Faculty of Health and Wellness

Diploma Emergency Care

Prehospital Emergency Care
Medical Emergencies

PHE151S

LEARNER GUIDE

2023

1
© 2023 Cape Peninsula University of Technology Diploma Emergency Care
 Welcome to PREHOSPITAL EMERGENCY CARE - MEDICAL EMERGENCIES
and we truly hope that you will enjoy this subject. The aim of this subject is to
provide you with the basic knowledge you will need to effectively assess and treat
patients up to a certain level of care. You will be able to apply this knowledge in
the pre-hospital environment. The outcomes described in this guide are
important, as you will be assessed accordingly.

Table of Contents

www.cput.ac.za
© 2023 Cape Peninsula University of Technology Diploma Emergency Care
1. Introduction 6

1.1. Instructions for using this guide 6

1.2. Educational approach to the subject 6

2. General 7

2.1. Contact information 7

2.2. Time-table 8

2.3. Blackboard (E-learning) 8

2.4. Study materials and purchases. 8

2.5. Self-study activities 9

2.6. Recommended reading 9

3. Subject/Module credits 10

4. Assessment 10

4.1. Assessment policy and regulations 10

4.2. Assessment opportunities: Administration 10

4.3. Assessment Breakdown 11

4.4. Assessment policy and regulations 11

4.5. Format and Referencing Style of Submitted Works 12

4.6. Plagiarism 12

5. Subject/Module specifications 13

6. Critical cross-field outcomes 13

7. Verbs used in assessment 14

8. Subject Outcomes 15

Study Unit: 1 Equipment 15

Study Unit 2: Airway management, Oxygen administration and Ventilation 18

Study Unit 3: Respiratory Emergencies 20

Study Unit 4: Cardiovascular Emergencies 21

Study Unit 5: Neurological Emergencies 22

Study Unit 6: Endocrine Emergencies 24

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

Study Unit 7: Gastrointestinal Emergencies 25

Study Unit 8: Cardiopulmonary Resuscitation 26

Study Unit 9: Obstetrics 28

Study Unit 10: Pharmacology 29

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

1. Introduction

1.1. Instructions for using this guide

This guide will assist you in participating effectively in this programme. The outcomes described in
this guide are very important and are mainly sources from your prescribed textbook. It is against
these outcomes that you will be assessed. Please refer to them regularly to gauge your own
progress. The learner guide contains important information on the minimum requirements for the
subject. These include administrative details, assessment criteria and general policies. Please
familiarise yourself with the content as the successful completion of this subject depends on it.

1.2. Educational approach to the subject

The design of the subject content was done using Biggs’ Constructive alignment1 theory for deep
and surface learning, where the subject content and assessments are directly linked/aligned with
the learning outcomes which in turn is aligned with the critical cross field outcomes as well as the
exit level outcomes, all in aims of promoting deep learning and thus a higher graduate pass rate.

The teaching practices is therefore being more problem based, making use of new technology to
keep students interested and focused and to promote deep learning, as well as integration of
knowledge across subjects and modules. This means that teaching practices has moved away
from the traditional didactic lectures to a more problem solving and group tasks approach where
students are required to invest many notional hours (not necessarily in a conventional class room
or during university hours) to meet one or all learning outcomes.

Scaffolding of learning (between and within subjects) will also contribute to deep learning. The
curriculum for this program will incorporate this scaffolding of knowledge, for example in this
subject, a student will be required to demonstrate limited knowledge, comprehension, application
and analysis of physics, but when engaging in theory of emergency medical care, the student will
be required to apply this knowledge and demonstrate all cognitive abilities within the full scope and
level of practice set out by the HPCSA. The teaching and learning activities will make use of
several resources and approaches to achieve the outcomes.

1 Biggs, J., 1996. Enhancing teaching through constructive alignment. Higher education, 32(3), pp.347-364.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

2. General

2.1. Contact information

Please familiarise yourself with the department staff involved in this subject. Please make an
appointment to see them should you need to discuss any matters.

