMS in terms of structure, funding, role, and function, both public and private.
• Correctly identify and explain the interdependence and interrelationships that exist between EMS and other Allied Health Care structures.
• Correctly identify and explain representatives of the health care team in terms of their key roles and responsibilities, as well as their interrelatedness.

Associated Assessment Criteria for Exit Level Outcome 3

• Correctly explain the importance of mental wellness for emergency care providers by emphasising its role and importance, with special emphasis on the impact on job effectiveness.
• Correctly describe strategies for identifying and managing one's own stress and stressful situations.
• Identify and explain processes for dealing with difficulties that may have an impact on mental wellness in accordance with the appropriate guidelines.
• Correctly identify potential problems in the emergency service environment in terms of their sources, impact, and mechanisms for preventing or mitigating their adverse impact.

Associated Assessment Criteria for Exit Level Outcome 4

• Describe the thorax accurately in terms of its composition, overall shape, spatial orientation, structures, and cavities.
• Provide correct explanations of normal abdominal anatomy and the capacity to integrate surface topographical and clinical anatomy of the abdomen into patient assessment and care.
• Accurately describe the pelvis in terms of its structure and contents, with a focus on gender.
• Describe the structures of the lower extremities accurately in terms of their composition and relative location.
• Describe the structures of the upper extremities and back accurately in terms of their composition and relative location.
• Accurately describe the composition and relative location of the head and neck structures
• Explain the anatomical distinctions between adults and children, and neonates accurately and in accordance with prevalent theories.
• Accurately describe, according to predominant views, the explanations for the anatomical adaptations to pregnancy.

Associated Assessment Criteria for Exit Level Outcome 5

• Appropriately define the body's organisation in terms of cellular physiology, tissue physiology, main systems, homeostasis, and feedback.
• Appropriately explain the physiology of the human body in terms of support and mobility principles.
• Accurately explain the neural and endocrine systems as the body's control systems.
• Accurately describe the functioning of the special senses.
• Accurately describe the functioning of the following systems:
• Nervous system.
• Cardiovascular system.
• Lymphatic system and immunity.
• Respiratory system.
• Digestive system.
• Reproductive system.
• Integumentary system.
• Musculoskeletal system.
• Urinary system.
• Appropriately explain fluid, electrolyte, and acid-base dynamics in terms of their influence on human physiology.
• Appropriately teach and apply the fundamental concepts of microbiology to emergency medical care settings in general, with special emphasis on communicable diseases and infection control.
• Accurately describe the physiological distinctions between adults and children in accordance with current concepts.
• Accurately describe the physiological adaptations to pregnancy in accordance with current notions.

Associated Assessment Criteria for E xit Level Outcome 6

• Within the emergency care context, accurately identify emergency vehicles based on specific responsibilities.
• Ergonomically design and keep the emergency vehicle in a constant state of preparedness. Use local operating procedures to identify and report vehicle faults.
• Test regularly and keep clean, disinfect, and readily access emergency equipment in accordance with local norms. Perform troubleshooting of equipment failure and necessary steps to rectify detected problems in accordance with local regulations.
• Appropriately recognise and describe emergency equipment in terms of indications, contraindications, precautions, complications, usage, and, if required, assembly.
• Drive emergency vehicles with proper regard for other road users and in accordance with the Road Traffic Act and current road conditions. Manage the vehicle under operating norms, with appropriate use of warning devices, and with proper regard and safety for other road users.
• Discuss the proper methods for registering, modifying, and branding emergency service vehicles in accordance with the legislation.
• Explain the applicable legislation in terms of emergency vehicles responding to emergencies and transporting patients or pressurized cylinders.
• Accomplish navigation efficiently by utilising appropriate navigational equipment.
• Involve protocols to be followed if a vehicle is in an accident and/or demonstrated in accordance with applicable regulations.
• Utilise communication equipment in accordance with defined protocols to facilitate successful communication.
• Examine a range of communication devices to discover their core components, operating principles, benefits, and shortcomings.
• Outline and explain the purposes, storage, maintenance, and usage of emergency care equipment related to the treatment of ill or injured patients.

Associated Assessment Criteria for Exit Level Outcome 7

• Accurately examine patients in a pre-hospital emergency environment, in accordance with a paramedic scope of practice.
• Perform the assessment professionally and consistently, considering the principles of gathering information on medical history.
• Perform within the paramedic scope of practice, assessments in line with accepted clinical guidelines for physical examination.
• Clinical evaluations successfully detect potential life-threatening symptoms or conditions.

Associated Assessment Criteria for Exit Level Outcome 8

• Explain and demonstrate the effective communication and practical functioning components of a one-person rope access system.
• Carry out single-person High Angle Rescue access operations appropriately utilizing rope rescue techniques and equipment relevant to the scenario.
• Present the science of fire behaviour in terms of how it affects rescues and how safety standards are used in a fire and/or poor visibility setting.
• Utilise personal protective equipment appropriately in accordance with established operating procedures.
• Present and demonstrate fire extinguishing methods.
• Appropriately recognise and characterise hazardous materials and circumstances in terms of their potential impact and measures to avoid or reduce their negative impact.
• Utilise in accordance with established operating procedures, self-contained breathing apparatus appropriately.
• Plan and validate search and rescue operations following the procedures to increase the chances for the safe rescue of patients from a fire or low-visibility area.
• Detail all automobile accidents, stabilization strategies, and extrication concepts in accordance with the relevant scientific principles.
• Describe the structural and damage characteristics of several types of motor vehicles.
• Stabilise vehicles in varied situations in accordance with predetermined methods.
• Construct in accordance with normal operating protocols, safety zones employing scene security barriers, patient protection, and personal protective equipment.
• Use appropriate instruments and procedures to rescue an entrapped patient, and to establish access and escape apertures.
• Follow standard procedures to stabilise, remove, and package entrapped people.
• Accurately explain and present multi-casualty rescue and emergency scenes in accordance with established processes.

