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Essentials of Paramedic Care,9780131711631
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Essentials of Paramedic Care

by ; ;
Edition:
2nd
ISBN13:

9780131711631

ISBN10:
0131711636
Format:
Hardcover
Pub. Date:
1/1/2007
Publisher(s):
Prentice Hall
List Price: $166.66
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Summary

Essentials of Paramedic Care, 2nd edition, is the first text program to take students beyond the skills necessary to practice as a paramedic and into the underlying principles upon which those practices are based. Correlated to the U.S. Department of Transportation's 1998 National Standard Curriculum for EMT-Paramedic, this text provides the background content and skills coverage required for paramedic education. The text, comprised of five divisions, covers all eight modules of the curriculum. Division 1: Introduction to Advanced Prehospital Care (includes Airway Management) Division 2: Patient Assessment Division 3: Trauma Emergencies Division 4: Medical Emergencies Division 5: Special Considerations/Operations (includes Assessment-Based Management)

Table of Contents

Photo Scans/Procedures xxxi
Letter to Students xxxv
Preface xxxvii
Acknowledgments xli
About the Authors li
Welcome to Paramedic Care liii
DIVISION 1 INTRODUCTION TO ADVANCED PREHOSPITAL CARE
1(5)
Introduction to Advanced Prehospital Care
2(4)
Introduction
6(1)
Part 1: Introduction to Advanced Prehospital Care
6(2)
Description of the Profession
6(1)
Paramedic Characteristics
7(1)
The Paramedic: A True Health Professional
7(1)
Expanded Scope of Practice
8(1)
Part 2: EMS Systems
8(15)
History of EMS
9(3)
Ancient Times
9(1)
Eighteenth and Nineteenth Centuries
9(1)
Twentieth Century
10(1)
The EMS Agenda for the Future
11(1)
Today's EMS Systems
12(11)
Local and State-Level Agencies
12(1)
Medical Direction
13(1)
Public Information and Education
14(1)
Communications
15(1)
Education and Certification
16(2)
Patient Transportation
18(1)
Receiving Facilities
19(1)
Mutual Aid and Mass-Casualty Preparation
20(1)
Quality Assurance and Improvement
20(1)
Research
21(2)
System Financing
23(1)
Part 3: Roles and Responsibilities of the Paramedic
23(8)
Primary Responsibilities
23(3)
Preparation
23(1)
Response
24(1)
Patient Assessment and Management
25(1)
Appropriate Disposition
25(1)
Patient Transfer
25(1)
Documentation
26(1)
Returning to Service
26(1)
Additional Responsibilities
26(1)
Community Involvement
26(1)
Cost Containment
27(1)
Citizen Involvement in EMS
27(1)
Professionalism
27(4)
Professional Attitudes
27(1)
Professional Attributes
28(2)
Continuing Education and Professional Development
30(1)
Part 4: The Well-Being of the Paramedic
31(16)
Basic Physical Fitness
31(3)
Core Elements
31(1)
Nutrition
32(1)
Preventing Cancer and Cardiovascular Disease
32(1)
Habits and Addictions
33(1)
Back Safety
33(1)
Personal Protection from Disease
34(4)
Infectious Diseases
35(1)
Infection Control Practices
35(3)
Death and Dying
38(3)
Loss, Grief, and Mourning
38(1)
What to Say
39(2)
When It Is Someone You Know
41(1)
Stress and Stress Management
41(4)
Shift Work
42(1)
Signs of Stress
43(1)
Common Techniques for Managing Stress
44(1)
Specific EMS Stresses
44(1)
Mental Health Services
45(1)
Disaster Mental Health Services
45(1)
General Safety Considerations
45(2)
Interpersonal Relations
45(1)
Roadway Safety
46(1)
Part 5: Illness and Injury Prevention
47(6)
Epidemiology
47(1)
Prevention Within EMS
48(2)
Organizational Commitment
48(1)
EMS Provider Commitment
49(1)
Scene Safety
49(1)
Prevention in the Community
50(3)
Areas of Need
50(1)
Implementation of Prevention Strategies
51(2)
Part 6: Ethics in Advanced Prehospital Care
53(35)
Overview of Ethics
53(3)
Relationship of Ethics to Law and Religion
53(1)
Making Ethical Decisions
53(1)
Codes of Ethics
54(1)
The Fundamental Questions
54(1)
Fundamental Principles
54(1)
Resolving Ethical Conflicts
55(1)
Ethical Issues in Contemporary Paramedic Practice
56(8)
Resuscitation Attempts
56(2)
Confidentiality
58(1)
Consent
59(1)
Allocation of Resources
59(1)
Obligation to Provide Care
60(1)
Teaching
60(1)
Professional Relation
60(1)
Research
61(3)
Medical/Legal Aspects of Advanced Prehospital Care
64(20)
Introduction
65(1)
Legal Duties and Ethical Responsibilities
65(5)
The Legal System
66(1)
Anatomy of a Civil Lawsuit
67(1)
Laws Affecting EMS and the Paramedic
68(2)
Legal Accountability of the Paramedic
70(3)
Negligence and Medical Liability
70(2)
Special Liability Concerns
72(1)
Paramedic-Patient Relationships
73(6)
Confidentiality
73(2)
Consent
75(3)
Legal Complications Related to Consent
78(1)
Reasonable Force
78(1)
Patient Transportation
79(1)
Resuscitation Issues
79(2)
Advance Directives
80(1)
Death in the Field
81(1)
Crime and Accident Scenes
81(1)
