Remote Medicine

Advanced Specialised#

Knowledge#

AS.K.1#

Discuss public health issues relevant to remote communities, including:

  • infrastructure, public health surveillance and procedures
  • disease control initiatives, environmental health issues
  • water supply, sewerage systems, water testing
  • power supply and generator maintenance, and
  • triage and the mortuary
  • requirements for post mortems for forensic and Coroners cases

AS.K.2#

Describe occupation and personal health and safety issues relevant to remote communities, including:

  • occupational medicine issues, and
  • personal safety issues and security

AS.K.3#

Identify links between social factors and health outcomes in a community, including:

  • the impact of poverty, nutrition, housing, education and employment opportunities, family relationships, social support, transport, and control over one’s life

  • the Barker hypothesis and health outcomes in adulthood

  • Principles of ethical practice in a remote community, including:

    • respecting different cultural frameworks for determining ethical behaviour
    • understanding the ethical principles underlying the care of chronically ill patients in remote practice – informed consent, confidentiality, autonomy and issues associated with dying
    • respecting a patient’s right to refuse, or vary treatment, and
    • understanding local issues that might impact upon the decision to treat a person locally or refer

AS.K.4#

Discuss the nature of remote communities, and of medical practice in these environments, including:

  • sociology of remote communities
  • treating self, family, pets and those you know and work with
  • having a greater responsibility of care
  • using different protocols appropriately
  • management skills and professional networks, and
  • strategies for reducing professional and personal isolation and burnout

AS.K.5#

Detail protocols for establishing a donor panel to use in an emergency, including managing a walk-in blood bank to take blood by donation.

AS.K.1#

Identify how to arrange for locum cover for planned leave and emergencies.

Skills#

AS.S.1#

Provide primary, secondary, emergency care for a remote community

AS.S.2#

Provide effective clinical care when away from ready access to specialist medical, diagnostic and allied health services

AS.S.3#

Identify community health needs and develop additional skills required to meet these

AS.S.4#

Diagnose and manage a remotely located patient over the telephone or radio, including:

  • assessing the capabilities of the person with the patient and ascertaining their understanding of the problems and the logistics
  • taking a comprehensive history including where language may be a communication barrier
  • giving appropriate instructions to nurses, Aboriginal health workers, other healthcare workers, and people with no medical training, including administration of medication and other treatments eg from Royal Flying Doctors or ships’ medical chest
  • assessing the logistics and resources involved in managing, or stabilising and transporting the patient if required
  • referring the patient appropriately as per protocols.

AS.S.5#

Stabilise, prepare, evacuate or retrieve patients, including:

  • familiarisation with local procedures and key contacts for aeromedical transfers
  • performing acute management and triage
  • ability to maintain the patient during retrieval, including understanding of altitude physiology and stabilisation
  • improvisation and novel methods of medical care
  • conducting a risk management assessment
  • managing logistical and resource considerations
  • accessing a specialist network and environment
  • lighting an airstrip at night and checking the airstrip
  • understanding daylight and weather reports and providing these to retrievers

AS.S.6#

Advocate on behalf of remote communities, including:

  • understanding of its cultural, social, political and familial contexts
  • talking to government and making submissions to government agencies
  • administration and health care planning
  • adopting a direct advocacy role where appropriate
  • participating in relevant working parties and committees
  • being multi-skilled and community-aware
  • undertaking an educational role, ie empowering your community and training staff and support colleagues to encourage their continued service

AS.S.7#

Maintain a personal and professional balance in a remote context including;

  • dealing with boundary issues, especially when caring for patients who might also be friends, family, or colleagues
  • showing an ability to fill multiple roles, such as professional colleague, friend, confidant, manager, parent, administrator, doctor
  • being critically self-reflective, with a demonstrated capacity to learn from mistakes through reflection and feedback
  • undertaking critical incident debriefing as required
  • dealing with ethical dilemmas of isolation and community enmeshment, especially following a traumatic incident or natural disaster
  • plan breaks for recreational and professional development leave
  • seeking professional assistance and support when required

AS.S.8#

Competent and independent performance of the procedural skills listed in the Procedural Skills Logbook and those skills specific to individual remote community or type of health service

Attributes#

At.4#

Clinical courage

At.2#

Adaptability

At.17#

Resourcefulness

Last updated on by acrrmbot