
The Advanced Practitioner in Acute, Emergency and Critical Care
Description
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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 Care presents:
- 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.
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Persons
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 Stone is 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 McCrea is an Advanced Critical Care Practitioner at Portsmouth University Hospital Trust.
Natalie Gardner is the Trust Clinical Lead for Advanced Clinical Practice and Non-Medical Prescribing at King's 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 Roberts is 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).
Content
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
Notes on Contributors
Name Bio Alexandra Gatehouse MSC, PG Dip ACCP (FICM ACCP member) BSc (Hons) Physiotherapy, CSP member and V300, Advanced Critical Care Practitioner
Alex Gatehouse qualified as a physiotherapist in 2000, and, following Junior Rotations in the Newcastle Trust, she specialised in Respiratory Physiotherapy in Adult Critical Care, also working within New Zealand. In 2012, she trained as an Advanced Critical Care Practitioner, completing a Masters in Clinical Practice in Critical Care and a non-medical prescribing qualification. Alex continues to rotate within all of the Critical Care Units in Newcastle Upon Tyne, also enjoying teaching on Advanced Life Support courses, Regional transfer courses, and within the units. Her interests are transfer, advanced airway management, ECHO, and education. Andrew Lee MSc, BSc (Hons), DipHE
Andrew is an Advanced Clinical Practitioner specialising in respiratory care. His medical journey was initiated in 2002 at Stoke Mandeville Hospital, Buckinghamshire, on a spinal and orthopaedic ward as a Health Care Assistant. He earned his nursing qualification from De Montfort University in 2007, progressing to work on a Vascular Surgery ward. His passion for respiratory care was ignited at Glenfield Hospital, where he served in a respiratory and cardiology admissions unit, subsequently advancing to the position of Critical Care Outreach Nurse. In 2018, Andrew completed his advanced practice master's degree at the University of Nottingham, and since then, he has been diligently serving as a respiratory ACP in Nottingham. With a special interest in pulmonary vascular disease, Andrew manages a pulmonary embolism follow-up clinic. Demonstrating his leadership skills, he is currently chairing the Respiratory ACP Network, working collaboratively with a remarkable team of respiratory ACPs. Angela Roberts Advanced Critical Care Practitioner (FICM ACCP Member), NMP (V300), BSc Adult Nursing
Angela qualified as an adult nurse in 2007 (MMU) and has since worked at Pilgrim Hospital, Boston, Basingstoke, and North Hampshire Hospital Intensive Care Units after qualifying.
Since 2007, she has progressed as an Advanced Critical Care Practitioner (ACCP) in 2017 and is a non-medical prescriber. Due to family commitments, she left the ICU to become an Advanced Nurse Practitioner at Southern Health, Petersfield Hospital.
Angela has always been passionate about education and supporting others through postgraduate healthcare. Barry Hill Associate Professor, Critical Care; Director of Employability for Nursing, Midwifery, and Health Programmes
PhD, MSc, PGCAP, BSc (Hons), DipHE, OA Dip, RN, NMC RNT/TCH, SFHEA. Associate Professor, and Director of Employability, Northumbria University, Consultant Editor for International Journal of Advancing Practice (IJAP); Clinical Editor for the British Journal of Nursing (BJN).
