EMERGENCY MEDICAL SERVICES NC II – TESDA COURSE MODULE

TESDA TRAINING REGULATIONS FOR EMERGENCY MEDICAL SERVICES NC II COURSE

The TESDA Course in EMERGENCY MEDICAL SERVICES NC II consists of competencies that a person must achieve to perform cardiopulmonary resuscitation with automated external defibrillation operation, maintain life support equipment and resources, implement safe access and extrication procedures in an emergency, contribute in receiving request for ambulance service, contribute in allocating ambulance service resources, contribute in coordinating emergency resources, deliver basic ambulance communication skills, contribute in on – road operations, contribute to emergency scene management, contribute to special event scene management, contribute to routine scene management, deliver pre- hospital patient care, contribute to ambulance operations management, transport emergency patients, transport non- emergency patients and drive ambulance under operational conditions.

A person who has achieved this Qualification is only competent to be the following and NOT as an Emergency Medical Technician (EMT):

• First-Aider
• Medical First Responder
• Ambulance Care Assistant

TRAINEE ENTRY REQUIREMENTS

Trainees or students wishing to enroll in these course qualifications should possess the following requirements:

• Must have completed at least ten (10) years of Basic Education or Alternative Learning System (ALS) Grade 10 Certificate of Rating Holder
• Must be a holder of LTO student permit to drive a motor vehicle
• Can communicate effectively both orally and in written form
• Physically, emotionally and mentally fit as assessed and certified by any Licensed
  Philippine Physician

This list does not include specific institutional requirements such as educational attainment, appropriate work experience, and others that may be required of the trainees by the school or training center delivering this TVET program.

EMERGENCY MEDICAL SERVICES NC II – TRAINING AND REGULATION MODULE

Course Title: EMERGENCY MEDICAL SERVICES
Level: NC II
Nominal Training Duration : 280 hours

This course is designed to enhance the knowledge, skills and attitude of EMERGENCY MEDICAL SERVICES NC II in accordance with industry standards. This course covers the basic, common and core competencies in perform basic life support, maintain life support equipment and resources, implement safe access and extrication procedures in an emergency, contribute in receiving request for ambulance service, contribute in allocating ambulance service resources, contribute in coordinating emergency resources, deliver basic ambulance communication skills, contribute in on – road operations, contribute in emergency scene management, contribute in a special event scene management, contribute in routine scene management, deliver pre- hospital patient care, contribute in ambulance operations management, transport emergency patients and transport non- emergency patients and drive ambulance under operational condition.

COMPETENCIES REQUIRED IN EMERGENCY MEDICAL SERVICES NC II

This units of competency comprising this qualification include Basic, Common, and Core Competencies.

To obtain this TESDA course in EMERGENCY MEDICAL SERVICES NC II, all units prescribed for this qualification must be achieved.

These units of competency comprising this qualification include the following:

UNIT CODE	CORE COMPETENCIES (280 Hours)
HCS322317	Perform Cardiopulmonary Resuscitation with AED Operation
HCS322302	Maintain life support equipment and resources
HCS322303	Implement safe access and extrication procedures in an emergency
HCS322318	Contribute in receiving request for ambulance service
HCS322319	Contribute in allocating ambulance service resources
HCS322320	Contribute in coordinating emergency resources
HCS322307	Deliver basic ambulance communication skills
HCS322321	Contribute in on- road operations
HCS322322	Contribute to emergency scene management
HCS322323	Contribute to special event scene management
HCS322324	Contribute to routine scene management
HCS322325	Deliver pre- hospital patient care
HCS322326	Contribute to ambulance operations management
HCS322327	Transport emergency patients
HCS322328	Transport non- emergency patients
HCS322316	Drive ambulance under operational conditions
UNIT CODE	COMMON COMPETENCIES (18 Hours)
HCS323201	Implement and monitor infection control policies and procedures
HCS323202	Respond effectively to difficult/challenging behavior
HCS323203	Apply basic first aid
HCS323204	Maintain high standard of patient services
UNIT CODE	BASIC COMPETENCIES (18 Hours)
500311105	Participate in workplace communication
500311106	Work in a team environment
500311107	Practice career professionalism
500311108	Practice occupational health and safety procedures

This section gives the details and contents of the units of competency required in EMERGENCY MEDICAL SERVICES NC II. These units of competency are categorized into basic, common and core competencies.

CORE COMPETENCIES

This section gives the details of the contents of the core units of competency required in EMERGENCY MEDICAL SERVICES NC II.

UNIT OF COMPETENCY : PERFORM CARDIO PULMONARY RESUSCITATION (CPR) WITH AUTOMATED EXTERNAL DEFIBRILLATOR (AED) OPERATION
UNIT CODE : HCS322317

This unit of competency deals with reviving the heart and lungs by performing cardiopulmonary resuscitation (CPR) with automated external defibrillator (AED).

