Medical, Quality Agreement by whp20147

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									Annex C

 MEDICAL TECHNICIAN QL6A     (TRAINED
       AT CFMSS AFTER MAY 2002)

                                                                            Has the level of      Has the level of       Has the level of
THE FOLLOWING IS A BREAKDOWN OF
                                                                         proficiency required   proficiency normally   proficiency required
TASKS THAT THE MED TECH QL6A COULD                                        to perform parts or   required to perform     to independently
BE REASONABLY EXPECTED TO                                                 elements of duties      duties and tasks     perform duties and
                                                                            and tasks under          under Non-                tasks
PERFORM (Sgt Level):                                                         Continuous             Continuous
                                                                             Supervision           Supervision
Assess Patients                                                                                          X

Assess patient physical / mental status                                                                  X
a. Conduct Medical Screenings                                                                            X
b. Conduct physical examinations                                                                         X
c. Document / record patient and clinical information                                                    X
d. Conduct a patient assessment                                                                          X

Treat Patient with illnesses                                                                                                    X
Limited to OTC medications IAW Restricted Acts Pharmaceutical

Treat patient with injuries                                                                                                     X
Limited to MSK injuries, STI, and AEC Protocols

The QL6A Med Tech, with due regard for universal precautions,
aseptic technique, patient protocols, safety and ethical/legal
guidelines, IAW their scope of practice and within their level of
formal instruction at
CFMSS shall:
                                                                                                                                X
a. Obtain a complete medical history
  Record patient screening using the following format:                                                                          X
  - CC-chief complaint                                                                                                          X
  - HPI-history of present illness                                                                                              X
  - Med Hx-medication history                                                                                                   X
  - PHx-past history related to chief complaint                                                                                 X
  - O/E-on examination                                                                                   X
  - IMP-impression, and                                                                                  X
  - Tmt Plan                                                                                             X
b. perform physical exam to include recommending of laboratory tests,                                                           X
if required to PA / MO
c. formulate an impression including differential diagnosis                                                                     X
d. recommending diagnostic tests, if required (Discuss and refer to PA                                   X
/ MO)
e. monitor blood transfusions                                                                            X
f. develop a treatment plan ( refer / discuss with PA / MO IAW Unit                                      X
SOPs)
g. refer to appropriate medical authority                                                                                       X
The QL6A Medical Technician with due regard for universal               QL5/6A Med Tech
precautions, aseptic techniques, patient protocols, safety, ethical       (at discretion of
/ legal guidelines, IAW their scope of practice and within their             Snr Medical
level of formal instruction at CFMSS shall: obtain a patient health         Authority) are
history,                                                                    authorized to
identify physical findings, formulate an impression and                    assign Ex Duty
differential diagnosis, develop a treatment plan for common             to a max of 2 days
conditions. These are to include OTC                                     and Light Duty to
medications, treatments, disposal, follow-up and documentation          max of 5 days with
procedures.                                                                 no extension.




They must recognize the signs & symptoms of the following conditions:

1. Respiratory:
a. bronchitis                                                                   X
b. pneumonia                                                                    X
c. asthma                                                                       X
d. environmental allergies                                                      X

2. Cardiovascular:
a. causes of chest pain                                                         X
b. myocardial infarction                                                        X
c. aneurysm (aortic)                                                            X
d. hypertension                                                                 X
e. deep venous thrombosis                                                       X
f. lymphadenopathy                                                              X

3. Neurological
a. headache                                                                     X
b. syncope                                                                      X
c. seizures                                                                     X

4. Gastrointestinal
a. ulcers                                                                       X
b. esophageal reflux                                                            X
c. hepatitis                                                                    X
d. appendicitis                                                                 X
e. cholecystitis                                                                X
f. hemorrhoids                                                                  X
g. pancreatitis                                                                 X
h. gastro-enteritis                                                             X
i. colitis                                                                      X
j. constipation

5. Genitourinary
a. epidiymitis                                                                  X
b. nephrolithiasis                                                              X
c. pyelonephritis                                                               X
d. prostatistis                                                                 X
e. urthritis                                                                    X
f. STD (chlamydia, gonorrhea, genital herpes, condyloma,                        X
trichomoniasis
g. Genital candidiasis                                                          X
h. Cystitis                                                                     X