Telephone Consulting
Name Venue E-mail address
number hours

Subject New Education

021 By
Co- Mrs R. Gihwala Building, GihwalaR@cput.ac.za
9538408 appointment
ordinator Bellville Campus

New Education
Full-time Mrs R. Gihwala Building, 021 953840 By
Bellville 8 GihwalaR@cput.ac.za
Lecturer appointment
Campus
New Education
Building, 021 As required
Secretary Ms R. Lewis LewisRA@cput.ac.za
Bellville 9538408
Campus

All appointments are to be scheduled through the department secretary in the interest of quality
consultations. Consultation times many vary due to operational requirements. Consultations will be
restricted to 20 minutes per student in the interest of optimal time management, unless the nature
of the matter is such that more time is warranted.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 2.2. Time-table

Details on the number of contact sessions with the lecturer per week; the number of tutorial
classes per week; and the number of practical/laboratory sessions per week are indicated on the
timetable. This is subject to change and should the time and venue change due to unforeseen
circumstances, your lecturer will inform you.

Contact Session Venue Day & Time

Lecture LT3 Wednesday 09:00 – 12h00

2.3. Blackboard (E-learning)

This subject will make use of the e-learning platform “Blackboard”. Blackboard will be used for all
announcements, resources and record keeping, so learners are to ensure that their passwords are
active. The ICT department can be contacted on 021 959 6407 for any problems. The subject will
make use of E-learning practices throughout this year. Learners may make use of computer and
internet facilities on campus if access is not available at home. E-learning resources will be
announced in good time.

2.4. Study materials and purchases.

The prescribed book for this subject is: Sanders M.J. 2018. Mosby’s paramedic Textbook; Fifth
edition.

In addition to the prescribed departmental uniform and personal protective equipment the following
items are required:

● Class notes

● Additional study material such as books for further reading,

● Calculators,

● Internet references

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 2.5. Self-study activities

Not only is it not possible to didactically present every outcome in the form of a lecture, it is also
educationally undesirable and does not contribute to the professional development of the learner.
Tutorials and self-study activities will be made available throughout the year. The learner is also
required to read through and understand the outcomes presented in this learner guide and to
ensure these outcomes are met autonomously. All outcomes are scaffolded over learning
presumed to have occurred in earlier years of study and foundational and prior knowledge will not
be revised during the year. If gaps in the learner’s prior knowledge are present the learner is
required to fill in these gaps in a self-directed manner. Tutorials may cover aspects of study cover
back-round aspects of the topic, or outcomes not covered in class. You will be required to submit
tutorials on a regular basis for monitoring purposes and as a gauge of your progress and
interaction with course material. Submission is required to allow the lecturer/s to identify ‘at risk’
learners and to allow timely interventions.

Tutorials will not be marked and will not count toward continuous assessment. You are strongly
advised to diligently complete tutorials as they direct learning. Test and exam questions may be
based on tutorials.

Some of the class time takes the form of group work or presentations by learners. You are required
to prepare for and participate in these activities. Group work and presentations are learning
activities and will not be marked nor will they count for assessment.

2.6. Recommended reading

▪ Prescribed works
▪ Works placed on Blackboard.
▪ Additional references as required

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

3. Subject/Module credits

Exit Level NQF

Subject Credits Study units
Outcomes Level

Equipment
Scene and Patient Assessment
Airway Management and Ventilation
Respiratory Emergencies
Pre-hospital Cardiovascular Emergencies
Emergency Care I 20 Neurologic Emergencies 13, 14, 15,17 5
Medical Diabetic Emergencies
Gastrointestinal Emergencies
Cardiopulmonary Resuscitation (CPR)
Obstetrics
Pharmacology

4. Assessment

4.1. Assessment policy and regulations

See the General Learner Guide 2023 for Assessment policy and regulations

4.2. Assessment opportunities: Administration

The University policy is one of continuous assessment. Throughout the year you will have multiple
assessment opportunities and the breakdown of the mark allocations are shown in the table below.
During the year you will accumulate marks that are weighted. These assessments are not limited
to tests, projects, practical examinations.

The lecturer will inform you on how the assessment marks for each subject will be calculated.
Assessment marks are calculated using weighted averages of formal tests, tutorials, assignments,
and practical assessments. Attendance of classes and contribution to tutorials and online
discussions could contribute to your final assessment mark.
**Please note: Examination and test dates are subject to change. Altered dates will be
communicated to you by the subject co-ordinator in advance.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 4.3. Assessment Breakdown

The policy of the university is one of continuous assessment which requires a mix of formative and
summative assessment with a minimum of one summative per term. The final mark for the module
will be made up three assessments.

