Pre Hospital Basic Surgical Skills Course.

R

Resusruss

Longterm Registered User
Last week I attended this course, at Nottingham City Hospital run by the boys at the Clinical Skills and Competency Centre.
What a day !, this is a full on, hands on course and Consultant lead.
It covered the following subjects:

Chest Drains and Needle decompression.
Surgical Airway.
NG and OG Tubes.
All IO devices - BIG,Eze IO, FAST, Cook.
Basic Suture Techniques.
Ring Blocks and Use of Local Anaesthetic.
Urinary Catheters.

All practicals where carried out on Cadaveric models and the cost of the day was only £150 with lunch included.

A top quality course.

Why did I attend ?, I wanted to put all the theory in to practice.

If you are a health care professional working in a remote or hostile situation then I feel this course would be a great CV enhancer.

Russ
 
I second this training establishment and the guys John & Paul known them over the years and are by far the best on the training circuit in my opinion thumbs up
 
Resusruss said:
Last week I attended this course, at Nottingham City Hospital run by the boys at the Clinical Skills and Competency Centre.
What a day !, this is a full on, hands on course and Consultant lead.
It covered the following subjects:

Chest Drains and Needle decompression.
Surgical Airway.
NG and OG Tubes.
All IO devices - BIG,Eze IO, FAST, Cook.
Basic Suture Techniques.
Ring Blocks and Use of Local Anaesthetic.
Urinary Catheters.

All practicals where carried out on Cadaveric models and the cost of the day was only £150 with lunch included.

A top quality course.

Why did I attend ?, I wanted to put all the theory in to practice.

If you are a health care professional working in a remote or hostile situation then I feel this course would be a great CV enhancer.

Russ
Click to expand...

I have spoken to paul and john in the past. I wanted to attend the course however I got given a paramedic interview day which I was unsuccessful at.
 
No dis-respect intended. Was there an exam and was this course certificated? and were you considered compitent to carry out all of these procedures upon completion?

I only ask as one day seems a short period in which to teach these subjects as you are looking at around 7-8 teaching hours (taking lunch into account) and only having manequin practice rather than supervised practice.
 
ISD,

The course awards an attendance certificate, all hands on was supervised on Cadaveric models, not plastic manikins.

The course is designed for Health Care professionals.

Hope that answers your questions.

Russ
 
Resusruss said:
ISD,

The course awards an attendance certificate, all hands on was supervised on Cadaveric models, not plastic manikins.

The course is designed for Health Care professionals.

Hope that answers your questions.

Russ
Click to expand...

Russ,

Thanks for the reply. Not attempting to put a downer on a course I haven't attended. It seems to have alot of content for one day, equally I fail to see the use of a course if you cannot use the skills at the end of it.
 
ISD,
Totally agree with you, its down to your employer/medical authority if you can use the skills taught on this course, there was an ECP and HART Paramedics on the course, that were going to be allowed to use the formal chest drain element of the course as underpinning knowledge, and once a mentoring period had been completed it was going to be added to there skill set.

Russ
 
The same theme crops up again and again and that is down to lack of understanding about how UK medical practice works.

A registered healthcare professional in the UK is solely responsible for determining their own suitability to perform a skill or procedure. This is granted to us by virtue of state registration. We have the freedom and autonomy to act within our own perceived level of skill and competence.

As such a licence to practice is not granted through attendance on a course, neither does a course certificate (regardless of what it says on the piece of paper) change what we can or can't do.

Our scope is determined usually by our employer and this is usually due to litigation or insurance and clinical governance issues.

If I perform a procedure and I am challenged then it would be down to me to prove to the satisfaction of a Court that I was competent to perform that procedure. Cannulation for example is a common skill but I don't have a piece of paper giving me permission to cannulate. This is implied through my exposure to the skill and a robust training programme prior to live practice.

I would have to satisfy a 'jury' of my peers that I was competent and that I held the level of skill of a person professing to practice the skill I was performing. This is called the Bolam test and is well established in English law. No piece of paper replaces my judgement and the need to satisfy my peers of my competence.

Russ is not suggesting that the course entitles him to practice any skills taught but if he goes away and practices the skills under supervision, this would provide strong evidence that he possessed the level of skill of a person professing to practice that technique. The course is a starting point that the healthcare professional will use to determine their own competence.

ALS is another much argued subject. The course and certificate are not a licence to practice, neither does the course or certificate make us competent. It delivers training in the core skills required. The licence to practice comes through HPC registration and the relevant legislation governing registered healthcare professionals.

My employer restricts the skillset of paramedics to JRCALC and any deviation has to be justified. This is because we need a common standard across the entire trust. We cannot have individual paramedics doing their own thing and delivering different levels of care. There needs to be a common standard and this is set by (in our case) the medical director who is a consultant in emergency medicine.

In the USA, the system is different with alphabet soup courses and in date 'cards' being required before a skill can be practised. The paramedic acts under the medical director's licence and therefore permission (whether verbal, through protocol or implied) is required for all skills and drugs. This is called a physician extender system.

The situation with chest drains has been argued and there is strong evidence that a chest decompression is as effective as a chest drain for up to 4 hours. Therefore we do not have the skill because we do not need it. I am trained in the skill and consider my self competent so if I performed it (even though I legally can) I would then have to justify it and I would struggle to satisfy my peers that it was an appropriate course of action to take.
 
Last edited:
The course also seems to be aimed at people who are already healthcare professionals and as such should already be competent in (for example) IO access. The course would then introduce different devices capable of achieving IO access. This is not introduction to a new skill, rather a new way of doing an existing skill. Therefore, the time required to cover this subject would be minimal. Device specific landmarks, operation of the device, specific hazards and contraindications. The rest would already be known by the paramedic.

It's the same with ALS, a paramedic is already competent in ALS. The RC(UK) ALS course should not therefore be teaching anything the paramedic doesn't already know. With the exception of blood gases (easy mnemonic ROME and a half hour session) and maybe the need to stand back and give instructions rather than get hands on as you would in an ambulance, the paramedic, ODP, Nurse or Doctor would already have the skills. The ALS course teaches a systematic method of applying those skills to cardiac arrest scenario.

As an example, I did an ILS course prior to training as a technician and was completely lost. My ALS course was a breeze as I had already covered he content in depth on my paramedic course and was just refreshing the algorithms. The course aimed to teach a common way of doing things so that the entire resus team was singing from the same hymn sheet.
 
Just completed a medic refresher course at Nottingham, the course was first class.
In addition, being the best value for time and money.
Paul and John some of the best pre-hospital instructors I have met over the years, and I say that as an instructor in most of these life support skills.
 
Last edited:
Just completed a medic refresher course at Nottingham, the course was first class.
In addition, being the best value for time and money.
Paul and John some of the best pre-hospital instructors I have met over the years, and I say that as an instructor in most of these life support skills.
 
just did the surg skill course and found it very usefull, i was allready familiar with the concepts taught as an off shore medic and have assisted on many of the procedures during hospital stints but i found it a great hands on refresher especialy as we used cadaver models which give a much better sense of the anatomy and feel of carrying out an intervention on a real pat. However the bigest gem for me was the use of a ashermans chest seal instead of purse string to secure a chest drain, genious! why nobody has ever shown me that before i dont know!!
however i would say that it is more of a refresher/fam visit than a teach as i dont think i would have found it long enough to gain any real copetancey in the more advanced procedures
 
Back
Top