Entrustable Professional Activities

LG7: Acute injury clinical assessment and management

Learning Goal 7

Acute injury clinical assessment and management

Assess and manage children with suspected acute injuries

This activity requires the ability to:

  • assess patients with suspected acute injury
  • perform primary, secondary, and tertiary surveys when assessing trauma patients
  • order and interpret appropriate investigations
  • provide appropriate treatments for patients with acute injuries
  • perform relevant procedures for managing acute injuries in the emergency department
  • manage urgent life- or limb-threatening injuries
  • demonstrate knowledge and understanding of trauma systems, and use these when indicated
  • provide leadership in managing trauma patients
  • create resuscitation and treatment plans for multi-trauma patients
  • diagnose injuries, and refer on for further specialised treatment and management as required
  • consider the impact of injuries on patients’ lives, and counsel on management strategies
  • pre-empt and prevent potential complications of injury, and implement follow-up plans
  • identify potential inflicted injuries, and manage appropriately

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • assess and examine suspected injuries accurately
  • perform trauma primary, secondary, and tertiary surveys, using a thorough, systematic approach
  • rationalise and arrange appropriate investigations
  • interpret investigations
  • provide acute treatment of injuries, including analgesia and procedural sedation options appropriate for patients’ age and presentation
  • treat and manage injuries as listed in acute injury knowledge guide
  • demonstrate knowledge of the potential risks and complications of injury and the prescribed treatments
  • recognise and sensitively work-up potential inflicted / non-accidental injuries

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • identify potential cases of inflicted / non-accidental injury, and, with guidance, perform appropriate work-ups
  • provide basic treatment and management of common injuries
  • recognise potential inflicted / non-accidental injuries
  • demonstrate awareness of need for sensitivity with potential inflicted / non-accidental injuries

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • establish and communicate clear roles, responsibilities, and priorities within the trauma team
  • effectively communicate with all members of the trauma team, and apply closed-loop communication where appropriate
  • communicate treatment and management plans to patients, families, and/or carers, including gaining consent, and, where appropriate, engaging patients, family, and/or carers in decisions around treatment options
  • clearly document in medical records the assessment, diagnosis, treatment, and management plans for patients with acute injuries
  • communicate concerns for suspected inflicted injuries via appropriate local processes

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • communicate with patients in a developmentally and age-appropriate way when assessing and managing acute injuries
  • communicate with families or carers, including gaining consent for investigations and management as required

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • use up-to-date evidence-based practice in the management of children with acute injuries
  • check processes are in place so investigations and results are reviewed, and injuries not missed
  • engage in local processes in reviewing and analysing multi-trauma presentations in multidisciplinary team meetings, such as trauma review meetings

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • follow local processes and protocols in managing children with acute injuries
  • evaluate quality and safety processes in the workplace

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • actively participate in multidisciplinary practice of trauma presentation assessment and management, including simulation where available
  • demonstrate effective supervision and teaching of junior colleagues in the assessment and management of children with acute injuries

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • supervise and support junior doctors in the management of acute injuries in children, including interpretation of investigations

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • incorporate current evidence-based trauma and injury guidelines into local processes and protocols
  • consider enrolling eligible patients in approved clinical trials with informed consent

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • refer to evidence-based clinical guidelines and protocols on the management of trauma and injuries in children

Cultural safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • assess and manage patients with acute injuries in a culturally sensitive and appropriate way
  • integrate culturally appropriate care of Aboriginal and Torres Strait Islander peoples and Māori into patients’ management

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • practise cultural competency appropriate for the community serviced
  • proactively identify barriers to healthcare access

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • facilitate interactions within multidisciplinary teams, respecting values, encouraging involvement, and engaging all participants in decision making

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • establish, where possible, patients’ wishes and preferences about care
  • show respect for knowledge and expertise of colleagues and other specialties

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • recognise the need for escalations of care, and escalate to appropriate staff or services
  • use appropriate guidelines, evidence sources, and decision support tools
  • investigate acute injuries appropriately while taking multiple factors into consideration, including resources available locally, and the risks of these, including radiation and the potential need for sedation to be able to perform procedures

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • recognise the bounds of their own abilities, and know when and how to seek assistance from other colleagues in the department or other specialities

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • lead a trauma team, including multidisciplinary members internal and external to the emergency department
  • apply crisis resource management principles when managing multi-trauma patients
  • work collaboratively with other health professionals to formulate appropriate management plans, including the appropriate timing and location of these events

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • lead a trauma team with supervision / support, demonstrating a structured approach and clear communication

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • use a considered and rational approach to the responsible use of resources, balancing costs against outcomes
  • collaborate with emergency medicine staff and other colleagues to develop policies and protocols for the investigation and management of common acute medical problems
  • follow policies on mandatory reporting, such as abuse and sexual assault
  • advocate for paediatric emergency care resources and policies

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • know and follow local processes for referring potential inflicted injuries to the appropriate services