Summative assessment is cumulative in nature and is utilized to determine whether students have
met the course goals or student learning outcomes at the end of a course or program, all the
summative assessment is listed below in the table.

Assignments will need to be completed as per the department standard with Harvard referencing.
See Blackboard with regards to requirements and method of submission.

PHE151S Assessment Date Weighting Term Dates

Theory Test 1 31 May 2023 20 Term 1

Theory Test 2 23 August 2023 25 Term 2

Viva Voce 18 October 2023 10 Term 3

Tutorial (March – October 2023) 15

Final Theory Exam 17 November 2023 30 Term 4

Total 100

4.4. Assessment policy and regulations

For all the assessments, the minimum required pass mark is 50% per assessment. Late
submission (past due date) will incur a mark penalty of 10% per day (also refer to general learner
guide).

Two types of assessment will be conducted throughout the year as set out in the assessment table
below. Formative assessments are part of the instructional process. When incorporated into
classroom practice, it provides the information needed to adjust teaching practice.

In this sense, formative assessment informs both the lecturing staff and students about the
students’ understanding at a point when timely adjustments can be made. These adjustments help
to ensure students achieve targeted standards-based learning goals within a set time frame.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 4.5. Format and Referencing Style of Submitted Works

The format of the assignment will be placed on Blackboard. The referencing style is Harvard
(author/year) unless otherwise specified by the facilitator. Two guides (Basic & Advanced) to
Harvard referencing methods are available from the CPUT website:
http://libguides.library.cput.ac.za/searchtags.php?iid=2936&gid=0&tag=harvard%20referencing
%20guide. Any submission without references or in a referencing style that is not Harvard unless
otherwise specified will not be considered for marking. Please note that non-referenced or poorly
referenced submissions may constitute plagiarism. Please note points 5.1 – 5.3 in the general
learner guide. If you are unsure, assistance with referencing and academic writing is available from
the Fundani Academic Writing Centre on campus. Please refer to you learner diary for contact
details or the campus student counselling services for assistance.

4.6. Plagiarism

It is unethical and illegal to submit someone else's work as your own - it is the same as stealing.
Plagiarism can take various forms. It can be blatant theft or accidental "borrowing". See the
following examples:

● You submit an assignment done by another student (or from a paper mill) as your own.

● You pay another student to write an assignment for you and hand it in as your own work.

● You copy and paste sections from someone else's work and add it to your work without

acknowledging the source.

Although this sometimes happens accidentally, it is still considered plagiarism:

● You have done a lot or reading and made notes for your assignment. At some point, you

find a good idea between your notes, but you can't remember whether it was your idea or
someone else's. If you submit this as your own work and it turns out that it was not your
idea, you have committed plagiarism.

● If you make use of someone else's work, you must make sure that you have the correct

citation information and add it to your assignment.

All assignments will be submitted via the plagiarism software on Blackboard. No

hand written or emailed submissions will be accepted.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

5. Subject/Module specifications

This subject focus on the equipment, patient assessment, pathophysiology and treatment of
medical emergencies in the pre-hospital emergency medical and rescue environments.

6. Critical cross-field outcomes

1. Identifying and solving problems using critical and creative thinking is demonstrated in the
assessment and treatment of patients.
2. Working effectively with others as a member of the team, group, organisation and community is
demonstrated within the context of providing emergency care and supporting other services.
3. Organizing and managing self and own activities responsibly and effectively is demonstrated in
the preparation and provision of emergency care.
4. Collecting, analysing, organizing and critically evaluating information is demonstrated in the
assessment and treatment of patients.
5. Communicating effectively using visual, mathematical and/or language skills in the modes of
oral and or written presentation is demonstrated through reports and the handover of patients
to other services.
6. Demonstrating effective use of science and technology is evidenced in all activities related to
emergency care and rescue.
7. Demonstrating an understanding of the world as a set of related systems

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

7. Verbs used in assessment

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

8. Subject Outcomes

This study unit is divided into the following units:

Study unit 1: Equipment

Study unit 2: Airway management and ventilation

Study unit 3: Respiratory Emergencies

Study unit 4: Cardiovascular Emergencies

Study unit 5: Neurologic Emergencies

Study unit 6: Diabetic Emergencies

Study unit 7: Gastrointestinal Emergencies

Study unit 8: Cardiopulmonary Resuscitation (CPR)