1. Assess the situation
   • Physical hazards are identified and minimized according to safety requirements and workplace procedures.
   • Risks to ambulance care assistants and others are assessed and appropriate response determined to ensure prompt control of situation.
   • Need for emergency services/medical assistance is ascertained and prioritized and triage undertaken where required.
   • Resources are deployed to appropriate locations as required in accordance with workplace procedure.
2. Contribute in the management of casualty/ies
   • Agreement for management of the casualty’s injury/illness is sought from person(s) where relevant.
   • Welfare procedure is determined and implemented according to casualty/ies needs.
   • Effects of injury are controlled and effective CPR and AED operation is determined and applied to meet the needs of the casualty
   • Casualty/ies level of consciousness, circulation, airway and breathing are monitored and responded to in a timely manner in accordance with effective pre-hospital care
   • Automated External Defibrillator(AED)is correctly operated in accordance with manufacturer’s/supplier’s instructions.
   • Recovery position is also determined and applied to meet the need of the patient
   • Management is finalized according to casualty/ies needs
3. Manage ambulance and personnel resources
   • Available resources required are identified and communication links with appropriate personnel, emergency management services and medical assistance are established as appropriate.
   • Emergency management service and medical assistance are established as appropriate
   • Correct amount of resources are deployed to appropriate locations in an effective manner to ensure timely arrival of required resources.
   • The provision of resources is documented and modifications recommended.
   • Evacuation of casualties is coordinated according to worksite evacuation procedures.
   • Support services are arranged for personnel involved in the incident in accordance with workplace principles and procedures.
4. Communicate essential incident details
   • Communication is maintained with relevant personnel using appropriate media and equipment.
   • Patient care information is communicated with other providers/careers as appropriate to meet their needs and in accordance with workplace procedures.
   • Information is calmly provided to reassure casualty, adopting a communication style to match the casualty’s level of consciousness.
5. Manage casualty in a remote and/or isolated area
   • Preparation for isolated travel or work is undertaken, accounting for expected contingencies.
   • Casualty’s condition is assessed and appropriate response is determined in order to minimize hazards and determine need for medical assistance.
   • Casualty’s condition is monitored and responded to in accordance with effective CPR and AED Operation
   • Reassurance and support is provided to the casualty.
   • Casualty’s comfort is ensured and determined by establishing and explaining the nature of the illness/injury and the management procedures.
   • Shelter from elements is undertaken in accordance with environmental conditions.
   • Condition of casualty is documented over time to assist in ongoing management.
   • Communication links to medical services are established to ensure prompt control action is undertaken.
   • Decision whether to transport casualty to medical assistance or wait is made by evaluating environmental and casualty’s condition.
   • Assistance in the evacuation of the casualty by emergency services is provided as required.
6. Evaluate the incident
   • Management of the incident is evaluated and where required an action plan is developed in consultation with relevant parties.
   • Participation in debriefing/evaluation occurs either by self or others or both in order to improve future operations and address individual’s needs.
   • Access is provided to bona fide critical stress facilitators where required/requested.
   • Site management/procedures are implemented and evaluated in accordance with risk assessment.

UNIT OF COMPETENCY : MAINTAIN LIFE SUPPORT EQUIPMENT AND RESOURCES
UNIT CODE : HCS322302

This unit of competency deals with the responsibilities in ensuring that adequate supplies of ambulance equipment and resources and records are maintained. He may or may not necessarily be responsible for the ordering and purchasing of equipment and resources, depending on the workplace organizational structure.

1. Ambulance resources May include:
   Non-consumables:
   • Machines (e.g. AED, Suction machine, etc.)
   • Books
   • Reference materials including MSDSS, ECC, OHSA, PhilHealth
   • Legislative regulations
   • Communication systems
   •  Relevant texts
   • Equipment (e.g. Trolley Cot, Scoop Stretchers, etc.)
     Consumables:
   • Emergency kits (bandages, tape, scissors, splinter removers, antiseptic, eye management, disinfectants, emergency numbers and contacts, etc.)
   • Dressings
   • Cold packs
   • Splints
   • Sharps disposal
   • Bio-hazardous waste
   • Bandages
   • Personal protective equipment
   • Disinfectants
   • Cervical collars
   • Supplemental oxygen device (e.g. nasal cannula, face mask, non-rebreather mask, etc.)
   • Intubation and Intravenous set (for the physician’s use only)
2. Legislation May include:
   • OSHA legislation
   • Regulations and codes of practice
   • Industrial relations legislation
3. Codes of practice May include:
   • Industry codes
   • Industry standards
   • Company procedures
   • National and local health and safety authorities
4. Relevant forms May include:
   • Incident/injury forms
   • Casualty history forms
   • Disease notification
   • ECC forms
   • PhilHealth membership
   • Workers’ compensation
   • Log book
   • Pre-participation records (sport)
   • Medical histories
   • Management records
   • Stock records
   • Infection control records 4.13 Training records
5. Policies and procedures may be from organizations such as May include:
   • Company Standard Operating Procedures
   • Others

UNIT OF COMPETENCY : IMPLEMENT SAFE ACCESS AND EXTRICATION PROCEDURES IN AN EMERGENCY
UNIT CODE : HCS322303

This unit of competency involves implementing procedures to enable safe access to a victim/patient at the scene of a life-threatening incident and then safely removing the victim/patient from the scene.

1. Assess emergency situation in relation to safe access and extrication
   • Information relevant to the situation is obtained on or before arrival.
   • Situation is viewed to identify and mitigate dangers according to standard local ambulance procedure.
   • Condition of victim/patient is assessed.
   • Obstacles impacting on safe access and extrication are accurately identified.
   • Access and extrication plan is formulated based on an assessment of all factors associated with the situation or incident in line with national emergency management arrangements.
   • Access and extrication plan is formulated and prioritized based on the main concerns of victim/patient welfare and safety of all personnel.
   • Equipment and personnel needs are assessed based on an assessment of all factors associated with the situation or incident.
   • Equipment and personnel needs are assessed based on victim/patient and personnel welfare as the prime concern.
2. Implement procedure to enable safe access and extrication
   • Additional personnel and equipment are requested or arranged as the need dictates.
   • Access/extrication plan is implemented using equipment and personnel necessary to ensure safe access/extrication and victim/patient welfare.
   • Means of safe access and extrication negotiated and maintained according to national OSH standards, as well as service policies and procedures.
   • Actions are in accordance with local ambulance standard operation procedures.
   • Available resources are utilized as necessary.
   • Must be familiar with the use of carry chairs.
3. Monitor access and extrication procedure in an emergency situation
   • Safety of victim/patient and personnel is of prime concern.
   • Progress of access/extrication is monitored constantly to ensure welfare of the victim/patient and safety of personnel.
   • Victim/Patient is monitored constantly to detect any change in condition.
   • All conditions and factors impacting on safe access/extrication and victim/patient welfare are monitored constantly.
   • Access/extrication plan is modified as necessary to ensure safety and the welfare of the victim/patient.