6. Gynecological
a. pelvic inflammatory disease                                                  X
b. dysmenorrhea                            X
c. amenorrhea                              X
d. pregnancy                               X

7. MSK
a. low back pain                           X
b. sprains/strains                         X
c. dislocations                            X
d. carpal tunnel sydrome                   X
e. AC joint injury                         X
f. Rotator cuff tendonitis                 X
g. Bursitis                                X
h. Tendonitis                              X
i. Patellofemoral syndrome                 X
j. Knee joint injury                       X
k. Shin splints                            X
l. torticollis                             X

8. Endocrine
a. diabetes                                X
b. hypothyroidism                          X
c. hyperthyroidism                         X



9. Psychiatric
a. stress and adjustment disorder          X
b. anxiety disorder                        X
c. PTSD                                    X
d. Mood disorders                          X
e. Chemical dependence / substance abuse   X

10. Dermatologic
a. contact dermatitis                      X
b. acne                                    X
c. paronychia                              X
d. warts                                   X
e. impetigo                                X
f. herpes simplex                          X
g. herpes zoster                           X
h. head lice                               X
I. Scabies                                 X

11. EENT
a. conjunctivitis                          X
b. red eye                                 X
c. herpes simplex                          X
d. glaucoma                                X
e. hordeolum                               X
f. detached retina                         X
g. otitis (internal, external)             X
h. viral rhinitis                          X
i. sinusitis                               X
j. strep throat                            X
k. tonsillitis                             X
Prescribe “Over The Counter” (OTC)                                 QL5/6A Med Techs      IAW Restricted
authorized pharmaceuticals                                         must be Certified         Acts:
                                                                    Pharmaceutical      Pharmaceuticals
                                                                    to perform this
                                                                  task independently.




The QL6 Med Tech is trained to treat the following:

a. Superficial Fungal infections                                                                          X
b. Dermatitis                                                                                             X
c. Nausea and vomiting                                                                                    X
d. Seasonal Allergies                                                                                     X
e. Common cold                                                                                            X
f. Diarrhoea                                                                                              X
g. Dyspepsia / GERD                                                                                       X
h. Muscle spasm                                                                                           X
I. Conjunctivitis                                                                                         X
j. Headaches                                                                                              X
k. Lice                                                                                                   X
l. Scabies                                                                                                X
m. Constipation                                                                                           X

Refer patient to higher medical authority                                                                 X

Obtain Vital Signs
a. Perform oral or tympanic temperature                                                                   X
b. obtain a radial pulse                                                                                  X
c. obtain respiratory rate                                                                                X
d. obtain a blood pressure reading using a sphygmomanometer and
stethoscope
e. obtain patients height and weight                                                                      X
f. record vital signs                                                                                     X

Test vision
a. test visual acuity                                                                                     X
b. test colour vision                                                                                     X
c. document results                                                                                       X

Perform fluroscien examination                                                                X

Test Hearing
a. examination of the ear with an otoscope                                                                X
b. explain audiometry procedure to patient                                                                X
c. perform audiometry                                                                                     X
d. document results                                                                                       X

Obtain a 12-lead electrocardiograph (EKG)
a. demonstrate functions and features of the EKG machine IAW                                              X
manufacturers instructions
b. prepare the patient for EKG                                                                            X
c. explain procedure to patient                                                                           X
d. demonstrate proper lead placement                                                                      X
e. perform EKG                                                                                            X
f. troubleshoot common problems with EKG                                                                  X
g. demonstrate post procedure care                                                                        X
h. demonstrate and perform maintenance of EKG machine IAW                                                 X
manufacturers instructions
Interpret basic ECG reading                                               X

Operate a cardiac monitor/defibrillator

Complete test procedures for cardiac monitor/ defibrillator as per        X
manufacturers instructions

OPERATE EXTERNAL CARDIAC DEFIBRILLATOR (AED)                                  X

Examine the head and neck IAW PCP / AEC Guidelines                            X

Examine the thorax IAW PCP / AEC Guidelines                                   X

Examine the abdomen IAW PCP / AEC Guidelines                                  X

Provide assistance to SMA with a minor surgical procedure

a Open sterile packs                                                          X
b. Prepare a sterile field                                                    X
c. Drape operative site                                                       X
d. Prepare medications and solutions                                          X
e. Using aseptic technique perform appropriate                                X
preparation of a minor surgery tray
f. Pass surgical instruments                                                  X
g. add sterile equipment as required                                          X
h. assist MO/PA to draw up local anesthetic                                   X
i. demonstrate proper documentation for minor surgical procedures             X

j. dismantle a minor surgery tray, disposing of sharps, linens, and bio       X
hazardous material
k. prepare minor surgery tray for sterilization                               X