Study unit 9: Obstetrics

Study unit 10: Pharmacology

Study Unit: 1 Equipment

After completion of this study unit, the learner should be able to:

1. Identify, disassemble and reassemble, maintain, clean and explain the functioning of
emergency care equipment.
2. Identify specific categories of medical equipment used in prehospital emergency care and
discuss the attributes, characteristics, use and maintenance of these categories of
equipment;
Diagnostic and monitoring equipment
2.1. Stethoscope
2.2. Sphygmomanometer (pneumatic, mercury and electronic)
2.3. Pupil torch
2.4. Glucometer
2.5. Peak Flow meter
2.6. 3-lead ECG monitor
2.7. Thermometer (Oral, rectal, tympanic)
2.8. Pulse oximeter

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 2.9. Capnograph

Airway, Oxygenation and Ventilation Equipment

2.10. Oropharyngeal airway
2.11. Nasopharyngeal airway
2.12. Pocket mask and 1-way valve
2.13. Bag-valve-mask-reservoir device
2.14. Flow diverter and PEEP valve
2.15. Oxygen regulator
2.16. Flow meters
2.17. Oxygen cylinders
2.17.1. Compressed gas
2.17.2. Liquid oxygen
2.18. Suction catheters
2.19. Manual aspirators and electric suction units
2.20. Oxygen delivery devices
2.20.1. Nasal Cannula
2.20.2. Simple facemask
2.20.3. Venturi Masks
2.20.4. Partial-rebreather
2.20.5. Non-rebreather
2.20.6. Nebuliser

Immobilisation and dressing equipment

2.21. Board and wire splints
2.22. Improvised splints
2.23. Scoop stretcher
2.24. Spine board (Long and short)
2.25. Kendrick extrication device
2.26. Head-blocks
2.27. Cervical collars
2.28. Spider harness
2.29. Ambulance dressing
2.30. Crepe bandage
2.31. Triangular bandage
2.32. Adhesive tape

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 2.33. Sanitary pads
2.34. Gauze swabs
2.35. Abdominal swabs

Pharmacological agents and drug administration equipment

2.36. Tablets, capsules and oral agents
2.37. Vials and ampoules
2.38. Unit-dose-vials
2.39. Metered dose inhalers and spacers
2.40. Inhaled agents
2.41. Syringes
2.42. Hypodermic needles

Circulation, fluid therapy and venous access devices

2.43. Automated external defibrillators
2.44. Manual Defibrillators
2.45. IV cannulas
2.46. IV bags
2.47. Administration sets
2.48. Extension sets
2.49. 3-way-taps
2.50. Pneumatic Anti-Shock garment

Transport and patient movement equipment

2.51. Ambulance stretchers
2.52. Stair chairs
2.53. Zip stretcher

Study Unit 2: Airway management, Oxygen administration and

Ventilation

After completion of this study unit, the learner should be able to:

1. Briefly describe the anatomy of the upper and lower airways as relevant to prehospital

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 emergency care.
2. Discuss the basic principles of airway assessment.
3. Define the characteristics of the clear airway and the threatened or obstructed airway.
4. Discuss the concepts ‘open’, ‘maintain’ and ‘protect’, as goals of prehospital airway
management.
5. Outline and discuss the signs and symptoms of upper and lower airway compromise under
the following headings:
5.1 Observation techniques
5.2 Auscultation, palpation and percussion techniques
5.3 Other signs of respiratory distress
5.4 Foreign body airway obstruction in both the conscious and unconscious patient;
5.5 Laryngeal spasm and oedema;
5.6 Fractured larynx; and
5.7 Tracheal trauma.
6. Briefly discuss pulmonary aspiration and discuss factors which determine aspiration risk.
7. Discuss oropharyngeal suctioning in airway management and list risks and adverse events
associated with suctioning.
8. Describe the following manual techniques used for airway management, as well as the
indications, contraindications and complications associated with each one, including:
8.1. Head-tilt-chin lift manoeuvre;
8.2. Jaw-thrust manoeuvre; and
8.3. Tongue-jaw lift.
8.4. Use of the recovery position
9. Discuss the indications, contraindications, insertion technique, advantages and possible
complications of the following airway adjuncts:
9.1. Nasopharyngeal airway
9.2. Oropharyngeal airway
10. Describe the recognition foreign body airway obstruction in an adult, a child, and an infant.
11. Describe the management of foreign body airway obstruction according to a defined protocol,
using the following techniques in the listed populations:
11.1 Heimlich manoeuvre (adults)
11.2 Chest Thrusts (child)
11.3 Cough
11.4 Chest Thrusts (pregnancy)
11.5 Back Slaps and chest thrusts (infants)
11.6 Magill’s forceps
12. Describe the procedure, indications, contraindications, advantages, disadvantages, and