UNIT OF COMPETENCY : CONTRIBUTE IN RECEIVING REQUEST FOR AMBULANCE SERVICE
UNIT CODE : HCS322318

This unit of competency involves contributing in receiving requests for ambulance services, and transferring the call for action.

1. Receive request for service
   • Incoming requests for service are answered promptly in accordance with local ambulance standard operating procedure.
   • Details of the situation are established using effective communication skills, techniques and resources, in accordance with local ambulance standard operating procedure.
   • Complete details of the request are accurately recorded in a timely and efficient manner and in accordance with local ambulance standard operating procedure.
   • The request is dealt with in a professional manner at all times.
2. Respond to request for service
   • Urgency of the request is determined using information gained from the person requesting the service.
   • The person requesting the service is provided with advice.
   • A suitable response is formulated and initiated using a prioritizing tool in accordance with local ambulance standard operating procedure.
3. Refer request
   • Any need to refer the request for service is identified and acted upon.
   • Request referred in line with the situation presented and in accordance with local ambulance standard operating procedure.
4. Finalize request
   • Call terminated in accordance with local ambulance standard operating procedure.
   • Follow-up action taken as necessary and in accordance with the needs of the situation, and local ambulance standard operating procedure.

UNIT OF COMPETENCY : CONTRIBUTE IN ALLOCATING AMBULANCE SERVICE RESOURCES
UNIT CODE : HCS322319

This unit of competency involves contributing in allocating resources to ensure effective ambulance service.

1. Allocate ambulance service resources
   • Requests for service are prioritized in accordance with local ambulance standard operation procedure.
   • Available resources are assessed in accordance with local ambulance standard operation procedure.
   • Resources are allocated to emergency, non-emergency and special requests in accordance with local ambulance standard operation procedure.
2. Dispatch ambulance service resources
   • Situation briefing to assigned personnel is adequate, clear, timely and accurate.
   • Communication is recorded according to local ambulance standard operation procedure.
   • Ambulance resources are dispatched within timeframes set by the Ambulance Service and in accordance with local ambulance standard operation procedure.
3. Monitor progress of assigned personnel
   • Assigned personnel arrival at scene of incident/situation is confirmed according to co-ordination procedures.
   • Assigned personnel capacity to deal with the situation/incident is established at earliest opportunity.
   • Need for additional resources is identified and arranged as needed.
   • Arrival at receiving facility is arranged and monitored.
   • Personnel and ambulance availability for re-assignment is noted according to local ambulance standard operation procedure.
   • Notify peer support/critical incident stress debriefing (CISD) team.
4. Maintain records of ambulance service co-ordination activity
   • Records of ambulance and personnel are maintained according to local ambulance standard operation procedure.
   • Records of supplementary resources are summoned and maintained according to local ambulance standard operation procedure

UNIT OF COMPETENCY : CONTRIBUTE IN COORDINATING EMERGENCY RESOURCES
UNIT CODE : HCS322320

This unit of competency involves contributing in coordinating service resources to ensure availability of vehicles, materials, equipment and personnel.

1. Coordinate ambulance and personnel resources
   • Resource allocation is undertaken in accordance with local ambulance standard operating procedure.
   • Known factors that may impact on service demand are monitored at all times.
   • Ambulance service resources locations and commitments are known at all times.
2. Liaise with ambulance communications personnel
   •  Personnel are given clear information at all times.
   • Factors affecting resource availability are communicated to personnel.
   • Factors affecting resource availability are sought from other ambulance communications personnel.
   • Information is documented according to local ambulance standard operating procedure.
   • “On scene” communication chain of command is implemented.
3. Liaise with other related organizations and emergency services
   • The need for involvement of other service is identified in a timely manner.
   • Other service involvement is determined in line with the case need.
   • Other service is contacted, adequately briefed, and appropriate assistance requested.

UNIT OF COMPETENCY : DELIVER BASIC AMBULANCE COMMUNICATION SKILLS
UNIT CODE : HCS322307

This unit of competency covers the skills required to exercise effective communication skills in work relating to ambulance operations.

1. Exercise effective communication techniques
   • Verbal and non-verbal communication is used constructively to achieve planned work outcomes.
   • All forms of communication with clients and colleagues reflect an understanding and respect for individual differences and needs.
   • Self-introduction occurs appropriately when required.
   • Interviewing and active listening techniques are used where needed to identify and confirm work requirements.
   • Communication is clear and relevant to situation, context and activities undertaken.
   • Touch and other non-verbal means of communication are used prudently, carefully and only as appropriate.
   • Advice about communication difficulties with clients or colleagues is sought and obtained from supervisor/appropriate person and implemented as required.
   •  Advice and assistance is sought from legitimate sources as and when appropriate to maintain and develop effective communication skills.
   • Own style is adjusted to incorporate advice that addresses performance issues to maintain the agreed standard of effective communication.
2. Convey and receive information using available modes of communication
   • Communication codes and equipment are used correctly.
   • Information received is acknowledged and/or clarified using active listening.
3. Follow routine instructions
   • Workplace instructions are interpreted correctly and carried out within agreed time frames.
   • Clarification of work instructions is sought when required to ensure understanding.
   • Difficulties in carrying out instructions are referred to supervisor or appropriate person to ensure required work outcomes.
4. Communicate with patients
   • Rapport is established through open, sensitive and confident manner.
   • Patient (or agent of patient) is informed about patient care procedures in a manner, and at a time consistent with the overall needs of the patient and situation as a whole.
   • Information is obtained from patient or others showing the firmness, sensitivity and respect for confidentiality demanded by the situation.
   • Interaction recognizes and respects religious, social and cultural differences between individuals that may require special communication skills or patient care procedures.
5. Complete reports as required
   • Reports are completed as required to the standard expected in the workplace.
   • Reports are completed correctly within identified time frames.
   • Reports are clear and accurate.
6. Present a positive image of the service to the public
   • Communication with the public is conducted in a courteous manner and respecting privacy.
   • Standards of personal presentation are appropriate to the organization.