Provide wound care
a. wound assessment                                                           X
b. explain procedure to patient                                               X
c. change a sterile dry dressing                                              X
d. apply spiral using kling                                                   X
e. apply figure of eight bandage                                              X
f. apply elastic bandage                                                      X
g. apply tube gauze (to a digit)                                              X
h. apply surgifix to a forearm                                                X
i. remove sutures and staples                                                 X
j. apply steri-strips                                                         X
k. educate patient with regards to wound care                                 X
l. demonstrate proper documentation of wound care and suture                  X
removal

Cauterize wounds (non electric)                                           X
Only Silver Nitrate applicators to be used

Irrigate a wound
a. explain procedure to patient                                               X
b. perform wound irrigation                                                   X
c. document wound irrigation                                                  X

Pack a wound / incisions
a. explain procedure to patient                                               X
b. perform wound packing                                                   X
c. document wound packing                                                  X

Perform primary closure of wounds
suture superficial wounds to include the epidermal and dermal layers   X
(excluding face and hands)

Remove sutures / staples                                                   X

Tape an ankle
a. explain procedure to patient                                            X
b. assess neurovascular status                                             X
c. apply closed basket weave                                               X
d. provide patient instructions                                            X

Apply other orthopedic devices:
a. knee brace                                                              X
b. wrist brace                                                             X
c. ankle brace                                                             X
d. finger splint                                                           X

Apply cast to immobilize injuries to the musculoskeletal injuries



Apply Cast                                                                 X
a. obtain order                                                            X
b. explain procedure to patient                                            X
c. apply cast                                                              X
d. explain cast care to patient                                            X
e. have cast examined by ordering MO/PA                                    X
f. document procedure                                                      X

Remove casts and orthopaedic appliances
a. obtain order for removal                                                X
b. explain procedure to patient                                            X
c. remove cast                                                             X
d. provide post cast removal care                                          X
e. document procedure                                                      X

Apply hot and cold treatments                                              X



Assist patient with the use of canes and crutches
a. size canes and crutches                                                 X
b. instruct and demonstrate on proper use of canes and crutches            X



Irrigate an ear (IAW Physician Rx)                                     X

Remove foreign body from eye conjunctiva but not cornea                X



Administer Medications                                                     X

Administer IV medications (excluding IV push)                          X

Coordinate an immunization parade                                      X

Prepare medications and solutions for administration
a. interpret medication orders                                            X
b. research medications in the CPS                                        X
c. calculate medication dosages                                           X

Administer topical and oral medications
a. prepare and administer eye drops                                       X
b. prepare and administer ear drops                                       X
c. prepare and administer oral medications                                X
d. document medication administration                                     X
e. monitor patient for drug reactions and complications IAW CPS           X

Administer parental medications
            (IAW PCP protocols and DMA Pharmaceutical)
a. prepare and administer a subcutaneous injection                    X
b. prepare and administer an intradermal injection                    X
c. prepare and administer an intramuscular injection                  X
d. document medication administration                                 X
e. monitor patient for drug reactions and complications IAW CPS       X

Inject local anaesthetic                                          X

Perform intravenous therapy
a. obtain order                                                           X
b. gather and prepare equipment                                           X
c. explain procedure to patient                                           X
d. start IV                                                               X
e. secure IV                                                              X
f. set flow rate                                                          X
g. chart procedure                                                        X

Monitor IV therapy
a. confirm order                                                          X
b. assess the amount to be infused                                        X
c. change IV bag if required                                              X
d. assess site                                                            X
e. document                                                               X

Discontinue IV
a. check order                                                            X
b. explain procedure                                                      X
d. discontinue IV                                                         X
e. assess the site and cathalon integrity                                 X
f. assess amount remaining to be infused                                  X
g. document procedure                                                     X

