Maharashtra SSC Health Care Pre-Voc/NSQF cheat sheet

India's health care system has three tiers: primary (sub-centre, PHC), secondary (district/sub-district hospital), and tertiary (medical college and specialist hospitals).

National Health Mission (NHM) is the umbrella programme combining the National Rural Health Mission and National Urban Health Mission; it funds ASHAs, PHCs and district hospitals.

ASHA (Accredited Social Health Activist) is a trained female community health worker, one per 1,000 rural population, and receives performance-linked incentives rather than a salary.

Health care careers split into clinical (doctor, nurse, pharmacist, lab technician), diagnostic (radiology, pathology), and support (ward boy, OT assistant, records, housekeeping) roles.

NSQF levels in health care range from Level 4 (General Duty Assistant) to higher levels for technician and supervisory roles; each level states the skill and autonomy expected.

General Duty Assistant (GDA) tasks include bed making, patient mobility, feeding assistance, vital-sign recording and reporting changes to the nurse - not prescribing or diagnosing.

Health insurance schemes relevant to the sector include Ayushman Bharat PM-JAY (secondary/tertiary hospitalisation) and ESIS for organised-sector workers.

Regulatory bodies: NMC for doctors, INC for nurses, PCI for pharmacists, and NABL for testing laboratories.

The communication cycle is sender → message → channel → receiver → feedback; noise is any interference at any stage and blocks accurate transmission.

Verbal communication uses words; non-verbal includes kinesics (body movement), proxemics (space), haptics (touch), paralanguage (tone, pitch) and eye contact.

Active listening means full attention, no interruption, paraphrasing back, and clarifying questions - it is not the same as hearing.

Therapeutic communication techniques include open-ended questions, reflection, restating and silence; blocking techniques include false reassurance, advising, and changing the subject.

In health care, use simple language and avoid jargon; confirm understanding by teach-back (patient repeats instructions in their own words).

Confidentiality applies to all patient information; share only with the treating team on a need-to-know basis and never in corridors or lifts.

Professional telephone etiquette: identify yourself and the facility, state purpose, speak clearly, and record the message with time and caller name.

Barriers to communication include language, hearing or speech impairment, pain, anxiety, cultural difference and environmental noise; each has a specific remedy such as an interpreter or a quiet room.

Levels of organisation: cell → tissue → organ → organ system → organism; the body has 11 major organ systems.

Normal adult vital signs: temperature 36.1–37.2 °C (97–99 °F), pulse 60–100 beats/min, respiration 12–20 breaths/min, blood pressure about 120/80 mmHg, SpO2 95–100%.

Skeletal system: 206 bones in an adult; the axial skeleton (skull, spine, rib cage) protects the brain, spinal cord, heart and lungs.

Blood has plasma, red cells (haemoglobin carries oxygen), white cells (defence) and platelets (clotting); normal adult haemoglobin is about 13–17 g/dL in males and 12–15 g/dL in females.

The digestive tract runs mouth → oesophagus → stomach → small intestine → large intestine; most absorption occurs in the small intestine.

The urinary system (kidneys, ureters, bladder, urethra) filters blood, balances water and electrolytes, and excretes urine.

Health is a state of complete physical, mental and social well-being, not merely the absence of disease (WHO definition).

Communicable diseases spread by contact, droplet, airborne, vector or vehicle routes; non-communicable diseases include diabetes, hypertension and cancer.

Hand hygiene is the single most effective infection-control measure; wash with soap and water for at least 40–60 seconds, or use alcohol-based hand rub for 20–30 seconds.

Bathe daily, paying attention to axillae, groin and feet; change undergarments daily and uniforms when soiled or after every shift.

Oral care twice daily and after meals; brush for about two minutes and replace a toothbrush every three months.

Nails should be short, clean and unpolished for clinical staff; long or artificial nails harbour organisms and are a known infection source.

Hair should be tied back and off the collar; a cap is worn in sterile and food-handling areas.

Foot care: dry well between toes to prevent fungal infection; wear clean, well-fitting, closed footwear.

Food hygiene: wash hands before handling food, keep raw and cooked food separate, and store food at safe temperatures (below 5 °C or above 60 °C).

Personal protective equipment order: hand hygiene → gown → mask/respirator → goggles → gloves; remove in reverse, with hand hygiene after glove removal.

Chain of infection: infectious agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host; breaking any link prevents transmission.

Standard precautions apply to all patients regardless of diagnosis and include hand hygiene, gloves, gown, mask, eye protection and safe sharps handling.

Transmission-based precautions add to standard precautions: contact (e.g. C. difficile), droplet (e.g. influenza), airborne (e.g. tuberculosis, measles).

Needlestick injury first aid: wash the site with soap and water, do not squeeze or scrub, report immediately and follow the facility's post-exposure prophylaxis protocol.

Biomedical waste segregation: yellow bag for human anatomical and soiled waste, red for contaminated recyclable plastic, white translucent for sharps, and blue for glass and metallic implants.

Sharps go into a puncture-proof, leak-proof container filled no more than three-quarters; never recap a needle by hand.

