Unit rationale, description and aim

Paramedics encounter situations and problems that require insightful and competent decision making to achieve optimal care outcomes for individuals and communities. To ensure robust decisions are performed by students, this first practice unit will assist in building knowledge and skills of paramedic practice with regards to people-centred care and the clinical environment. This unit will translate introductory knowledge and theory acquired in PARA126 Paramedicine Theory: Primary Care into practice and clinical context. Continuing with case-based learning, students will explore, experiment, reflect and refine their ability to assess, identify and care for individuals affected by primary care aetiologies and presentations explored in PARA126. Students will begin to incorporate therapeutic and social skills into a paramedic decision making framework, underpinned by theory and evidence, both in the laboratory environment and while undertaking clinical placement.

The aim of this unit is to impart the knowledge and skills allowing student to assess, recognise and apply people-centred care principles for various introductory primary health presentations within practice and clinical context.

2025 10

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  • Semester 2Multi-mode
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  • Semester 2Multi-mode

Prerequisites

PARA104 Foundations of Paramedic Practice OR PARA115 Fundamentals of Paramedicine Care

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

Demonstrate appropriate clinical assessments, ther...

Learning Outcome 01

Demonstrate appropriate clinical assessments, therapeutic, social and cognitive skills for the management and culturally safe care of people affected by illnesses and injuries typical of primary care presentations and requiring basic life support within the context of clinical paramedicine.
Relevant Graduate Capabilities: GC3, GC8

Integrate appropriate clinical assessments, therap...

Learning Outcome 02

Integrate appropriate clinical assessments, therapeutic, social and cognitive skills into a paramedic decision making framework in order to assist people affected by illnesses and injuries typical of primary care presentations within the context of clinical paramedicine
Relevant Graduate Capabilities: GC2, GC7

Reflect upon the application of a paramedic decisi...

Learning Outcome 03

Reflect upon the application of a paramedic decision making framework, therapeutic/social/cultural skills and professionalism in the clinical environment
Relevant Graduate Capabilities: GC1, GC12

Content

Topics will include: 

  • Primary care 
  • Continuum of Care/ Health Pathways 
  • Interdisciplinary roles and teams in primary care 
  • Introduction to technology in health care 
  • Introduction to models of primary health care 
  • Prevention and promotion 
  • Reporting systems and documentation 
  • Primary care presentations, clinical-decision making and applied management principles: 
  • Minor injuries 
  • Falls 
  • Wounds 
  • Burns 
  • Fractures/Dislocation 
  • Minor head injury 
  • Illness 
  • Ear, nose and throat 
  • Introduction to infectious diseases 
  • Pain 
  • Gastroenterological  
  • Urology  
  • Introductory concepts of fluid loss 
  • Applying primary care and associated aetiologies assessments: 
  • Physiological; 
  • Social; 
  • Psychological assessments. 
  • Foundational therapeutic skills to support primary care:  
  • Principles of safe drug administration  
  • Intravenous access 
  • Intramuscular administration 
  • Intranasal administration 
  • Introduction drug dose calculation 
  • Analgesic agents 
  • Antiemetic agents 
  • Fluid therapy 
  • Vaccinations 
  • Introduction to Basic Life Support (BLS) 
  • Airway clearance techniques 
  • Primary airway adjuncts  
  • Oxygenation 
  • Ventilation 
  • Cardiopulmonary Resuscitation 
  • Defibrillation 

Assessment strategy and rationale

A range of assessment items consistent with University assessment requirements and policy will be used to ensure students achieve the unit learning outcomes, attain the graduate attributes and meet professional capabilities required in paramedicine. With the ethos that assessments support and guide learning, students will see a direct relationship between each task and their development. 

The summative quiz will enable students to demonstrate their acquisition of knowledge throughout the unit and provide a strong foundation to further integrate skills into a paramedic-decision making framework and application within the clinical environment.  Students will engage in three formative quizzes throughout the semester, prior to the summative quiz. The formative quizzes will provide students with an understanding of how their learning is progressing within the unit. The final summative quiz formally assesses the student's knowledge and students are required to meet the requisite standard to pass this assessment. Students will have a total of two attempts to successfully pass this assessment.