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 complications of performing needle cricothyroidotomy.
13. Briefly discuss the uptake, storage and delivery of oxygen in the human body.
14. Discuss the administration, advantages and risks of supplemental medical oxygen in the
prehospital emergency care context.
15. Differentiate the use and purpose of common oxygen delivery devices in the prehospital
emergency care context:
15.1. Nasal Cannula
15.2. Simple Facemask
15.3. Partial rebreather mask
15.4. Non-Rebreather
15.5. Venturi mask
15.6. Bag-valve-mask-reservoir device
16. Describe the concept, indications, contraindications, risks and technique of rescue breathing
with:
16.1. Mouth-to-mouth breathing
16.2. Mouth-to-nose breathing
16.3. Mouth-to-stoma breathing
16.4. One-way-valve-barrier device
16.5. Pocket mask
16.6. Bag-valve-mask-reservoir device
17. Describe the complications of the technique of rescue breathing, specifically relating to:
17.1. Hyperinflation of the patient’s lungs
17.2. Gastric distention
17.3. Blood/body fluid concerns
17.4. Rescuer hyperventilation
18. Describe the technique and purpose of cricoid pressure.
19. Describe the mechanism of how pulse oximetry functions.
20. Discuss the limitations of the use of pulse oximetry, including the limitations, inaccuracies and
false readings that can occur.
21. Understand how to assess for adequate and inadequate respiration, including the use of
pulse oximetry.
22. Recognize the need for advanced airway management by ECPs (Indications for Supraglottic
airways)

Study Unit 3: Respiratory Emergencies

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

After completion of this study unit, the learner should be able to:

1. Discuss the components of the focused examination of the respiratory system.

2. Interpret abnormal clinical and diagnostic assessment findings associated with the
emergency presentation of pulmonary disease and conditions under the following headings:
2.1 Patient impression
2.2 Primary survey concerns
2.3 Focused medical history
2.4 Focused physical examination
2.5 Vital signs
2.6 Peak flow meter readings
2.7 Pulse oximetry
2.8 Ongoing assessment and monitoring
3. Discuss the concept of respiratory failure.
4. Differentiate Type 1 from Type 2 respiratory failure
5. Describe the clinical features of a patient with inadequate respirations.
6. Discuss the pathophysiology, clinical presentation and prehospital management (according to
a defined protocol) of:
2.54. Obstructive Airway Disease
6.1.1 Acute exacerbations of;
6.1.2 Asthma
6.1.3 Chronic Obstructive Pulmonary Disease (COPD)
2.55. Pneumonia
2.56. Atelectasis
2.57. Toxic inhalations
2.58. Non-cardiogenic pulmonary oedema
2.59. Pneumothorax
2.60. Tension pneumothorax
2.61. Haemothorax

Study Unit 4: Cardiovascular Emergencies

After completion of this study unit, the learner should be able to:

1. Discuss the burden of disease associated to cardiac pathology.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 1.1. Identify risk factors and prevention strategies associated with cardiovascular
disease.
1.2. Describe the epidemiology of cardiovascular disease in both the Western Cape
province, as well as the South African context.
2. Discuss abnormal assessment (pathological) findings associated with cardiac disease and
conditions under the following headings:
2.1 Initial patient impression
2.2 Primary survey
2.3 Focused medical history
2.3.1 Describe how to perform a focused significant medical history related to
cardiac disease.
2.4 Focused physical examination
2.4.1 Describe how to conduct a physical exam on a patient with suspected
cardiac disease.
2.5 Ongoing assessment and monitoring
2.6 Risk factor mitigation
3 Discuss the use and application of the 3-Lead electrocardiogram for patient monitoring in the
prehospital emergency care setting.
4 Discuss the morphology of a 3-lead Electrocardiogram (ECG) tracing and relate the listed
components to the cardiac conduction system, cardiac action potential and cardiac cycle:
4.1 P wave
4.2 QRS complex
4.3 T wave
4.4 PR interval
4.5 QT interval
4.6 ST segment
5 Briefly discuss pathological conditions associated with the development of acute coronary
syndromes, specifically;
5.1 Atherosclerosis
5.2 Hypertension
5.3 Diabetes Mellitus
5.4 Obesity
6 Discuss the pathophysiology, clinical presentation and management of:
6.1 Stable angina pectoris
6.2 Acute Coronary Syndromes (ACS):
6.2.1 Unstable angina pectoris
6.2.2 Acute Myocardial Infarction (AMI)

