The Advanced Practitioner in Acute, Emergency and Critical Care

Dedicated text for trainee and newly-qualified Advanced Practitioners specialising in acute, emergency and critical care

Aligned with the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC) regulatory body requirements, this formative text is the first of its kind, covering a variety of key topics for advanced practitioners working in acute, emergency and critical care.

Written by experienced advanced practitioners and academics closely involved in the delivery of both the clinical and academic components of advanced practice training programmes,The Advanced Practitioner in Acute, Emergency and Critical Carepresents:

• Complex decision making, covering legal and ethical frameworks (including patient safety), communication skills and breaking bad news, and end of life care
• Diagnosis and management of patients, covering radiology, principles of point of care ultrasound (PoCUS), laboratory tests and prescribing
• Resuscitation and first stage management of the critically unwell, advanced resuscitation skills, shock, intra- and inter-hospital transfers, and organ donation
• History taking, physical examination, and consultation models
• Learning support with accreditation considerations boxes, clinical investigations, examination scenarios, pharmacology boxes, pathological and psychological considerations, social and cultural considerations, case studies, self-assessment questions, and more

Utilising a multi-professional and inclusive framework of advanced level practice, this is an essential resource for all trainee and newly-qualified advanced practitioners. The text also serves as an excellent classroom aid for lecturers teaching advanced practice courses.

The Editors

Sadie Diamond-Fox is an Advanced Critical Care Practitioner (FICM ACCP Member) at Newcastle upon Tyne Hospitals and Strategic Lead for Advanced Practice Programmes; Assistant Professor in Advanced Critical Care Practice (Fellow - HEA), and a PhD Candidate (ImpACCPt Study) at Northumbria University, UK.

Barry Hill is an Associate Professor of Nursing Science and Critical Care at Northumbria University, UK. He is a certified Advanced Practitioner (MSc), Independent and Supplementary Prescriber (V300), and Senior Fellow (SFHEA) with AdvanceHE. Barry is a Commissioning Editor for the British Journal of Nursing, and a Consultant Editor for the International Journal for Advancing Practice.

Sonya Stoneis an Associate Professor of Advanced Clinical Practice and Director of Postgraduate Education and CPD in the School of Health Sciences at the University of Nottingham. She is an Advanced Clinical Practitioner in Cardiac Intensive Care at Nottingham University Hospitals NHS Trust and Clinical Lead for eICM at the Faculty of Intensive Care Medicine.

Caroline McCreais an Advanced Critical Care Practitioner at Portsmouth University Hospital Trust.

Natalie Gardneris the Trust Clinical Lead for Advanced Clinical Practice and Non-Medical Prescribing at Kings College Hospital in London and works clinically as an Advanced Critical Care Practitioner. Natalie is the Co-Chair for the Faculty of Intensive Care Medicine ACCP Sub-Committee, and also serves as an Officer in the British Army Reserves.

Angela Robertsis an Advanced Nurse Practitioner within Southern Health NHS Trust. She is a certified ACCP (FICM ACCP Member), Independent and Supplementary Prescriber and Designated Prescribing Practitioner (DPP).

About the Editors viii

Notes on Contributors xi

Preface xxiii

Acknowledgements xxv

How to Use Your Text Book xxvii

Unit 1 Continuous Professional Development, Appraisal and Revalidation 1

Chapter 1 Governance 3
Ollie Phipps

Chapter 2 Continuous Profession Development (CPD), Appraisal and Revalidation 19
Vikki-Jo Scott

Unit 2 Complex Decision Making 35

Chapter 3 Ethics and Legal Principles 37
Nick Fox

Chapter 4 Communication Skills and Breaking Bad News 50
Phil Broadhurst and Emma Underdown

Chapter 5 Advanced Clinical Decision-making and End-of-life Care 63
Rachel Allen-Ashcroft and Victoria Metaxa

Unit 3 History Taking and Physical Examination Skills in Acute, Emergency, and Critical Care 75

Chapter 6 Consultation Models and Diagnostic Reasoning 77
Sadie Diamond-Fox, Rebecca Connolly, Alexandra Gatehouse, John Wilkinson, Angela Roberts, Caroline McCrea, and Sonya Stone

Chapter 7 Respiratory Presentations 106
Andrew Lee, Rebecca Chamoto, Rebecca Kurylec, Kirsty Laing, Kathryn Thomas, Emma Toplis, Padma Parthasarathy, and Rebecca Stacey

Chapter 8 Cardiac Presentations 136
Rachel Wong

Chapter 9 Neurological and Endocrine Presentations 169
Rebecca Connolly and Sonya Stone

Chapter 10 AECC Renal and Genitourinary Presentations 196
Rachel Allen-Ashcroft and Sonya Stone

Chapter 11 Gastrointestinal and Hepato-Pancreato-Biliary 222
Angela Roberts

Chapter 12 Haematological and Oncological Presentations 240
Barry Hill

Chapter 13 Rheumatological and Immunological Presentations 263
Caroline McCrea, Barry Hill, Sonya Stone, and Sadie Diamond-Fox

Chapter 14 Mental Health Presentations 283
Clare Allabyrne

Unit 4 Diagnosis and Management in Acute, Emergency, and Critical Care 303

Chapter 15 Radiology 305
Joe Wood, Stephanie Shea, and Tracey Maxfield

Chapter 16 Principles of Point of Care Ultrasound 327
Hannah Conway

Chapter 17 Laboratory Tests 359
Sarah Henry and Natalie Gardner

Chapter 18 Pharmacology and Prescribing for the Acute, Emergency, and Critical Care Populations 391
Jill Bentley, David Thom, and Joseph Tooley

Chapter 19 Advanced and Extended Procedures for AECC Populations 414
Phil Evans and Sean Buchanan

Unit 5 Resus& 1st Stage MX of the Critically Unwell 445

Chapter 20 Advanced Life Support 447
Sadie Diamond-Fox and Alexandra Gatehouse

Chapter 21 Shock 483
Francesca Riccio and Phil Broadhurst

Chapter 22 Intra/Inter Hospital Transfers 508
Mark Cannan, Stuart Cox, and Kirstin Geer

Chapter 23 Organ Donation and Optimisation 521
Jill Featherstone and Stevie Park

Prefixes and Suffixes 532

Normal Values 545

Index 549