Initiate Pre-Hospital Treatment for Trauma and Medical
Emergencies
Perform initial scene survey                                              X
a. applying PCP /BTLS/PHTLS protocols                                     X
b. fit cervical collar                                                    X
c. apply cervical collar                                                  X
d. stabilizing patient spine                                              X
e. transporting casualties                                                X

Immobilize patient                                                        X
PROVIDE ADVANCED EMERGENT                                 Med Techs with        Highlighted in      X
CARE (IAW)                                                     PCP / TA       yellow are the AEC
                                                           certification are protocols taught on
                                                        trained in the below    QL5 / Bridging
                                                              protocols.     crses after Apr 2004

CARDIAC PROTOCOL
CARDIAC CHEST PAIN                                                                                  X
CARDIAC ARREST                                                                                      X
POST-ARREST STABILIZATION                                                                           X
DISCONTINUE RESUSCITATION                                                                           X
DO NOT RESUSCITATE                                                                                  X

RESPIRATORY PROTOCOL
SOB WITH HISTORY OF ASTHMA/COPD                                                                     X
ANAPHYLAXIS/ANAPHYLACTIC SHOCK                                                                      X
TENSION/SYMPTOMATIC PNEUMOTHORAX                                                                    X

TRAUMA PROTOCOLS AND PROCEDURES
HYPOVOLEMIA                                                                                         X
BURNS                                                                                               X
PAIN                                                                                                X

MEDICAL PROTOCOLS AND PROCEDURES
ADULT ALTERED LOC-NYD                                                                               X
DIABETIC EMERGENCY                                                                                  X
SUSPECTED ADULT NARCOTIC OVERDOSE                                                                   X
SEIZURES                                                                                            X
ANTIBIOTIC PROTOCOL                                                                                 X
HOSTILE AND VIOLENT PATIENTS                                                                        X
POST EXPOSURE PROPHYLAXIS                                                                           X

ENVIRONMENT PROTOCOLS AND PROCEDURES
HYPOTHERMIA                                                                                         X
DIVING EMERGENCY                                                                                    X
DRUG MONOGRAPHS                                                                                     X
AS PER PRE HOSPITAL PROTOCOL & PROCEDURES                                                           X

EMERGENT MEDICAL PROCEDURES
INSERT ENDOTRACHEAL TUBE                                                              X
BLADDER CATHETERIZATION                                                               X
ASSESS SUSPECTED SPINAL INJURY                                                                      X
SALINE LOCK                                                                           X
PERFORM EMERGENCY NEEDLE THORACENTHESIS                                               X
NOTIFICATION AND HOSPITAL REPORT                                                      X

NEEDLE CRICOTHYROIDOTOMY                                                              X

Perform IV Therapy                                                                                  X

Monitor patient fluid intake and output                                                             X

Monitor patients for drug reactions and complications                                               X

Monitor patient progress                                                              X

Monitor blood transfusion                                        X

Perform bladder catheterization                                                       X
Manage Airway and Perform advanced airway management

a. assess airway                                                 X
b. insert a combitube                                            X
c. insert nasopharyngeal airway                                  X
d. insert oralpharyngeal airway                                  X
e. prepare equipment for intubation                              X
f.administer O2 by nasal prong                                   X
g. administer O2 by Simple face mask                             X
h. administer O2 by non-rebreather mask                          X
i. administer O2 by bag valve mask                               X

Suction a patients airway                                        X

Prepare nasal gastric tray                                       X

Prepare equipment for intubation                                 X

Insert endotracheal tube                                     X

Prepare Minor Surgery Supplies and Equipment                     X

Prepare supplies and equipment for sterilization
a. inspect and clean instruments prior to sterilization          X
b. prepare tray for sterilization                                X
c. prepare individual instruments for sterilization              X

Load sterilizers                                                 X

Operate sterilizer IAW manufacturer’s instructions               X

Perform activities of daily living                           X

Develop nursing care plans                                   X

Implement nursing care plans                                 X

Instruct patients on self care                               X

Provide health maintenance education                         X

 Prepare a patient unit
a. prepare an open bed                                           X
b. prepare a closed bed                                          X
c. prepare a surgical bed                                        X
d. perform terminal cleaning of the patient unit                 X

Prepare a body after death                                       X
             (IAW Provincial or operational guidelines)