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 6.3 Heart failure
6.4 Pericardial tamponade
6.5 Cardiogenic shock
6.6 Aortic aneurysm
6.7 Hypertensive Emergencies
7 Differentiate the typology of chest pain
7.1 Evaluate the severity of chest pain
7.2 Interpret the 3-Lead ECG tracing in a patient with cardiac chest pain
7.2.1 Describe the relationship of the ECG to electrical activity
7.2.2 Explain and summarize the steps in rhythm analysis.
7.2.3 Describe the ST segment and T-wave rhythm changes that can occur on
the ECG in the presence of chest pain.

Study Unit 5: Neurological Emergencies

After completion of this study unit, the learner should be able to:

1. Discuss abnormal assessment findings associated with neurologic conditions under the
following headings:
1.1. Initial patient impression
1.2. Primary survey
1.3. Focused medical history
1.4. Focused physical examination
1.5. Ongoing assessment and monitoring
1.6. Risk factor mitigation
2. Discuss the pathophysiology, clinical presentation, complications, management and
therapeutic targets of a patient with a Cerebrovascular Accident (CVA)
2.1. Discuss the following validated assessment stroke tools;
2.1.1.1. The Cincinnati Prehospital Stroke Scale
2.1.1.2. Los Angeles Prehospital Stroke Screen
3. Define Transient Ischaemic Attack (TIA)
4. Discuss the pathophysiology, clinical presentation, complications, management and
therapeutic targets of syncope
5. Discuss the pathophysiology, clinical presentation, complications and management of
seizures
1.7. Discuss and differentiate between the various types of seizures, including:

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 generalized; absence; atonic; myoclonic; tonic-clonic; partial; and complex partial.
1.8. Define Status Epilepticus and differentiate from a seizure
1.9. Discuss the non-pharmacological management of seizures
1.10. Identify the common causes of seizures
1.10.1. Alcohol/Toxins
1.10.2. Hyper/hypothermia
1.10.3. Infection
1.10.4. Hypoxia
1.10.5. Uremia
1.10.6. Traumatic brain injury
1.10.7. Stroke
1.10.8. Shock (Neurogenic, cardiogenic)
1.11. Differentiate between syncope and seizures.

Study Unit 6: Endocrine Emergencies

After completion of this study unit, the learner should be able to:

1. Discuss abnormal assessment findings associated with diabetes mellitus and associated
conditions under the following headings:
1.1. Initial patient impression
1.2. Primary survey
1.3. Focused medical history
1.4. Focused physical examination
1.5. Ongoing assessment and monitoring
1.6. Risk factor mitigation
2. Discuss the pathophysiology and clinical presentation of:
2.1. Diabetes Mellitus
2.1.1 Type 1 Diabetes
2.1.2 Type 2 Diabetes
2.1.3 Gestational Diabetes Mellitus
2.2. Define Diabetes Insipidus
2.3. Discuss and differentiate between Diabetic Ketoacidosis (DKA) and Hyperosmolar
nonketotic coma (referred to as hyperosmolar hyperglycaemic nonketotic syndrome
[HHNS])
3. Discuss the sequelae of the above presentations such as metabolic acidosis and renal failure

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 4. Discuss the management of hyperglycemia according to defined protocols
5. Discuss the management of hypoglycemia according to defined protocols.
6. Differentiate between hypoglycemia and refractory hypoglycemia
7. Discuss the management of refractory hypoglycemia according to defined protocols.