Barry is an experienced leader, academic, educator, researcher, and clinical nurse. His current role is Associate Professor and Director of Employability for Nursing, Midwifery, and Health. He has a demonstrated history of working within academia in Higher Education (HE). Barry is a senior fellow (SFHEA) and an HEA mentor, a certified Intensive Care Nurse, with an MSc in Advanced Practice (Clinical); NMC Registered Nurse (RN), NMC Registered Teacher (TCH), and NMC registered independent and supplementary prescriber (V300). He is skilled in clinical research and clinical education, and is passionate about higher education, especially nursing science, advanced clinical practice (ACP), critical care, non-medical prescribing (NMP), and pharmacology. Barry's clinical career was at Imperial College NHS Trust, London. Barry is a strongly education-focused professional who has published 9 books, 60 book chapters, and 100 peer-reviewed journal articles. He is the Consultant Editor for the International Journal of Advancing Practice (IJAP) and the Clinical Editor for the 'At A Glance' and 'Advanced Clinical Practice' series within the British Journal of Nursing (BJN). Caroline McCrea MSc Cardiorespiratory Nursing, PG Dip ACCP (FICM ACCP Member), BN (Hons), NMC RN and V300
Caroline qualified as a nurse in 2008 and began her career in Cardiac Nursing. The first eight years of her career were spent in specialist Cardiothoracic Nursing roles. In 2014, she completed her MSc in Cardiorespiratory Nursing and went on to become a Cardiothoracic Nurse Practitioner and non-medical prescriber. Following on from this specialist role, she progressed further to become an Advanced Critical Care Practitioner (ACCP) and was awarded Faculty of Intensive Care Medicine (FICM) Membership. Caroline has always had a great passion for education, and continues to compliment her clinical work with teaching across a variety of disciplines. Her key interests are ECHO, Simulation, advanced level practice, and medical education. Clare Allabyrne Clare Allabyrne is currently the Associate Professor and Professional Lead for the MSc Advanced Clinical Practice Mental Health (ACPMH) at London Southbank University and a Fellow of the Higher Education Academy
A dual qualified nurse (Adult and Mental Health) by profession, her areas of expertise include advanced clinical practice in mental health, child and adolescent mental health, forensic psychiatry, liaison psychiatry, substance use, physical health care in mental health, service user involvement/people participation, multi-agency/partnership working, leadership, service creation, and innovation. Clare worked for 35 years in the NHS across physical and mental health care services in clinical, therapeutic, senior operational, clinical academic, and corporate/strategic leadership roles. David Thom MSc DipIMC(RCSEd) BSc(Hons) MCPara SRParaNMP(V300), Anaesthesia Associate and Advanced Practitioner - Critical Care
David qualified as a Paramedic in 2013 working in the West Midlands and the Southeast while completing his BSc in Pre-Hospital and Emergency Care. He has worked in a range of domains, including frontline services, the Isle of Man TT, major public events, and sport. He subsequently trained as a FICM Advanced Critical Care Practitioner, completing his MSc and Non-Medical Prescribing. Subsequently, he worked on the Dorset and Somerset Air Ambulance and passed the DipIMC(RCSEd) by examination. More recently, he is undergoing training as an Anaesthesia Associate on the PGDip pathway. Interests include Pharmacology, Education, and Critical Care. Francesca Riccio Paediatric Consultant Anaesthetist, FRCA, Bachelor of Medicine
Francesca is a paediatric anaesthetist working in University Hospital Southampton. She has always had a keen interest in teaching, in particular, simulation. Throughout her training she has watched the development of advanced practitioners, particularly in the acute setting and believes they are hugely valuable to an ever expanding and demanding healthcare system. Emma Toplis Advanced Clinical Practitioner
Emma is a Registered Nurse who began her career in older people's care. In 2015, she embarked on her journey as a trainee Advanced Clinical Practitioner (tACP). This transition allowed her to explore various clinical specialities, build a comprehensive knowledge base and enhance her skills in advanced practice. Among the several specialities, Emma fosters a deep passion for respiratory medicine. She has since developed a sub-specialist interest in interstitial lung disease. Additionally, she has become an instrumental figure in the quest for quality improvement within respiratory care, cementing her role as a core member of the In-hospital Quality Improvement for Respiratory (InQuIRe) quality improvement faculty. Emma also successfully completed a quality improvement project on improving tobacco dependency management with the Respiratory team at the University Hospitals of Derby and Burton. This project was presented at the BTS 2022 summer conference and awarded the first prize. Through the respiratory Advanced Clinical Practitioner network, Emma finds an excellent opportunity to champion and share best practices in her speciality. Emma Underdown MSc Advanced Clinical Practice, PGDip Advanced Clinical Practice, BSc (Hons) Intensive Care Practice, DipHE Adult Nursing, NMC RN and V300 Independent Non-Medical Prescriber
Emma qualified in 2011 as a nurse and began her career initially as a surgical specialty nurse before moving into Critical Care. She worked for four years as an Intensive Care nurse, gaining her post-graduate degree in Intensive Care Practice. She later spent three years working as a Senior Sister in Critical Care Outreach. She commenced her Advanced Clinical Practice training in 2019 within Emergency Medicine, where she continues to work.
Emma is a keen clinician and clinical educator who delivers education and training across various disciplines and specialties. Her areas of interest include...
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