Prepare patient for medical / surgical procedures                X

Prepare patients for diagnostic procedures                       X



Provide ventilatory care to post cricothyroidotomy patient       X


Conduct inhalation therapy                                       X
Perform peak expiratory flow test
a. explain the procedure to the patient                               X
b. document results to include expected values IAW manufactures       X
guidelines

Assist with patient mobility
a. place patient in fowlers position                                  X
b. place patient in semi-fowlers position                             X
c. place patient in supine position                                   X
d. place patient in prone position                                    X
e. place patient in lateral position                                  X
f. transfer patient from stretcher to bed                             X
g. transfer patient to wheelchair                                     X

Restrain patients                                                 X

Assist the patient with personal hygiene
a. explain procedure to patient                                       X
b. gather equipment                                                   X
c. prepare patient for bath                                           X
d. bathe patient                                                      X
e. document procedure                                                 X

Prepare a patient for a meal
a. assist patient in preparation for meal                             X
b. verify dietary order                                               X
c. arrange the tray and assist as required                            X
d. observe amount consumed                                            X
e. document intake                                                    X

LABORATORY PROCEDURES

Obtain specimens                                                      X

Collect specimens                                                     X
a. obtain order                                                       X
b. gather supplies                                                    X
c. explain the procedure to the patient                               X
d. collect urethral smear                                             X
e. collect throat swab                                                X
f. collect wound swab                                                 X
g. collect sputum sample                                              X
h. collect stool sample                                               X
i. collect urine sample                                               X
j. collect mid-stream urine                                           X
k. label specimens/samples                                            X
l. process specimens IAW unit SOPs                                    X
m. document procedure                                                 X

Perform lab stick urinalysis
a. obtain order                                                       X
b. perform test                                                       X
c. document findings                                                  X

Obtain Venous blood sample with a
vacutainer
a. obtain order                                                       X
b. gather supplies                                                    X
c. explain procedure to patient                                            X
d. obtain single sample                                                    X
e. obtain multiple samples                                                 X
f. label specimens                                                         X
g. process specimens IAW unit SOPs                                         X
i. document procedure                                                      X

Perform occult blood test                                              X

Perform glucose testing using a glucometer                             X
a. obtain order                                                        X
b. gather supplies                                                     X
c. explain procedure to patient                                        X
d. perform procedure                                                   X
e. document results                                                    X

Perform Health and Safety Inspections

Conduct health hazards inspections                                     X

Inspect field accommodations and facilities                            X

Inspect food services facilities / storage areas                       X

Inspect medical facilities                                             X

Analyse water specimen                                                 X

Control communicable diseases                                          X

Perform medical administration and supply tasks                            X

Maintain medical records
a. document patient information                                            X
b. process medical documentation                                           X
c. audit medical files and records IAW unit SOP                        X
d. access information on the DIN to include CFMO’s, DAOD’s, and            X
CFAO’s

Encode / decode diagnosis and treatment                                    X

Process medical reports and returns                                        X

Monitor reports and returns                                                X

Process medical accounts and invoices                                      X

Implement Medical policies, agreements and understandings                  X




Manage medical supplies and equipment                                      X
a. verify contents of medical kits IAW unit SOP’s                          X
b. demand deficient supplies by using medical stores requisition IAW       X
unit SOP’s
c. verify serviceability of medical equipment IAW unit SOP’s               X

Verify distribution accounts                                               X
Prepare Major Medical Equipment                                         X
Programme (MMEP)

Maintain level of supplies in emergency vehicles                            X

Issue medical supplies                                                      X

Conduct inventory of medical supplies                                       X

Supply Medications                                                          X

Supply narcotics / controlled drugs                                     X

Maintain security of narcotics and controlled drugs                     X

Dispose of drugs                                                        X

Prepare equipment / instruments / supplies for shipment /                   X
deployment

Coordinate shipment of equipment / instruments / supplies                   X



Perform user maintenance on Health Services equipment                       X

Manage CFFET/CFS 5 SOI

Control equipment and materials                                             X

Medical Operations
Conduct field deployment site recce                                         X
Deploy Medical sub - units                                                  X
Set up field medical facility                                               X
Develop local defence plan                                                  X
Load equipment and supplies in vehicles                                     X
Co-ordinate ambulance shuttle system                                        X
Co-ordinate search for casualties                                           X
Search for casualties                                                       X
Prepare helicopter landing zone                                             X
Configure vehicles for casualty transport                                   X
Load/unload casualties from transport vehicles                              X
Transport Casualties                                                        X
Receive and triage casualties                                               X
Initiate evacuation report                                                  X
Conduct patient CBR protection drill                                        X
Provide CBR casualty care                                                   X
Conduct patient CBR decontamination drill                                   X