Study Unit 7: Gastrointestinal Emergencies

After completion of this study unit, the learner should be able to:

1. Discuss abnormal assessment findings associated with gastrointestinal emergencies and

associated conditions under the following headings:
1.1. Initial patient impression
1.2. Primary survey concerns
1.3. Focused medical history
1.4. Focused physical examination
1.4.1. Describe the location and type of abdominal pain, with particular reference
to: visceral, somatic and referred pain.
1.4.2. Describe how a physical examination should be performed, with particular
reference to the IPAP method: inspection; palpation; auscultation; and
percussion.
1.5. Ongoing assessment and monitoring
1.6. Risk factor mitigation
2. Discuss the administration of crystalloid fluid boluses in the management of medical
emergencies according to a defined protocol
3. Discuss the pathophysiology, clinical presentation, risk of haemorrhage, risk of infection and
prehospital emergency management of the following disorders:
3.1 Esophageal varices
3.2 Mallory Weiss syndrome
3.3 Peptic ulcer disease
3.4 Gastrointestinal haemorrhage
3.5 Cholecystitis
3.6 Appendicitis
3.7 Pancreatitis
3.8 Ulcerative colitis

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 3.9 Crohn disease
3.10 Gastroenteritis
3.11 Acute hepatitis
3.12 Bowel obstruction
3.13 Haemorrhoids
3.14 Atonic gut

Study Unit 8: Cardiopulmonary Resuscitation

After completion of this study unit, the learner should be able to:

1. Discuss “the principle of futility” in the context of ethical issues and how this relates to CPR.
2. Describe the methods that emergency care providers can use to improve and optimize
survival rates for victims of cardiac arrest.
3. Discuss the physiology of circulation provided by external chest compressions.
5. Discuss the reasons and rationale behind the most recent changes to the 2010 and 2015
AHA Guidelines from the 2005 Guidelines. Particular focus should be placed on: the reasons
for changes in success rates; the universal compression-ventilation ratio; CPR quality; the
shift in focus for level of life support; etc.
6. Discuss Cardiopulmonary Resuscitation (CPR) for adults, paediatrics and neonates:
6.1. Explain and demonstrate the basics steps for CPR in each age category
6.2. Correctly perform chest compressions and ventilations
6.3. Identify when to start CPR on a victim and demonstrate the complete sequence for
one and two-rescuer CPR.
6.4. Bag-Valve-Mask (BVM) technique and rescue breathing
7. Describe the benefits and indications for cricoid pressure during ventilations, as well as the
risks that accompany its use during advanced airway placement.
8. Discuss the considerations, and mitigation techniques when performing CPR on patients with
head, neck, or spine injuries.
9. Recognise agonal gasps and differentiate them from other respiratory patterns
10. Describe how to place a patient into the recovery position and explain its function.
11. Explain the links in the chain of survival, including the importance associated with each link.
11.1. Compare the system-specific chains of survival for cardiac arrest, particularly
between the in-hospital and out-of-hospital settings.
12. Automated External Defibrillator:
12.1. Explain the importance of early defibrillation.
12.2. Explain the steps common to the operation of all AEDs.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 12.3. Demonstrate the correct placement of the AED pads for the adult, paediatric and
infant patient.
12.4. Describe the AED prompts which will guide the rescuer during CPR.
12.5. Discuss paediatric defibrillation with specific relevance to pad size and dose
attenuators.
13. Defibrillation:
13.1. Differentiate between automated and manual external defibrillation.
13.2. Identify the ECG tracings and discuss causes and pathophysiology of the following
shockable cardiac arrest rhythms;
13.2.1. Ventricular Fibrillation
13.2.2. Pulseless Ventricular Tachycardia
13.3. Identify the ECG tracings and discuss the causes and pathophysiology of the
following non-shockable cardiac arrest rhythms;
13.3.1. Asystole
13.3.2. Pulseless Electrical Activity
13.4. Explain the mechanism and electrophysiological benefit of defibrillation.
13.5. Differentiate between monophasic and biphasic defibrillators.
13.6. Discuss initial and subsequent defibrillation energy level settings in the adult,
paediatric and infant patient.
13.7. Define refractory ventricular fibrillation
13.8. Define refractory pulseless ventricular tachycardia
13.9. Discuss the safe use of a defibrillator.
13.10. Explain the potential hazards to the rescuer and patient when using the defibrillator.
13.11. Explain transthoracic resistance, its influences, and how to reduce it.
13.12. Discuss the cardiac arrest algorithms for shockable and non-shockable cardiac
arrest.