UNIT OF COMPETENCY : CONTRIBUTE IN ON-ROAD OPERATIONS
UNIT CODE : HCS322321

This unit of competency involves day-to-day management of ambulance in on-road operations, excluding patient care.

1. Contribute in relaying communication
   • Communication techniques and procedures are managed to ensure they are consistent with implementing rules and regulations, laws, ordinances, service policies and procedures.
   • Communication with control centre is managed to ensure that it is established and maintained.
   • Notification of receiving facility is managed to ensure that local policies and procedures are adhered to.
2. Oversee ambulance and equipment preparation, maintenance and cleaning
   • Ambulance and equipment are maintained in a clean and serviceable condition according to legal/industrial requirements and service policy and procedures.
   •  Ambulance operating stock is maintained to acceptable minimum and maximum levels.
3. Contribute in the transport of patients
   • Transportation of patients is managed to ensure they are transported safely and smoothly to avoid further damage or injury.
     3.2 Driving is well controlled to ensure hazards are recognized and negotiated safely.
     3.3 Driving of ambulance is managed to ensure that legal and industrial requirements governing emergency vehicles are adhered to.
   • Safe driving is provided to ensure route is chosen appropriately according to distance, time constraints, travel and terrain.
   • Safe driving is provided to ensure that road map is read accurately and quickly, as required.
   • Communication between driver and patient care officer is managed to ensure safe transport and effective patient care.
4. Contribute in scene management
   • Safety of scene is ensured in accordance with legal, industrial and service guidelines.
   • Control of hazards is ensured in accordance with requirements to protect welfare of patients and personnel.
   • Application of resources is in accordance with requirements of the scene, service policies and procedures and relevant legal and industrial requirements.
   • Ensure communication with allied services contributes to safety and well-being of patients and ambulance personnel.

UNIT OF COMPETENCY : CONTRIBUTE TO EMERGENCY SCENE MANAGEMENT
UNIT CODE : HCS322322

This unit of competency involves management of procedures involving victim/patient care at the scene of an emergency.

1. Contribute in identifying real and potential hazards in the environment
   • Information is gathered to allow accurate assessment of the situation or incident.
   • Hazards (existing and potential) are accurately identified.
   • The approach to an incident is accurately accessed, looking for visible signs of danger.
   • Appropriate resources are positioned to facilitate safe/timely ambulance access and extrication.
2. Communicate with those involved in the incident
   • Information about the incident or scenarios communicated to coordinator in accordance with service policies.
   •  Information is communicated to people involved in the incident in accordance with service policies.
3. Control hazards/scene safety
   • Existing and potential hazards to the safety and welfare of patients and others are mitigated or avoided/negated.
   • Personal protective clothing and equipment is worn/used as necessary.
   • Infection control procedures are implemented when necessary.
   • Resistive and/or combative patients are managed appropriately.
   • Security of the scene for ambulance personnel is ensured by the ambulance/medical command in consultation with incident commander.
   • Resources are made available, utilized appropriately, and replenished as needed.
4. Communicate with medical and other emergency and allied services with EMT’s supervision to ensure safety at scene
   • Apply the standard operating procedures for communication and coordination with medical services and allied services.
   • Communicate necessary information for allied services thru channels (Chain of Command).
5. Monitor the environment
   • The environment is monitored to identify changes that may compromise safety or victim/patient care.
   • Environmental changes requiring further control are quickly recognized and communicated to appropriate agencies.

UNIT OF COMPETENCY : CONTRIBUTE TO SPECIAL EVENT SCENE MANAGEMENT
UNIT CODE : HCS322323

This unit of competency involves attending the scene of sporting or special events involving large numbers of people or special risks, and ensuring safety at the scene.

1. Attend mass gathering events
   • Planning stage of any event is participated and attended in accordance with mass gathering guidelines stated in World Health Organization (WHO).
   • Scene of event is assessed using all available information and first hand observation.
   • Hazards (existing and potential) and the level of risk and accurately identified utilizing current emergency risk management process.
   • Emergency management plan is developed, or existing emergency management plan is implemented in consultation with event organizers.
   • Ambulance Staging is developed and implemented to underpin ambulance operations and their role within the emergency management plan.
   • Ambulance resources are deployed in accordance with the unified management plan.
   • Ambulance resources are positioned to facilitate access and egress.
   • Lines of communication are established and maintained in accordance with the management plan and Service policies and procedures.
2. Ensure safety at the scene
   • Ambulance is positioned strategically: a) to ensure safety for vehicle, crew, patient, equipment, b) allow accessibility.
   • The Personnel are properly identified and personal protective clothing and equipment is worn as required
   • Security of the scene for Emergency Medical Services (EMS) is ensured by the Medical Commander in consultation with the event Incident Commander or Security Commander.
   • Coordinate with Allied Services regarding mitigation of specific hazards to enable patient treatment in hazard-free environment in line with standard ambulance staging procedures in accordance with established standards.
   • Actions are in accordance with current and existing established standard.

UNIT OF COMPETENCY : CONTRIBUTE TO NON-EMERGERGENCY ROUTINE SCENE MANAGEMENT
UNIT CODE : HCS322324

This unit of competency involves the routine management of a non-emergency situation to ensure safety at the scene.

1. Attend to nonemergency event
   • Ambulance is positioned to facilitate access and departure while keeping safe all personnel and the vehicle.
   • Hazards, real or potential, are identified where there are risks to participants or bystanders.
   • Lines of communication with others are identified and maintained according to service policy and procedures.
   • Correct communication procedures are observed in accordance with service policy and procedures.
2. Take appropriate measures to ensure safety at the scene
   • Ambulance is positioned to protect self, team and patient(s).
   • Personal protective clothing is worn in accordance with operating procedures.
   • Ambulance resources are utilized and improvised to secure the scene.
   • Appropriate roles are undertaken as prescribed by Acts, regulations, service policy and procedure.
   • Risk is minimized by enlisting hazard reduction agents to enable provision of treatment in hazard-free or hazard reduced environment.
   • Action is in accordance with current and existing established standard.