The Objective Structured Clinical Examination (OSCE) is considered an important component within the paramedicine profession. It contributes to learning by providing the opportunity to apply theory and demonstrate skills in an isolated manner and/or integrated within a decision-making framework and practice. It aims to emulate real-world clinical presentations and problems where students will be tasked with providing solutions and care. The OSCE allows for quick feedback on the students’ stage of development and competencies, which will assist with future clinical practice. Students will have a total of two attempts to successfully pass this assessment.

The Work Integrated Learning (WIL) portfolio allows an opportunity for students to document their clinical placement experience, receive feedback and develop good record management skills. Accurate and professional record management skills are essential attributes of a registered paramedic. Furthermore, reflection is a cornerstone attribute of a health professional. Thus, the associated reflection gives the opportunity to reflect and subsequently develop application of decision-making skills, therapeutic skills and professionalism within a real-world environment. Students must pass this assessment on the first attempt.

Given the nature of paramedicine and its associated risks, it is essential that students are able to demonstrate that they are fit and safe to practice within in the clinical practice environment. Thus, passing all three assessments in this unit is required. These assessments assess knowledge that is essential to the unit of study that students cannot progress in the course without.

Assessment Task 1 is an ungraded hurdle task with a maximum of two attempts.

Assessment Task 2 is an ungraded hurdle task with a maximum of two attempts.

Assessment Task 3 is an ungraded hurdle task. Students must demonstrate they have met the learning outcomes associated with their clinical placement experience and are allowed unlimited attempts to submit a satisfactory WIL portfolio.

Overview of assessments

Assessment Task 1 (Ungraded Hurdle): Summative Qu...

Assessment Task 1 (Ungraded Hurdle): Summative Quiz

Enables students to demonstrate appropriate clinical assessments, therapeutic, social, and cognitive skills for the management and care of people affected by illnesses and injuries typical of primary care presentations.

Weighting

Pass/Fail

Learning Outcomes LO1

Assessment Task 2 (Ungraded Hurdle): Objective St...

Assessment Task 2 (Ungraded Hurdle): Objective Structured Clinical Examination (OSCE) 

Enables students to demonstrate their competency and incorporation of therapeutic, psychomotor, social and cognitive skills into culturally safe paramedic practice to address presenting clinical challenges.  

Weighting

Pass/Fail

Learning Outcomes LO1, LO2

Assessment Task 3 (Ungraded Hurdle): Work Integra...

Assessment Task 3 (Ungraded Hurdle): Work Integrated Learning (WIL) Portfolio

Enables students to demonstrate their ability to record and maintain documentation and develop reflective skills relating to real world application of paramedicine. 

Weighting

Pass/Fail

Learning Outcomes LO3

Learning and teaching strategy and rationale

This unit fosters student-centred active learning and accommodates diverse student needs. Teaching and learning strategies that engage the student with materials, concepts and experiences that will support achievement of the aims and objectives of the Unit as well as relevant Graduate Attributes and professional capabilities. PARA127, coupled with PARA126 Paramedicine Theory: Primary Care, will create foundational knowledge of primary care within the discipline of paramedicine. 

Usually situated in the first year, this unit will be predominately delivered in a face-to-face style and will introduce the clinical practice environment. This, combined with online delivery, will provide opportunities for both independent and social learning. Online learning materials will assist in priming students for practice and will aid in reflection and conceptualisation. The materials will include readings and exercises that will support application of theory and help to self-identify knowledge gaps.  

Practical classes will allow students to experiment with concepts developed during PARA126. Cases and management plans discussed and created in PARA126 will be further explored and refined by providing the opportunity to develop and enact skills, paramedic clinical decision making, communication strategies and attributes of teamwork. Varying levels of realism will engage students' senses to advance psychomotor, emotional, social and cognitive skills. Within the practical class environment, methods of learning will include skills stations, role-play, facilitated scenarios and simulations, peer-to-peer learning, audio and visual practice recordings analysis, and/or structured feedback and debriefs.  