Assist in the administration of a medical facility                          X

Assist in the management of health service delivery to ensure               X
appropriate and timely provision of patient care and workplace
safety
· provide advice to the financial coordinator as to forecasts and       X
expenditures that impact upon areas of responsibility
· ensure accountability of designated material resources                    X
· ensure compliance to the legal guidelines with regards to narcotics       X
and controlled drugs
· assist in the planning of unit level operational deployment        X
gather information pertaining to medical incidents and/or patient        X
complaints
process medical incident reports and as required and without error       X
encode/decode diagnosis and treatment

The QL6 Med Tech is taught the following supportive knowledge            X
in order to complete above task:
CRB(M) procedures;
Budget accounting procedures;
Budget preparation;
Collective agreements;
HS equipment user maintenance procedures;
Mass casualty management procedures;
Principles of triage;
Helicopter casualty evacuation;
Drug disposal procedures;
Mental health team role/functions;
Immunization policies;
Surveillance requirements for communicable disease;
Occupational Health;
Aircraft accident/incident investigation procedures;
Narcotics and controlled drugs;
Sexual assault protocol;
Medical kits and panniers;
Civilian medical supply sources;
Medical documents;
Medical Category system;
Release of medical information (Privacy Act);
Med Tech responsibilities/limitations;
Ambulance shuttle system principles;
International Classification of Diseases and Injuries;
Field medical facility set up principles and procedures;
Casualty evacuation chain;
CFHS operational role, organization, functions and capabilities;
CF Medical Supply System;
Geneva Convention and protocols as they apply to medical services;

Medico-legal responsibilities of medical personnel;
NBC disaster response procedures;
Office automation software;
Medical abbreviations, symbols and terminology;
Medical and professional ethics;
Use of personal protective equipment;
Patient evacuation procedures;
Personal computer operation;
Service Personnel Holding List (SPHL);
Medical quality management programs;
Medical risk management programs;
Entitlements to medical care;
Biological waste disposal procedures;
Liquid and solid waste disposal procedures;
Financial administration manual;
Deployment site requirements;
Occupational structure and responsibilities of HS NCMs;
Hygiene and sanitation requirements and procedures;
CFMO;
Medical support principles;
Medical estimates;
MMEP procedures;
Branch directives;
CF Medical/Environmental doctrine;
Climatic conditions and effects on environmental health;
Investigative procedures;
Housekeeping requirements;
Memorandum of Understanding (MOU)/Letter of Agreement (LOA);

Continuum of care;
Health Promotion;
Health Prevention;
Occupational Health;
Universal precaution;
Civilian public health organizations;
Medical ethics;
PMed intelligence reports;
Personal Protective Equipment (PPE);
Auditing procedures;
Quality control/management;
Universal precautions; and
Medico-legal responsibilities and professional ethics.
Assist in the management of human resources.                         X

Ensure facility efficiency and cohesiveness by effectively           X
managing civilian employees
Middle Management Course (MMC) and                                   X

Initiate changes to facility establishment IAW Middle                X
Management Course (MMC.

The QL6 Med Tech is taught the following supportive knowledge        X
in order to complete above task:
Budget accounting procedures;
Budget preparation;
Canadian workload measurement system;
Civilian classification;
Civilian personnel administrative policies;
Collective agreements;
Mental health team role/functions;
Ergonomics;
Industrial/occupational health regulations;
Release of medical information (Privacy Act);
Office automation software;
Medical abbreviations, symbols and terminology;
Medical and professional ethics;
Use of personal protective equipment;
Personal computer operation;
KService Personnel Holding List (SPHL);
Medical quality management programs;
Medical risk management programs;
Financial administration manual;
Third party accountability;
Memorandum of Understanding (MOU )/ Letter of Agreement (LOA);   X

Occupational Health;
HS facilities accreditation process; and
Medical ethics.

								
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