UNIT OF COMPETENCY : DELIVER PRE- HOSPITAL PATIENT CARE
UNIT CODE : HCS322325

This unit of competency involves assessing basic patient needs, planning the procedure(s) to be implemented, implementing procedure(s) and monitoring the state of the patient at the level of basic patient care.

1. Contribute in making initial patient assessment
   • Pre-planning is conducted before arrival at scene based on information communicated in request for service.
   • Scene survey is conducted according to local ambulance standard operating procedure.
   • Primary survey is conducted according to local ambulance standard operating procedure.
   • Vital signs are checked and monitored in accordance with local ambulance standard operating procedure.
   • History of the event is obtained following established procedures.
   • Transport requirements and appropriate destination are assessed, considering patient’s condition and the type of resources needed to ensure that requirements of urgency and patient care are met.
2. Contribute in implementing patient care procedures as the situation presents itself
   • Assist the EMTs in patient care procedures which are commenced as patient’s present condition determines, with reference to local clinical guidelines.
   • Must be familiar with all the supplies and equipment in the ambulance.
   • Where the situation or patient’s condition requires treatment that is outside the scope or authority to practice of the attending officer, the need for assistance is recognized and sought immediately.
   • Ambulance equipment utilized in patient management is correctly operated according to manufacturer/supplier’s instructions and local clinical guidelines.
   • Patient care techniques are implemented in accordance with infection control procedures and techniques.
   • Practice safe lifting and patient handling techniques in accordance with established existing International Labor Organization and local EMS policies and procedures.
3. • Patient and his/her presenting conditions are re-assessed at appropriate intervals as required according to local ambulance standard operating procedure.
   • Assist the EMTs in monitoring pulse Oximeter (SPO2)
4. Endorse patients requiring basic care
   • Relevant patient details are documented according to local ambulance standard operating procedure.
   • Patient confidentiality is maintained at all times.
   • Documentation for endorsement procedures conveys all necessary information.
   • Information is conveyed appropriately to those individuals involved in ongoing patient care to facilitate understanding and optimize continuing patient care.
   • Basic Patient care is maintained until responsibility for patient care is taken over by staff of the receiving agency.

UNIT OF COMPETENCY : CONTRIBUTE TO AMBULANCE OPERATIONS MANAGEMENT
UNIT CODE : HCS322326

This unit of competency involves the efficient use of ambulance in delivering emergency medical services.

1. Maintain operations to meet quality standards
   • Supplies (necessary for operations are available and meet service requirements (except medicines)).
   • Operations within the area of responsibility meet service delivery specifications.
   •  Information and advice given to staff, members of the public and related organizations are accurate, in line with service policy and within the manager’s area of responsibility.
   • Operational information is communicated to the appropriate people in a manner, at a level and at a pace to promote understanding.
   • Systems to monitor quality, time and cost specifications for service provided are fully and correctly implemented and maintained.
   • Factors which disrupt operations affecting service delivery are recognized and appropriate action taken to minimize their effects.
   • Complete an accurate record of operations in accordance with service policies and procedures in relation to ambulance operation.
   • Make recommendations for improving efficiency of operations and quality of service which are promptly communicated to the appropriate people.
   • Operations are in accordance with local ambulance standard operating procedure.
2. Create and maintain conditions conducive to productive work and quality service
   • Highest possible level of safety is applied to the work environment.
   • A sufficient supply of resources is established and maintained to meet community needs.
   • Staff working conditions and use of resources satisfy current legislation and service guidelines.
   • Maintenance frequency and the use of equipment conform to service standards, schedules and procedures.
   • Where resources do not meet requirements, the matter is referred to the appropriate person/s.
   • Workplace accidents and incidents are reported promptly to the appropriate person/s and recorded as required.
   • Recommendations for improving conditions are promptly referred to the appropriate person/s.
   • All necessary records are complete, accurate and legible and available to authorized person/s when required.
   • Records are reviewed to ensure completeness and accuracy, in accordance with service policy.
3. Monitor and control the use of resources
   • Expenditure is within agreed budgets, does not compromise future spending requirements and conforms to service
   • The contribution of each team member can make to control of resources is communicated effectively.
   • Records of expenditure are complete, accurate and legible.
   • Prompt corrective action is taken in response to actual or potential significant deviations from plans.
   • Requests for expenditure outside the person in charge/superior’s area of responsibility are promptly referred to the appropriate person/s.

UNIT OF COMPETENCY : TRANSPORT EMERGENCY PATIENTS
UNIT CODE : HCS322327

This unit of competency involves transportation of patients and other appropriate personnel under emergency circumstances.

1. Convey and receive information relating to emergency transport
   • Communication with control center is established and maintained according to local ambulance standard operation procedure.
   • Appropriate receiving facility is notified according to local ambulance standard operation procedure.
2. Transport patient under emergency conditions
   • Ambulance is driven in a manner that avoids exacerbation of patient’s condition.
   • Hazards are recognized and negotiated at low risk.
   • Vehicle is driven according to legal requirements governing emergency vehicles.
   • Appropriate route is chosen according to distance, time, travel and terrain.
   • Communication is established and maintained as required between driver and patient care officer to ensure safe
3. Load, unload and secure patient and equipment for emergency transportation
   • Loading/unloading is conducted smoothly, consistent with safe work practices, and local ambulance standard operating procedure.
   • Patient’s illness/injury is not exacerbated by unnecessary movement during loading and unloading.
   • Patients are removed from scene in a manner consistent with relevant Acts, Regulations and in accordance with local ambulance standard operating procedure.
   • Equipment is secured in accordance with relevant Philippine Standards, Acts, and regulations and in accordance with local ambulance standard operating procedure.

