PHEM curriculum unit 3.1 · Theme 3: Using Pre-hospital Equipment
The DipIMC is blueprinted against phase 1 of the UK Pre-hospital Emergency Medicine (PHEM) curriculum. This page covers unit 3.1, Apply equipment governance principles and practice.
Below are 2 free practice questions from the DipIMC.Ninja bank, in the Part A single best answer format. Every answer names the textbook page, guideline or statute it was written from, so you can check it rather than take it on trust. The bank holds 5 questions on this unit.
Question 1 · Law, Ethics & Human Factors · Easy
A doctor joining an immediate care scheme is assembling a personal response bag and wants to buy a traction splint of a type that neither the local ambulance service nor the receiving emergency department (ED) uses. What is the strongest objection?
AOnly equipment listed in the JRCALC formulary may be carried by members of the scheme
BTraction splints are for ambulance crews and should not be carried by individual doctors
CA splint type not used locally will not be covered by the scheme's indemnity insurance
DA splint type not used locally must first be registered with the Care Quality Commission
EIt should be compatible with the kit used by the local ambulance service and the ED
Show answer
Answer: E
It should be compatible with the kit used by the local ambulance service and the ED
The Oxford Handbook's key principles for personal pre-hospital equipment are to use only equipment you are thoroughly familiar with, to use only equipment compatible with the emergency services' equipment in your area, to be familiar with the specialist equipment they carry, and to keep equipment maintained, with out-of-date disposables replaced. Interchangeability with equipment used in the emergency department or by the ambulance service is also listed among the features of an effective splint. In practice a splint that nobody else uses cannot be exchanged or resupplied locally, and colleagues may not be able to remove and reapply it; the ABC lists equipment maintenance and resupply among the standard operating procedures a pre-hospital service needs. JRCALC is a clinical guideline, not an equipment list, and neither insurance cover nor Care Quality Commission registration is the principle at stake here.
Where this comes from
Oxford Handbook of Pre-Hospital Care
Ch. 1 An approach to pre-hospital care · Medical equipment: key principles · pp. 16–17“Only use equipment which is compatible with the emergency services equipment in your area.”
Ch. 1 An approach to pre-hospital care · Medical equipment: key principles · pp. 16–17“Only use equipment with which you are thoroughly familiar.”
Ch. 13 Patient rescue and transportation · Immobilization: the features of effective splints · pp. 706–712“Interchangeability with equipment used in the ED or by the ambulance service.”
ABC of Prehospital Emergency Medicinep. 197Ch. 36 Clinical Governance · Box 36.2: non-clinical standard operating procedures“Equipment maintenance and resupply”
At a music festival medical post, a paramedic finds that the portable suction unit's battery clip is cracked, so the battery drops out if the unit is knocked. Earlier that day the unit cut out during a patient contact and suction was briefly interrupted, though the patient came to no harm. After withdrawing the unit and reporting internally, to which external body and route should the device problem be reported?
AThe Care Quality Commission, through a statutory notification
BThe MHRA, through the Yellow Card scheme for medical devices
CThe Health and Safety Executive, through a RIDDOR report form
DThe Health Services Safety Investigations Body, by referral
ENHS Resolution, through its claims notification process
Show answer
Answer: B
The MHRA, through the Yellow Card scheme for medical devices
Suspected problems ('adverse incidents') with a medical device are reported to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card scheme, as soon as possible. GOV.UK gives as examples someone injured or almost injured by a device because it is broken or its instructions are unclear, and a patient's treatment being interrupted because of a faulty device — exactly this case, even though no harm resulted. GOV.UK states that anyone can report a problem; the crew's internal incident report does not replace it. The ABC's chapter on clinical governance lists the statutory reporting systems for medicines, medical devices and aviation as a source of risk information, and advises sharing knowledge of equipment failures because they are unlikely to be unique. The CQC, the Health and Safety Executive (RIDDOR), HSSIB and NHS Resolution are not the route GOV.UK gives for reporting a suspected problem with a medical device; that route is the Yellow Card scheme.
ABC of Prehospital Emergency Medicinep. 199Ch. 36 Clinical Governance · Risk management“the statutory reporting systems in place for medicines, medical devices, aviation”