The tutorial will actively integrate both theoretical and practical units by building on knowledge and experiences created throughout the unit and degree. This process will be structured yet organic. It will be facilitated to promote discussion and provide clarification and guidance for examining and reflecting upon experimentation and application of patient care plans, skills, emotions and paramedic clinical decision making. 

As the practice of paramedicine relies heavily on social interaction and cooperation, it is expected that students will emulate this within the learning environments. Early and additional feedback on learning, and tailored support, are provided to facilitate students’ transition to university.

To extend learning, students will have the opportunity to explore and apply knowledge and skills of paramedicine in the real-world environment. Supervised clinical placement will be provided within an appropriate emergency, urgent care, primary health care, simulated or other relevant environment. The supervised and facilitated clinical placement provides a safe environment where students can provide people-centred care which is essential for successful culturally safe practice within paramedicine. Clinical placement experiences will enable students to reflect on practice and the principles of paramedicine.  

National Safety and Quality Health Service Standards (Second Edition)

In connection to the learning outcomes, the Australian Commission on Safety and Quality in Health Care Standards developed in this unit are:

  • Relating to

    Clinical Governance Standard

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Partnering with Consumers Standard

    Relevant Learning OutcomeLO1

  • Relating to

    Medication Safety Standard

    Relevant Learning OutcomeLO1, LO2

  • Relating to

    Comprehensive Care Standard

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Communicating for Safety Standard

    Relevant Learning OutcomeLO1

  • Relating to

    Recognising and Responding to Acute Deterioration Standard

    Relevant Learning OutcomeLO2

Paramedicine Board of Australia Professional Capabilities for Registered Paramedics

The Paramedicine Board of Australia is responsible for assessing, consulting on and setting the standards for paramedics practicing in Australia. These standards and relevant domains are articulated in the Professional Capabilities for a Registered Paramedic document. The learning outcomes of this unit are matched to the relevant capabilities, in order to align your development with the requirements of a paramedic.  

  • Relating to

    Practise ethically and professionally, consistent with relevant legislation and regulatory requirements


    • Demonstrate understanding of: reporting obligations, legal responsibilities, legal requirements, ethical and professional responsibilities, and the legal and ethical boundaries of paramedicine practice.
    • Manage personal, mental and physical health to ensure fitness to practice.
    • Follow mandatory and voluntary reporting obligations. • Apply the Paramedicine Board of Australia’s Code of conduct to their practice.
    • Provide relevant information to a patient and demonstrate appropriate methods to obtain informed consent.
    • Demonstrate knowledge of Australia’s healthcare systems, their standards and requirements.
    • Demonstrate understanding of the basic principles underpinning bio- ethics in paramedicine practice.
    • Demonstrate culturally safe practice when providing healthcare services for Aboriginal and Torres Strait Islander Peoples.
    • Exercise appropriate levels of autonomy and professional judgement in a variety of practice settings.
    • Operate within the current legislation applicable to paramedicine practice.
    • Practise in accordance with the applicable legislation governing the safe use of scheduled medicines by paramedics in the jurisdiction of practice.

    Legal responsibilities may include an understanding of responsibilities contained in relevant Commonwealth, state and territory legislation and regulations, specific responsibilities to maintain confidentiality, confirm informed consent and exercising duty of care.

    Informed consent is a person’s voluntary decision about healthcare that is made with knowledge and understanding of the benefits and risks involved.

    Principles underpinning bio-ethics must include: respect the rights of the individual, respect the autonomy of the individual, cause no harm, and advance the common good.

    Relevant aspects of the Australian health care systems may include knowledge of service provision arrangements, the structure of the health system, points of access and the range of roles that paramedics may play within that structure.

    Key elements of fitness to practise must include competence, professionalism, including a sense of responsibility and accountability, self-awareness and professional values, sound mental health and the capacity to maintain health and wellbeing for practice.

    Reporting obligations must include making a notification about the health (impairment), conduct or performance of a registered health practitioner that may be placing the public at risk; as well as of their own impairments to practice.