Study Unit 9: Obstetrics

After completion of this study unit, the learner should be able to:

1. Distinguish between the different trimesters of pregnancy.

2. Describe the assessment and history taking appropriate in the prehospital emergency care
environment, pertaining to a pregnant patient.
3. Differentiate between normal and abnormal delivery.
4. Identify the stages of labor.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 5. Identify the clinical features of imminent delivery.
6. Prepare the mother for delivery, as appropriate in the prehospital environment, including
adequate consideration for modesty and privacy.
7. Discuss the procedure for normal vaginal delivery per defined protocol
8. Discuss the steps in delivering the placenta and describe the examination of the placenta.
9. Discuss the use of Nitrous Oxide as an analgesic for the patient in labour
10. Describe the management of the mother and newborn post-delivery when no complications
are present.
11. Describe how and when to cut the umbilical cord.
12. Discuss the pathophysiology, clinical presentation and immediate management of for post-
partum haemorrhage
13. Describe the use of oxytocin during the third stage of labour as prophylactic management for
post-partum haemorrhage.
14. Discuss the pathophysiology, clinical presentation, management considerations and non-
pharmacological management of:
13.13. Prolapsed cord
13.14. Breech delivery
15. Discuss the initial steps of assessment for neonates, including drying and warming,
positioning, suctioning, and stimulation
16. Discuss the application of the APGAR score.
17. Discuss and describe the initial care of the healthy newborn
18. Discuss the method and importance of kangaroo-mother-care (KMC) and initiation of suckling

Study Unit 10: Pharmacology

After completion of this study unit, the learner should be able to:

1. Identify the principles of Pharmacology.

2. Explain the following terms:
1.1. Drug
1.2. Antagonists
1.3. Agonists
1.4. Biological half-life
1.5. Biotransformation

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 1.6. Blood-brain barrier
1.7. First-pass metabolism
1.8. Idiopathic
1.9. Maintenance dose
1.10. Pharmaceutics
1.11. Pharmacodynamics
1.12. Pharmacokinetics
1.13. Placebo
1.14. Potentiation
1.15. Summation
1.16. Synergism
1.17. Therapeutic action
1.18. Therapeutic index
1.19. Therapeutic range
1.20. Tolerance
1.21. Untoward effects
1.22. Toxicity
3. Discuss medication safety under the following headings:
1.3. Legal compliance, including the HPCSA medication legislation
1.4. Moral and ethical responsibilities
1.5. Ethical responsibilities
1.6. Outline and describe the different drug schedules and legislation relating to each
4. Discuss medication administration under the following headings:
3.1. Differentiate between chemical, generic, and trade names of medications.
3.2. Differentiate between the various forms of drugs.
3.3. Discuss the specific anatomy and physiology of the autonomic nervous system in
relation to the desired effects of medication.
3.4. Identify the principles of Pharmacodynamics.
3.5. List and differentiate between the various routes of administration.
3.6. Identify the principles of Pharmacokinetics.
3.7. Describe medication response relationships.
3.8. Identify steps to reduce medication errors and limit the harmful effects of medication
administration.
3.9. Discuss the recognition and management of adverse medication reactions.
4. Identify the principles of vascular access and medication administration
4.1. Explain the relationship between fluid and electrolyte physiology.

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

 4.2. Differentiate between compositions of intravenous fluids and explain their effects.
4.3. Discuss formulas as a basis for performing drug calculations.
4.4. Apply principles of mathematics to calculate drug dosages.
4.5. Explain the importance of aseptic and sterile techniques.
5. Discuss the scheduling, mechanism of action, indications, contraindications, adverse events,
precautions, dosage and administration of the following drugs:
6.1 Acetyl Salicylic Acid
6.2 β2-Stimulants (inhaled)
6.3 Corticosteroids (Hydrocortisone, Methylprednisolone)
6.4 Dextrose Intravenous (Adult)
6.5 Glucagon
6.6 Ipratropium Bromide
6.7 Medical oxygen
6.8 Nitrous oxide
6.9 Oral glucose powder/gel
6.10 Oxytocin
6.11 Thiamine

© 2023 Cape Peninsula University of Technology Diploma Emergency Care

© 2023 Cape Peninsula University of Technology Diploma Emergency Care