Associated Assessment Criteria for Exit Level Outcome 9

• Appropriately categorise patients, and request backup for those who are critically ill or unstable.
• Accurately gather the patient's medical history and perform the handover from a referring health professional in accordance with organizational protocols. This comprises a routine patient assessment and the recording of vital signs.
• Appropriately prepare the patient for transfer, considering the type of transport.
• Clearly identify standard transport equipment in terms of its intended purpose, appropriate application, and fundamental operation.
• Perform transfers from hospital beds to stretchers correctly, utilising suitable ergonomic processes and techniques.
• Supply accurate descriptions of the significance, role, or function of pre-hospital and interfacility patient transfer.
• Maintain the patients' hydration and nutritional condition in accordance with the established criteria.
• Maintain ventilation and temperature regulation in accordance with the patient's needs.
• Accurately calculate the fuel consumption of the vehicle, as well as its oxygen and fluid consumption, to guarantee that they are sufficient for the length of the transfer.
• Adhere during the transfer period, the basic nursing procedures of rotating, cleaning, draining the catheter bag, and preventing pressure ulcers appropriately.
• Use effective teamwork, clear communication, careful adherence to instructions, and efficient completion of assigned duties to assist emergency care practitioners.
• Perform transfer of patients to the receiving institution, filing, and record keeping in accordance with organisational processes and standards.
• Accurately describe the aviation atmosphere in terms of atmospheric science. Flight stresses in terms of their sources, effects, and treatments.
• Properly identify aero-medical environment influences in terms of their impact on equipment and procedures.
• The description of aero-medical transportation considerations is accurate.
• Properly explain pilot spatial disorientation in terms of causes, effects, preventative strategies, and corrective measures.
• Accurately specify general characteristics, aircraft safety and landing zone requirements, basic survival, main and secondary concerns, emergency procedures, and patient loading and unloading for aero-medical aircraft types.
• Accurately specify and implement the procedures for the air evacuation of patients in accordance with the principles and criteria for aviation evacuation.

INTEGRATED ASSESSMENT

In addition to the purpose of the Diploma in Emergency Medical Care qualification, the College assessment strategy is aligned with the exit level outcomes, teaching and learning activities, content, and assessment tasks of the qualification. As part of the College assessment strategy, assessments serve to measure learners' progress within the qualification and to gather evidence of learners' performance against the exit level outcomes of the Diploma in Emergency Medical Care. Each subject of the qualification comprises a minimum of three formative assessments and one summative assessment. Formative assessment makes up 50% of the total subject mark. Summative assessment contributes the remaining 50% of the subject mark. The exception to this assessment strategy is the emergency medical care practicals, workplace clinical practice, and medical rescue subject, which are based on continuous assessment due to their practical nature.

To determine learners' applied competence, the College uses the following forms of assessment

• Written assessments as part of formative and summative assessments, assignments, and tutorials. These assessments will be marked using a marking memo and, in some instances, an assessment rubric guide. These assessments contribute to the total mark for the subject.
• Patient simulations will be utilized in assessments that mimic real-life or emergency care scenarios. These simulations allow for assessment of applied competence in the safety of a clinical laboratory without the risk to a real patient.
• Practical exercises, such as the Objective Specific Clinical Examination (OSCE), to demonstrate specific paramedic skills, a combination of skills, or the use of equipment.
• Logbooks will be used to assess learners' progress and achievements and will include clear instructions for use and give guidance on how essential information is to be recorded for workplace clinical practice, to monitor and check activities, record processes, record achievement of clinical skills, and exposure to various clinical settings
• Portfolios will include a collection of different types of evidence relating to workplace learning and assessment. It will include a variety of clinical case reflections. The evidence in the portfolio must meet the requirements of the learner outcomes.
• Case studies are often presented in the form of a paragraph or text to analyze occurrences, the purpose of analyzing occurrences, drawing conclusions, and reporting on recommended courses of action to improve emergency care treatment or education.
• Assignments will be used as a formative assessment in theory subjects to develop learner academic writing skills, problem-solving skills, and knowledge access and processing. Learners will be given the opportunity to receive feedback on draft assignments before final submission for marking. Assignments as a form of an assessment will also be used in the workplace clinical practice part of the curriculum, to develop and promote reflection on practice from real-life patient cases, thus promoting learning from experience and nurturing reflective paramedic practitioners.
• Role plays will be used for formative assessment of behavioural and communication outcomes, to provide learners with immediate feedback on their progress towards the professional attributes of the qualification. These forms of assessments will not carry a weighting towards a final mark.
• Learners will be conducting peer assessment as part of the emergency medical care practicals in the College clinical laboratory. This assessment involves a checklist of specific steps to perform a clinical skill or to demonstrate correct use of clinical equipment. Learners will have to complete a pre-determined number of peer assessments before they can be assessed by the subject lecturer for competence.