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Provide each patient with an appropriate level of dignity and care


    • Demonstrate understanding of the influence of socio-cultural factors on patient attitudes and behaviour.
    • Display appropriate professional behaviour in patient interactions.
    • Provide culturally safe care for all patients.
    • Identify and respect appropriate boundaries between patients and health professionals.
    • Assess each situation, determine the nature and severity of the problem and apply the required knowledge and experience to provide a response that is in the best interest of the patient/s.
    • Facilitating advance care planning where appropriate.

    Socio-cultural factors may include those related to cultural and linguistic diversity, age, gender, disability, socio-economic, geographic locations; and identifying as Aboriginal and Torres Strait Islander Peoples.

    Appropriate professional behaviour must include behaviour that:

    • is culturally safe for Aboriginal and Torres Strait Islander patients to access safe and responsive healthcare, free of racism
    • respects socio-cultural difference, is empathetic and non-discriminatory, regardless of individuals’ or groups’ race, culture, religion, age, gender identity, sexuality, physical or mental state, and
    • respects, and so far as possible, upholds the rights, dignity, values and autonomy of every patient. This includes their role in the diagnostic and therapeutic process and in maintaining health and well being.

    Cultural Safety is determined by Aboriginal and Torres Strait Islander individuals, families and communities. Culturally safe practise is the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practicing behaviours and power differentials in delivering safe, accessible and responsive healthcare free from racism.

    • To ensure culturally safe and respectful practice, health practitioners must:
    • acknowledge colonisation and systemic racism, social, cultural, behavioural and economic factors which affect individual and community health
    • acknowledge and address individual racism, their own biases, assumptions, stereotypes and prejudices and provide care that is holistic, free of bias and racism
    • recognise the importance of self-determined decision- making, partnership and collaboration in healthcare which is driven by the individual, family and community, and
    • foster a safe working environment through leadership to support the rights and dignity of Aboriginal and Torres Strait Islander People and colleagues.

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Assume responsibility, and accept accountability, for professional decisions


    • Recognise and respond appropriately to unsafe or unprofessional practice.
    • Integrate organisational directives, policies, procedures and guidelines with Professional standards.
    • Apply relevant quality frameworks and processes to practice.

    Quality frameworks may include workplace specific frameworks, relevant jurisdictional publications and the Australian Safety and Quality Framework for Health Care published by the Australian Commission on Safety and Quality in Health Care.

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Communicate clearly, sensitively and effectively with the patient and other relevant people 


    • Establish a rapport with the patient to gain understanding of their issues and perspectives, and to encourage their active participation and partnership in care and/or treatment.
    • Communicate with the patient and/or other relevant people to collect and convey information and reach an agreement about the purpose of any care and treatment.
    • Convey knowledge and procedural information in ways that engender trust and confidence, and respects patient confidentiality, privacy and dignity.
    • Respond appropriately to patient queries or issues.
    • Use appropriate communication skills to effectively manage avoidance, confusion and confrontation particularly with those who cannot communicate verbally or physically.
    • Identify and effectively manage communication barriers, including anxiety and stress, specific to individual patients and/or carers.
    • Make appropriate adjustments to communication style to suit the needs of the patient including those from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander Peoples.
    • Make provisions to engage third parties, including interpreters, to facilitate effective communication with patients whose first language is not English, whenever possible.

    Communication needs may be influenced by English language skills, health literacy, age, health status and culture.

    Appropriate adjustments may include the paramedic demonstrating an awareness of the ways that their own culture and experience affect their interpersonal style and having an awareness of strategies to ensure this does not present an impediment.

    Communication techniques must include active listening, use of appropriate language and detail, use of appropriate verbal and non-verbal cues and language, written skills and confirming that the other person has understood.

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Collaborate with other health practitioners


    • Establish and maintain effective and respectful collaborative working relationships as a member of a healthcare team.
    • Demonstrate an understanding of professional roles and responsibilities of healthcare team members and other service providers and how they interact with the role of a paramedic.
    • Follow appropriate protocols, procedures and guidelines to give and receive relevant and timely verbal and written communication.
    • Effectively supervise tasks delegated to other healthcare team members.
    • Consult effectively with healthcare team members and other relevant people to facilitate continuity of care.
    • Make appropriate referrals, delegations and handovers to other healthcare team members and other service providers.