UNIT OF COMPETENCY : TRANSPORT NON-EMERGENCY PATIENTS
UNIT CODE : HCS322328

This unit of competency involves the transport of non-emergency patients, checking the ambulance vehicle and equipment.

1. Prepare and check vehicle and equipment
   • Ambulance and equipment is checked systematically and comprehensively based on a local vehicle checklist.
   • Ambulance checks are conducted on a regular basis according to Service procedures to ensure serviceability of ambulance and equipment.
   • Ambulance checks ensure interior and exterior cleanliness of ambulance in accordance with service policies and procedures pertaining to the minimization of infection risk to both ambulance personnel and patients/clients.
   • Ambulance operating stock is maintained to acceptable minimum and maximum levels.
   • Ambulance and equipment is maintained according to local policy and procedures.
2. Ensure faults in ambulance and equipment are remedied
   • General nature of fault is identified and reported according to local policy and procedure.
   • Further damage to malfunctioning ambulance or equipment is assessed against patient care priorities and avoided when possible.
   • Minor faults are rectified where possible.
   • Need for additional or replacement resources is established and communicated to appropriate personnel.
3. Convey and receive information through use of necessary modes of communication
   • Communication techniques and procedures are consistent with acts, regulations and in accordance with local standard operating procedure.
   • Communication with control center is established and maintained in accordance with local standard operating procedure.
   • Appropriate receiving facility is notified in accordance with local standard operating procedure.
4. Load, unload and secure nonemergency patient and other specific personnel for transportation
   • Loading/unloading is conducted smoothly, consistent with safe work practices, Service policy and procedures in accordance with the national code.
   • Patient is given appropriate support/assistance during loading/unloading.
   • Appropriate personnel are transported to accompany the patient where such a need has been identified and there is a capacity to do so, in accordance with local standard operating procedure.
   • Equipment and belongings are secured appropriately to avoid movement during travel.
   • Must be familiar with the use of carry chairs
5. Drive vehicle
   • Ambulance is driven in a reduced risk manner and according to legal requirements.
   • Appropriate route is chosen according to distance, time constraints, travel and terrain.
   • Communication is established between driver and patient or patient care officer to ensure effective patient care during transport.
   • Map is consulted accurately, when necessary.
6. Transport patient’s relatives or other specific personnel
   • Personnel are transported to accompany the patient where such a need has been identified and there is a capacity to do so, in accordance with local standard operating procedure.
   •  Safety of the personnel, the patient and the patient’s relatives in the ambulance is considered during transport.

UNIT OF COMPETENCY : DRIVE AMBULANCE UNDER OPERATIONAL CONDITIONS
UNIT CODE : HCS322316

This unit covers the competency to drive ambulance safely, including the systematic, safe and efficient control of all vehicles functions and effective management of hazardous situations under operational conditions.

1. Prepare ambulance for operational response
   • The ambulance is selected to meet operational requirements and is suitable to use in the terrain.
   • Preliminary check of the vehicle is completed to ensure it is serviceable.
   • Assist in checking the equipment and accessories to ensure they are available and serviceable.
   • Cabin drill and start-up checks are completed in accordance with operational standards.
   • Engine is started in accordance with manufacturer’s specifications.
   • Audible and visual warning systems including instruments and gauges are checked to ensure that they are all operational.
2. Drive the ambulance
   • Ambulance is prepared for, and safely operated in terrain suitable to the vehicle.
   • Ambulance and/or trailers are operated and positioned in accordance with traffic regulations in accordance with local ambulance standard operation procedure to ensure safe and efficient operation.
   • Reduced-risk driving techniques are used which minimize the likelihood of injury to persons or damage to equipment or property and in accordance with local ambulance standard operation procedure.
3. Monitor traffic, road and terrain under operational conditions
   • Ambulance movement is controlled in response to external conditions to ensure safety of persons.
   • The most efficient route of travel is taken through monitoring factors likely to cause delays or route deviations.
   • Traffic and surface conditions are consistently monitored and acted upon to enable safe operation and ensure no injury to people or damage to property, equipment, loads and facilities.

COMMON COMPETENCIES

UNIT OF COMPETENCY : IMPLEMENT AND MONITOR INFECTION CONTROL POLICIES AND PROCEDURES
UNIT CODE : HCS323201

This unit is concerned with infection control responsibilities of employees with supervisory accountability to implement and monitor infection control policy and procedures in a specific work unit or team within an organization. This unit does not apply to a role with organization-wide responsibilities for infection control policy and procedure development, implementation or monitoring.

1. Provide information to the work group about the organization’s infection control policies and procedures.
   • Relevant information about the organization’s infection control policy and procedures, and applicable industry codes of practice are accurately and clearly explained to the work group
   • Information about identified hazards and the outcomes of infection risk assessments is regularly provided to the work group
   • Opportunity is provided for the work group to seek further information on workplace infection control issues and practices
2. Integrate the organization’s infection control policy and procedure into work practices
   • Infection control policy and procedures are implemented by supervisor and members of the work group.
   • Liaison is maintained with person responsible for organization-wide infection control.
   • The Supervisor’s coaching support ensures that individuals/teams are able to implement infection control practices
   • Work procedures are adopted to reflect appropriate infection control practice
   • Issues raised through consultation are dealt with and resolved promptly or referred to the appropriate personnel for resolution
   • Workplace procedures for dealing with infection control risks and hazardous events are implemented whenever necessary
   • Employees are encouraged to report infection risks and to improve infection control procedures
3. Monitor infection control performance and implement improvements in practices
   • Infection control hazardous events are investigated promptly to identify their cause in accordance with organization policy and procedures
   • Work procedures to control infection risks are monitored to ensure compliance
   • Work procedures are regularly reviewed and adjusted to ensure improvements in infection control practice
   • Supervisor provides feedback to team and individuals on compliance issues, changes in work procedures and infection control outcomes
   • Training in work procedures is provided as required to ensure maintenance of infection control standards
   • Inadequacies in work procedures and infection control measures are identified, corrected or reported to designated personnel
   • Records of infection control risks and incidents are accurately maintained as required
   • Aggregate infection control information reports are used to identify hazards, to monitor and improve risk control Method and to indicate training needs

UNIT OF COMPETENCY : RESPOND EFFECTIVELY TO DIFFICULT/ CHALLENGING BEHAVIOR
UNIT CODE : HCS323202

This unit of competency covers the knowledge, skills and attitudes to effectively respond to difficult or challenging behavior of patient.

