EP Pre-course Workbook Minor Injury- Aug09(Mb)

Emergency Practitioner Minor Injury Workbook

Adult and Paediatric Modules

Mitam Barooah & Liz Bates


Amended August 2009 Page 2

Foreword

To optimise your learning during the two weeks of the course, we have put together this workbook which will benefit you by preparing you for areas expected to be covered in the course. The handbook must be handed in on the first day of the course. All of the information required for preparation for the course and in answering the workbook can be found in anatomy books, journals and on the internet. A list of reading material is provided at the end of the workbook. You will be expected to have understanding of the following and we strongly recommend that you focus your pre-course preparation on these areas:

Your professional responsibility as an independent practitioner Musculoskeletal – anatomy of the upper and lower limbs (including the

knowledge of muscle groups and their function, structures associated with joint structure and movement, ligaments and their role in stability of the joints, vascular and nerve distribution, anatomical structures in the hand)

Wound Care (including principles of wound healing and methods of wound closure)

Issues relating to the paediatric patient (including non-accidental injury and child protection)

Patient Group Directives used in your practice including pharmacokinetics and pharmacodynamics of medications you use regularly.

NICE guidelines for management of Head injury Guidelines for requesting x-rays in your Trust

(Note: Completion of this pre-course workbook will also help you to understand and reflect on issues concerning your development as an emergency practitioner. This will contribute to your NMC portfolio by demonstrating evidence of progression towards a new level of competence)

Name…………………………………………………………………………



1 Why do you want to expand your role to become an Emergency

Practitioner? 2 What concerns do you have about expanding your practice?



3 Who will benefit from your role expansion and why? 4 What qualities do you think are required to achieve success as an

emergency practitioner?



5 As an emergency practitioner, there will be responsibilities and

competencies that will overlap with those of doctors. How do you propose to develop, contribute and integrate within a service that has traditionally been a “doctor’s role”?



6. Label the following structures within the eye.

Give a brief description of the function of each structure:

1.

2.

3.

5

6

4

10

7

8

9



7a. Give a brief definition of the following: Pharmacokinetics First Pass effect (can use a diagram) Bioavailability List factors which may modify drug response List methods of administration for medications (e.g., oral) Give a definition of Pharmacodynamics.



7b. List the PGD’s used regularly within your department.



8. Describe the wounds shown below.

(a)

(b)

(c) Taking into consideration the brief history given with each pictures, answer the following: Would you close the wound? Why? What methods of closure can you use? Mention their advantages and disadvantages. What complications would you look out for?

Wound (a):

Patient is a builder; wound on dominant hand caused by Stanley knife.

Wound (b):

Injury following an assault

Wound (c):

Patient trying to separate dogs fighting, bitten on lower leg



Wound a: Wound b: Wound c:



9. Reviewing the anatomy of the upper and lower limbs will optimise

your learning during the course. Name the anatomical term corresponding to each number in the following eight radiographs.









10. What do you see in the picture? Describe how this may heal.

Outline different methods of immobilisation. Highlight potential complications.



11. How would you describe this X-Ray if you are referring it to a

specialist over the phone?



12 Identify the nerve supply for the following:

The dorsum of the hand, sensory innervation

1. ……………..

2. ……………

3. ……………

The palm of the hand, sensory innervation

1. ……………….

2. ………………

3. ………………



13 List the movements shown in the following sketches along with the

corresponding opposite movement. Shoulder

Knee

Hip



14. Please complete the following table (continue on separate sheet if necessary):

Indications & Contraindications

Mechanism of action Doses: Adults & Children

Methods of administration

Side effects

Pa

rac

eta

mo

l

NS

AID

s

(ib

up

rofe

n/D

iclo

fen

ac

)

Op

iate

s

(Mo

rph

ine

an

d

Co

de

ine

de

riv

ati

ve

s)

Lo

ca

l A

na

es

the

tics

(Lig

no

cain

e/M

erc

ain

)

Te

tan

us

(To

xo

id

an

d

Imm

un

og

lob

ulin

)



15. A driver of a car attends a walk in centre with a history of neck stiffness following a rear-end shunt by another car while he was stationary. Describe the possible injuries likely by this ‘whiplash’ mechanism, concentrating in particular on the anatomical structures around the neck and back.



Recommended Reading Barnes, K. (2003) Paediatrics. A Clinical Guide for Nurse Practitioners.

London. Butterworth Heinemann

Epstein O, Perkin G, DeBono D & Cookson J (2003) Clinical Examination (3rd edition) London, Mosby

Dolan B & Holt L (1999)

Accident and Emergency: Theory into Practice

London, Balliere Tindall

Edwards C, Stillman P (1995)

Minor Illness or Major Disease?

London, The Pharmaceutical Press

Walsh M, Crumbie A & Reveley S (1999) Nurse Practitioners: Clinical Skills and Professional Issues Oxford, Butterworth-Heinemann

Kumar, P. Clark M .(2005) Clinical Medicine. Saunders

Ewles,L & Simnett, I (2003) Promoting Health: A Practical Guide (4th

ed)

London, Belier Tindall

Trounce J & Gould D. (2004)

Clinical Pharmacology for Nurses (17

th ed)

London, Churchill Livingstone

Guly HR (1996) History Taking, Examination and Record Keeping in

Emergency Medicine

Oxford, Oxford University Press.

Boynton R, Dunn E, & Stephens G (2000) Manual of Ambulatory Paediatrics

London, Lippincott, Williams & Wilkins

Walsh, M. (2000) Nursing Frontiers: Accountability and the Boundaries of

Care. London. Butterworth Heinemann.

Prosser S, Worster B, MacGregor J, Dewar K, Runyard

P & Fegan J (2000) Applied Pharmacology

Edinburgh, Mosby

Courtenay M & Butler M (1999) Nurse Prescribing: Principles and Practice

London, Greenwich Medical Media

Ford M & Munro J (2000)

Introduction to Clinical Examination

Edinburgh, Churchill Livingstone

Department of Health & Home (2003) The Victoria Climbie Inquiry. London HMSO

Applegate, E. (2000) The Anatomy and Physiology Learning System (2nd

Ed).

London. Saunders

Drake, R., Wayne Vogly, A., Mitchell, A. (2004) Grays Anatomy for Students. Churchill Livingstone.

Khaw P., Shah P., Elkington, A. (2004) ABC of Eyes 4th

edition. Willey Blackwell.

Ludman H., Bradley P., (2007) ABC of Ear, Nose & Throat ( 5th

edition) BMJ Books

Buxton, P. (2003) ABC of Dermatology. 4th

edition. Willey Blackwell.

Hastings A., Redsell S. (2006) The Good Consultation Guide for Nurses.

Radcliffe Publishing. Oxford.

Documents

EP Pre-course Workbook Minor Injury- Aug09(Mb)