    Healthcare team members may include registered health practitioners, accredited health professionals, volunteers, licensed and unlicensed healthcare workers, police, fire and other emergency service personnel.

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Make informed and reasonable decisions


    • Operate within a framework of making informed, evidence-based, reasonable and professional judgements about their practice, with acting in the best interests of their patients as their primary concern.
    • Make sensible, practical, and culturally safe decisions about their practice, taking account of all relevant information and the best interests of the people who use, or are affected by, the service being provided.

    Relevant Learning OutcomeLO2, LO3

  • Relating to

    Use clinical reasoning and problem-solving skills to determine clinical judgements and appropriate actions


    • Apply evidence-based practice principles along with critical and reflective thinking to resolve clinical challenges.
    • Demonstrate a logical and systematic approach to problem-solving and situation analysis.
    • Analyse and critically evaluate the information collected to make clinical judgments.
    • Recognise that clinical judgements involve consideration of conflicting information and evidence.
    • Formulate a diagnosis informed by the patient assessment and analysis of context and situation.
    • Identify the time criticality of treatment, referral, handover and where appropriate, transport.

    Critical thinking may include skills in questioning, analysing, synthesising, interpreting, and cognitive reasoning, and the critical appraisal of literature and evidence.

    Reflective practice may include critical self-reflection during and after a clinical challenge or experience. It may involve structured and informal reflection to review and integrate knowledge including culturally safe practise and findings into practice.

    Relevant Learning OutcomeLO2, LO3

  • Relating to

    Draw on appropriate knowledge, resources and skills in order to make professional judgements


    • Select or modify approaches to meet the needs of patients, their relatives and carers, reflecting culturally safe practice when practicing.
    • Practise situational awareness to changes in risks or hazards and change their practice as needed to take account of new developments.
    • Using appropriate resources to support professional decision-making.
    • Demonstrate a level of skill in the use of information technology appropriate to their practice. 

    Relevant Learning OutcomeLO2, LO3

  • Relating to

    Identify ongoing professional learning, development needs and opportunities


    • Demonstrate an understanding of legal and professional responsibilities to undertake continuing professional development(CPD).
    • Critically reflect on personal strengths and limitations to identify learning and development required to improve and adapt professional practice.
    • Seek input from others to confirm professional learning and development needs.
    • Plan and implement steps to address professional learning and development needs, inclusive of culturally safe practice.
    • Maintain records of involvement in both formal and informal professional learning and development activities.

    Professional learning and development may be provided by the professional community and the broader healthcare network/practice.

    Relevant Learning OutcomeLO2, LO3

  • Relating to

    Protect and enhance patient safety


    • Follow patient identification procedures to confirm the correct match of a patient with the intended procedure, care and/or treatment.
    • Obtain valid informed consent when possible.
    • Identify and manage risks associated with patient transfers.
    • Ensure when patients are required to be moved it is in a considered and safe manner.
    • Identify and manage the risk of infection, including during aseptic procedures.

    Patient identification procedures for interfacility transfer and handover of a patient consistent with best practice approaches published by bodies such as the Australian Commission on Safety and Quality in HealthCare.

    Infection prevention and control risk management: Registered paramedics must demonstrate an understanding of transmission modes of healthcare associated and community-acquired infections (host, agent and environment); established practices for preventing the transmission including effective hand hygiene; and ability to implement NHMRC infection prevention and control guidelines.

    Relevant Learning OutcomeLO1, LO3

  • Relating to

    Maintain records appropriately


    • Record information systematically in an accessible and retrievable form.
    • Keep accurate, comprehensive, logical, legible and concise records.
    • Use only accepted terminology in completing patient records.
    • Review, communicate, record and manage patient information accurately, consistent with protocols, procedures and legislative requirements for maintaining patient records.

    Patient information management must comply with confidentiality and privacy. A registered paramedic must demonstrate awareness of the legislative requirements and any other relevant legislation about ownership, storage, retention and destruction of patient records and other practice documentation.