Fire safety: RACE (Rescue, Alarm, Contain, Extinguish/Evacuate) and PASS (Pull, Aim, Squeeze, Sweep) for a fire extinguisher.

Patient safety measures include bed rails, call bell within reach, non-slip footwear, correct patient identification with two identifiers, and side rails lowered before transfer.

Bed making: use clean linen, tuck sheets firmly, avoid creases under the patient, and keep the pillow opening away from the face; soiled linen goes into the correct bag, never on the floor.

Positioning: supine (flat), lateral (side-lying), Fowler's (head raised 45–60°), semi-Fowler's (30°), Trendelenburg (head lower than feet), and prone.

Pressure ulcer (bed sore) prevention: reposition at least every two hours, keep skin clean and dry, use pressure-relieving devices, and inspect bony prominences.

Measuring pulse: place two fingers (not the thumb) over the radial artery at the wrist, count for one full minute, and record rate, rhythm and volume.

Oral temperature is measured under the tongue with the mouth closed for about 3 minutes; axillary temperature is about 0.5 °C lower than oral.

Intake-output charting records all fluids taken and voided in millilitres over 24 hours; report a urine output below 30 mL/hour to the nurse.

Feeding assistance: raise the head of the bed, check the diet order, feed slowly, and stop if the patient coughs or chokes (risk of aspiration).

Before any procedure, identify the patient, explain the procedure, provide privacy, and obtain consent; record the procedure, time and observations.

First-aid sequence: assess the scene for safety, check responsiveness, call for help, then follow DRABC - Danger, Response, Airway, Breathing, Circulation.

Adult CPR: compressions at 100–120 per minute, 5–6 cm deep, 30 compressions to 2 rescue breaths, on a firm flat surface; use an AED as soon as available.

Choking adult: encourage coughing; if ineffective, give up to 5 back blows between the shoulder blades, then up to 5 abdominal thrusts, and repeat.

Severe bleeding: apply direct pressure with a clean cloth, elevate the limb if possible, and add layers without removing the first dressing.

Burns: cool with running water for at least 20 minutes, remove jewellery before swelling, cover loosely, and never apply ice, toothpaste or oil.

Fracture or suspected spinal injury: immobilise, do not move the casualty unless there is immediate danger, and support the head and neck in line.

Fainting: lay the person flat, raise the legs about 30 cm, loosen tight clothing, and ensure fresh air.

Poisoning or snakebite: do not induce vomiting or cut and suck the wound; keep the person still, immobilise the bitten limb below heart level, and get to hospital.

Sphygmomanometer measures blood pressure: inflate the cuff about 20–30 mmHg above the point where the radial pulse disappears, then deflate slowly at 2–3 mmHg per second.

Stethoscope is used for auscultation of heart, lung and bowel sounds; ear-pieces point forward into the ear canal for a proper seal.

Thermometers: digital (oral/axillary), infrared tympanic, and mercury (now being phased out because of toxicity).

Pulse oximeter clips on a finger and reads SpO2; nail polish, cold hands and poor perfusion cause false low readings.

Sterilisation methods: autoclave (steam under pressure, 121 °C for 15–20 minutes), hot-air oven (dry heat, 160 °C for 2 hours), and chemical disinfectants such as glutaraldehyde.

Records must be accurate, legible, dated, timed and signed; corrections are made with a single line, initialled, never erased or overwritten.

Common records: admission and discharge register, vital-sign chart (TPR chart), intake-output chart, medication chart, and incident report.

Medical records are legal documents retained per facility policy; they may be released only with patient consent or by legal order.

Core ethical principles: autonomy (patient's right to decide), beneficence (do good), non-maleficence (do no harm), justice (fair treatment) and confidentiality.

Informed consent requires the patient to be competent, informed of risks and benefits, and free from coercion; it is documented before procedures.

Professional boundaries: never accept gifts of significant value, never discuss patients outside work, and never form personal or financial relationships with patients.

Employability skills sought by health care employers: punctuality, teamwork, communication, infection-control compliance, and accurate record keeping.

A résumé or CV for health care lists qualifications, NSQF certification, clinical exposure, and skills such as vital-sign recording and bed making.

Entrepreneurship options in the sector include home-care and elderly-care services, medical equipment supply, diagnostic collection centres, and pharmacy retail.

A business plan states the service, target market, pricing, staffing, licences and break-even point; health facilities need registration under applicable state rules.

Workplace rights and duties: safe working conditions, minimum wages, grievance redressal, and the duty to report errors and incidents honestly.

This section is a repeat of domain 1 on purpose; use it as a quick revision of sector structure, schemes, roles, regulators and NSQF levels.

Sector tiers: primary (sub-centre, PHC), secondary (district hospital), tertiary (medical college and specialist hospital).

Key scheme: National Health Mission funds ASHAs, PHCs and district hospitals; PM-JAY covers hospitalisation for eligible families.

Career streams: clinical, diagnostic and support; GDA is an NSQF-linked role focused on patient assistance, not diagnosis or prescribing.

Regulators: NMC (doctors), INC (nurses), PCI (pharmacists), NABL (laboratories).