1. Plan responses
   • Responses are planned to instances of difficult or challenging behavior to maximize the availability of other appropriate staff and resources
   • Specific manifestations of difficult or challenging behavior are identified and strategies appropriate to these behaviors are planned as required.
   • Safety of self and others is given priority in responding to difficult or challenging behavior according to institutional policies and procedures.
2. Apply response
   • Difficult or challenging behavior is dealt with promptly, firmly and diplomatically in accordance with institutional policy and procedures.
   • Communication is used effectively to achieve the desired outcomes in responding to difficult or challenging behavior
   • Appropriate strategies are selected to suit particular instances of difficult or challenging behavior
3. Report and review incidents
   • Incidents are reported according to institutional policies and procedures
   • Incidents are reviewed with appropriate staff and suggestions appropriate to area of responsibility are made.
   • Debriefing mechanisms and other activities are used and participated in
   • Advice and assistance is sought from legitimate sources when appropriate.

UNIT OF COMPETENCY : APPLY BASIC FIRST AID
UNIT CODE : HCS323203

This unit covers the knowledge, skills and attitudes required to provide an initial response where First Aid is required. In this unit it is assumed that the First Aider is working under supervision and / or according to established workplace First Aid procedures and policies

1. Assess the situation
   • Physical hazards to self and casualty’s health and safety are identified
   • Immediate risks to self and casualty’s occupational health and safety (OSH )are minimized by controlling the hazard in accordance with OSH requirements
   • Casualty’s vital signs and physical condition are assessed in accordance with workplace procedures
2. Apply basic first aid techniques
   • First Aid management is provided in accordance with established First Aid procedures
   • Casualty is reassured in a caring and calm manner and made comfortable using available resources
   • First Aid assistance is sought from others in a timely manner and as appropriate
   • Casualty’s condition is monitored and responded to in accordance with effective First Aid principles and workplace procedures
   • Details of casualty’s physical condition, changes in conditions, management and response are accurately recorded in line with organizational procedures
   • Casualty management is finalized according to his/her needs and First Aid principles
3. Communicate details of the incident
   • Appropriate medical assistance is requested using relevant communication media and equipment
   • Details of casualty’s condition and management activities are accurately conveyed to emergency services/relieving personnel
   • Reports to supervisors are prepared in a timely manner, presenting all relevant facts according to established company procedures

UNIT OF COMPETENCY : MAINTAIN HIGH STANDARDS OF PATIENT SERVICES
UNIT CODE : HCS323204

This unit covers the knowledge, skills and attitudes required in the maintenance of high standards of patient services.

1. Communicate appropriately with patients
   • Effective communication strategies and techniques are identified and used to achieve best patient service outcomes
   • Complaints are responded to in accordance with organizational policy to ensure best service to patients
   • Complaints are dealt with in accordance with established procedures
   • Interpreter services are accessed as required
   • Action is taken to resolve conflicts either directly, where a positive outcome can be immediately achieved, or by referral to the appropriate personnel
   • Participation in work team is constructive and collaborative and demonstrates an understanding of own role
2. Establish and maintain good interpersonal relationship with patients
   • Rapport is established to ensure the service is appropriate to and in the best interests of patients
   • Effective listening skills are used to ensure a high level of effective communication and quality of service
   • Patient concerns and needs are correctly identified and responded to responsibly and accordingly established procedures and guidelines
   • Effectiveness of interpersonal interaction is consistently monitored and evaluated to ensure best patient service outcomes
3. Act in a respectful manner at all times
   • Respect for differences is positively, actively and consistently demonstrated in all work
   • Confidentiality and privacy of patients is maintained
   • Courtesy is demonstrated in all interactions with patients, their visitors, careers and family
   • Assistance with the care of patients with challenging behaviors is provided in accordance with established procedures
   • Techniques are used to manage and minimize aggression
4. Evaluate own work to maintain a high standard of patient service
   • Advice and assistance is received or sought from appropriate sources on own performance
   • Own work is adjusted, incorporating recommendations that address performance issues, to maintain the agreed standard of patient support

BASIC COMPETENCIES

UNIT OF COMPETENCY : PARTICIPATE IN WORKPLACE COMMUNICATION
UNIT CODE : 500311105

This unit covers the knowledge, skills and attitudes required to gather, interpret and convey information in response to workplace requirements.

1. Obtain and convey workplace information
   • Specific and relevant information is accessed from appropriate sources
   • Effective questioning, active listening and speaking skills are used together and convey information
   • Appropriate medium is used to transfer information and ideas
   • Appropriate non- verbal communication is used
   • Appropriate lines of communication with supervisors and colleagues are identified and followed
   • Defined workplace procedures for the location and storage of information are used
   • Personal interaction is carried out clearly and concisely
2. Participate in workplace meetings and discussions
   • Team meetings are at ended on time
   • Own opinions are clear expressed and those of others are listened to without interruption
   • Meeting inputs are consistent with the meeting purpose and established protocols
   • Workplace interactions are conducted in a courteous manner
   • Questions about simple routine workplace procedures and matters concerning working conditions of employment are asked and responded to.
   • Meetings outcomes are interpreted and implemented
3. Complete relevant work related documents
   • Range of forms relating to conditions of employment are completed accurately and legibly
   • Workplace data is recorded on standard workplace forms and documents
   • Basic mathematical processes are used for routine calculations
   • Errors in recording information on forms/documents are identified and properly acted upon
   • Reporting requirements to supervisor are completed according to organizational guidelines

UNIT OF COMPETENCY : WORK IN TEAM ENVIRONMENT
UNIT CODE : 500311106

This unit covers the skills, knowledge and attitudes to identify role and responsibility as a member of a team.