    Relevant Learning OutcomeLO1, LO3

  • Relating to

    Monitor and review the ongoing effectiveness of their practice and modify it accordingly


    • Monitor and evaluate the quality of practice and the value of contributing to the generation of data for quality assurance and improvement programs.
    • Consider feedback from colleagues and critically reflect on their own paramedicine practice.
    • Make reasoned decisions to initiate, continue, modify or cease care or treatment, or the use of techniques or procedures, and record the decisions and reasoning appropriately.

    Relevant Learning OutcomeLO1, LO3

  • Relating to

    Audit, reflect on and review practice 


    • Demonstrate the principles, application and need for quality control and quality assurance in paramedicine practice.
    • Demonstrate an awareness of the role of audit and review in quality management, including quality control, quality assurance, culturally safe practice and the use of appropriate outcome measures.
    • Maintain an effective audit trail and work towards continual improvement.
    • Participate in quality assurance programs, where appropriate or required.
    • Reflect on practice and the application of such reflection to their future practice.
    • Participate in case conferences and other methods of review.

    Relevant Learning OutcomeLO1, LO3

  • Relating to

    Understand the key concepts of the bodies of knowledge which are specifically relevant to paramedicine practice


    • Understand the structure, function and pathophysiology of the human body, relevant to their practice, together with knowledge of health, human growth and development, disease, disorder and dysfunction.
    • Understand the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process.
    • Understand the theoretical basis of and the variety of approaches to assessment and intervention.
    • Demonstrate an applied knowledge of human anatomy and physiology sufficient to understand the nature and effects of injury or illness and to conduct assessment and observation in order to establish patient management strategies.
    • Understand psychological and social factors, including intergenerational trauma that impact and influence an individual in health and illness.
    • Understand the clinical sciences underpinning paramedic practice, including physiological, pharmacological, behavioural and functional.

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Conduct appropriate diagnostic or monitoring procedures, treatment, therapy or other actions safely


    • Maintain the safety of self, patients and those involved in their care.
    • Practice safely and effectively across the full range of patient presentations and circumstances.
    • Arrive at a reasonable working diagnosis.
    • Position for safe and effective interventions.
    • Demonstrate an applied knowledge of the indications and contra-indications of using specific paramedic interventions including their modifications.
    • Modify and adapt practice appropriate and inclusive of a culturally safe practice environment.

    Relevant Learning OutcomeLO1, LO2, LO3

  • Relating to

    Formulate specific and appropriate patient care and treatment actions


    • Adapt practice to meet the needs of different groups distinguished by, for example, physical, psychological, environmental, cultural or socio-economic factors within their authorised scope of practice.
    • Demonstrate sensitivity to the factors which shape lifestyle that may impact on the individual’s health and affect the interaction between the patient and registered paramedic.
    • Utilise knowledge, reasoning and problem-solving skills to determine appropriate judgements and actions.
    • Prioritise the care provided to optimise safety and health outcomes for the patient and demonstrate a logical and systematic approach to problem-solving in a culturally safe framework.

    Relevant Learning OutcomeLO1, LO2, LO3

Representative texts and references

Representative texts and references

Bryant, B., & Knights, K. (2015). Pharmacology for health professionals (5th ed). Chatswood, NSW: Elsevier Australia. 

Bullock, S., & Hales, M., (2018) Principles of Pathophysiology (2nd ed.). Melbourne, VIC: Pearson Australia. 

Curtis, K., & Ramsden, C. (2019). Emergency and trauma care for nurses and paramedics (3rd ed.). Chatswood, NSW: Elsevier Australia. 

Hall, J.E., (2015). Guyton And Hall Textbook of Medical Physiology. (13th ed.). Chatswood, NSW: Elsevier. Philadelphia, PA: Elsevier. 

Talley, N.J. & O’Connor, S. (2018). Talley & O’Connor’s Clinical Examination. (8th ed.). Volumes 1 and 2. Chatswood, NSW: Elsevier. 

Tortora, G., & Derrickson, B. (2016). Principles of anatomy and physiology (15th ed). Hoboken, NJ: Wiley and Sons. 

Townsend, R., & Luck, M. (2019). Applied paramedic law and ethics (2nd ed.). Australia and New Zealand. Sydney: Elsevier. 

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