1. Describe team role and scope
   • The role and objective of the team is identified from available sources of information
   • Team parameters, reporting relationships and responsibilities are identified from team discussions and appropriate external sources.
2. Identify own role and responsibility within team
   • Individual role and responsibilities within the team environment are identified.
   • Roles and responsibility of other team members are identified and recognized.
   • Reporting relationships within team and external to team are identified.
3. Work as a team member
   • Effective and appropriate forms of communications used and interactions undertaken with team members who contribute to known team activities and objectives.
   • Effective and appropriate contributions made to complement team activities and objectives, based on individual skills and competencies and workplace context.
   • Observed protocols in reporting using standard operating procedures.
   • Contribute to the development of team work plans based on an understanding of team’s role and objectives and individual competencies of the members.

UNIT OF COMPETENCY : PRACTICE CAREER PROFESSIONALISM
UNIT CODE : 500311107

This unit covers the knowledge, skills and attitudes in promoting career growth and advancement.

1. Integrate personal objectives with organizational goals
   • Personal growth and work plans are pursued towards improving the qualifications set for the profession
   • Intra- and interpersonal relationships is are maintained in the course of managing oneself based on performance evaluation
   • Commitment to the organization and its goal is demonstrated in the performance of duties
2. Set and meet work priorities
   • Competing demands are prioritized to achieve personal, team and organizational goals and objectives.
   • Resources are utilized efficiently and effectively to manage work priorities and commitments
   • Practices along economic use and maintenance of equipment and facilities are followed as per established procedures
3. Maintain professional growth and development
   • Trainings and career opportunities are identified and availed of based on job requirements
   • Recognitions are sought/received and demonstrated as proof of career advancement
   • Licenses and/or certifications relevant to job and career are obtained and renewed

UNIT OF COMPETENCY : PRACTICE  OCCUPATIONAL HEALTH AND SAFETY PROCEDURES
UNIT CODE : 500311108

This unit covers the outcomes required to comply with regulatory and organizational requirements for occupational health and safety.

1. Identify hazards and risks
   • Safety regulations and workplace safety and hazard control practices and procedures are clarified and explained based on organization procedures
   • Hazards/risks in the workplace and their corresponding indicators are identified to minimize or eliminate risk to co-workers, workplace and environment in accordance with organization procedures
   • Contingency measures during workplace accidents, fire and other emergencies are recognized and established in accordance with organization procedures
2. Evaluate hazards and risks
   • Terms of maximum tolerable limits which when exceeded will result in harm or damage are identified based on threshold limit values (TLV)
   • Effects of the hazards are determined
   • OHS issues and/or concerns and identified safety hazards are reported to designated personnel in accordance with workplace requirements and relevant workplace OHS legislation
3. Control hazards and risks
   • Occupational Health and Safety (OHS) procedures for controlling hazards/risks in workplace are consistently
     followed
   • Procedures for dealing with workplace accidents, fire and emergencies are followed in accordance with organization OHS policies
   • Personal protective equipment (PPE) is correctly used in accordance with organization OHS procedures and practices
   • Appropriate assistance is provided in the event of a workplace emergency in accordance with established organization protocol
4. Maintain OHS awareness
   • Emergency-related drills and trainings are participated in as per established organization guidelines and procedures
   • OHS personal records are completed and updated in accordance with workplace requirements

DEFINITION OF TERMS

• Aspiration – the entry of secretions or foreign material into the trachea and lungs
• Assault – refers to a violent physical or verbal attack
• Bag Valve Mask with reservoir – refers to a supplemental oxygen device used to provide positive pressure ventilation to patients who are not breathing or not breathing adequately.
• Body Mechanics – refers to using the body in an efficient and careful way
• Chair Lifts – power-driven chair assembly used to transport patients
• Cardiopulmonary Resuscitation (CPR)– refers to good quality of external chest compression and adequate rescue breaths
• Choking – refers to a person having difficulty in breathing due to foreign body airway obstruction
• Capnography (End Tidal CO2) – a device measures the exhaled carbon dioxide level.
• First Aid Kit – emergency tools used to administer immediate treatment to injured person.
• Hazardous Waste – refers to items contaminated with blood, body fluids, or body substances that maybe harmful to others
• Pulse Oximeter – a device measures the percentage of oxygen in the hemoglobin
• Pressure or Elastic Bandage – refers to a piece of material used to cover a wound and Immobilize a part of the body or restrict the movement
• Sling – refers to a material or a piece of cloth used to support the upper extremities
• Splint – refers to a hard plastic or piece of wood used to immobilize a limb in the case of fractures or deformity.
• Stressors – refers to an agent or factor that produces stress
• Scoop Stretchers – refers to a device used in transferring patients in a lying position.
• Suffocation – refers to suppression of one’s breathing due to lack of oxygen
• Suicide – refers to the act of intentionally killing or injuring oneself
• Thermal Blanket – refers to a material used to decrease the body temperature or keep the patient warm
• Triangular Bandage – refers to a tool used to hold the dressing in place and to immobilize an injured body part
• Trolley cot – refers to a rolling device used to transport patient.
• Walking frames – refers to a assistive device used to support body weight for patients with difficulty in walking
• Wheel Chair – refers to a device used to transport patient from one place to another in a sitting position
• AED (Automated External Defibrillator) – a machine that analyzes and delivers electrical treatment.
• GPS– Global Positioning System
• LOC– Level of consciousness
• OSHA – Occupational Safety and Health Act
• PPE – personal protective equipment
• SPO2 – saturation of peripheral oxygen
• HEPA (High Efficient Particulate Air Respirator Mask) – special personal protective equipment for airborne diseases