Documentation
81(3)
Anatomy and Physiology
84(4)
Introduction
87(1)
Part 1: The Cell and the Cellular Environment
88(17)
The Normal Cell
88(6)
Cell Structure
88(2)
Cell Function
90(1)
Tissues
90(1)
Organs, Organ Systems, and the Organism
91(1)
System Integration
92(2)
The Cellular Environment: Fluids and Electrolytes
94(7)
Water
94(4)
Electrolytes
98(1)
Osmosis and Diffusion
99(2)
Acid-Base Balance
101(4)
The pH Scale
101(1)
Bodily Regulation of Acid--Base Balance
102(3)
Part 2: Body Systems
105(136)
The Integumentary System
105(2)
The Skin
105(1)
The Hair
106(1)
The Nails
107(1)
The Blood
107(10)
Components of Blood
108(6)
Hemostasis
114(3)
The Musculoskeletal System
117(21)
Skeletal Tissue and Structure
117(3)
Skeletal Organization
120(12)
Bone Aging
132(2)
Muscular Tissue and Structure
134(4)
The Head, Face, and Neck
138(13)
The Head
138(5)
The Face
143(6)
The Neck
149(2)
The Spine and Thorax
151(9)
The Spine
151(4)
The Thorax
155(5)
The Nervous System
160(17)
Fundamental Unit: The Neuron
160(2)
The Central Nervous System
162(9)
The Peripheral Nervous System
171(6)
The Endocrine System
177(11)
Hypothalamus
179(1)
Pituitary Gland
180(4)
Thyroid Gland
184(1)
Parathyroid Glands
184(1)
Thymus Gland
185(1)
Pancreas
185(1)
Adrenal Glands
186(1)
Gonads
187(1)
Pineal Gland
187(1)
Other Organs with Endocrine Activity
187(1)
The Cardiovascular System
188(17)
Anatomy of the Heart
188(4)
Cardiac Physiology
192(6)
Anatomy of the Peripheral Circulation
198(2)
The Physiology of Perfusion
200(5)
The Respiratory System
205(12)
Upper Airway Anatomy
205(3)
Lower Airway Anatomy
208(2)
The Pediatric Airway
210(1)
Physiology of the Respiratory System
210(7)
The Abdomen
217(3)
Abdominal Vasculature
218(1)
The Peritoneum
219(1)
The Digestive System
220(3)
The Digestive Tract
220(2)
Accessory Organs of Digestion
222(1)
The Spleen
223(1)
The Urinary System
223(5)
The Kidneys
224(4)
The Ureters
228(1)
The Urinary Bladder
228(1)
The Urethra
228(1)
The Reproductive System
228(11)
The Female Reproductive System
228(6)
The Male Reproductive System
234(5)
General Principles of Pathophysiology
239(2)
Introduction
240(1)
Part 1: How Normal Body Processes Are Altered by Disease and Injury
241(27)
Pathophysiology
241(1)
How Cells Respond to Change and Injury
241(5)
Cellular Adaptation
241(2)
Cellular Injury
243(3)
Cellular Death: Apoptosis and Necrosis
246(1)
Fluids and Fluid Imbalances
246(4)
Water
246(1)
Edema
247(1)
Intravenous Therapy
247(3)
Acid--Base Derangements
250(2)
Acidosis and Alkalosis
250(2)
Genetic and Other Causes of Disease
252(5)
Genetics, Environment, Lifestyle, Age, and Gender
252(2)
Family History and Associated Risk Factors
254(3)
Hypoperfusion
257(11)
The Pathophysiology of Hypoperfusion
257(4)
Types of Shock
261(4)
Multiple Organ Dysfunction Syndrome
265(3)
Part 2: The Body's Defenses against Disease and Injury
268(41)
Self-Defense Mechanisms
268(3)
Infectious Agents
268(2)
Three Lines of Defense
270(1)
The Immune Response
271(2)
How the Immune Response Works: An Overview
271(1)
Characteristics of the Immune Response and Immunity
271(1)
Induction of the Immune Response
272(1)
Inflammation
273(6)
Inflammation Contrasted to the Immune Response
273(1)
How Inflammation Works: An Overview
274(1)
Acute Inflammatory Response
274(1)
Mast Cells
274(3)
Systemic Responses of Acute Inflammation
277(1)
Chronic Inflammatory Responses
277(1)
Local Inflammatory Responses
278(1)
Resolution and Repair
278(1)
Variances in Immunity and Inflammation
279(3)
Hypersensitivity
279(1)
Deficiencies in Immunity and Inflammation
280(2)
Stress and Disease
282(9)
Concepts of Stress
282(2)
Stress Responses
284(3)
Stress, Coping, and Illness Interrelationships
287(4)
Life-Span Development
291(16)
Introduction
292(1)
Infancy
292(4)
Physiological Development
292(3)
Psychosocial Development
295(1)
Toddler and Preschool Age
296(2)
Physiological Development
296(1)
Psychosocial Development
297(1)
School Age
298(1)
Physiological Development
298(1)
Psychosocial Development
299(1)
Adolescence
299(1)
Physiological Development
299(1)
Psychosocial Development
300(1)
Early Adulthood
300(1)
Middle Adulthood
301(1)
Late Adulthood
301(6)
Physiological Development
301(2)
Psychosocial Development
303(4)
General Principles of Pharmacology
307(2)
Introduction
309(1)
Part 1: Basic Pharmacology
309(17)
General Aspects
309(2)
Names
309(1)
Sources
310(1)
Reference Materials
310(1)
Components of a Drug Profile
311(1)
Legal Aspects
311(2)
Federal
311(1)
State
312(1)
Local
313(1)
Standards
313(1)
Patient Care: The Safe and Effective Administration of Medications
313(3)
Six Rights of Medication Administration
313(1)
Special Considerations
314(2)
Pharmacology
316(10)
Pharmacokinetics
317(5)
Pharmacodynamics
322(4)
Part 2: Drug Classifications
326(49)
Classifying Drugs
327(1)
Drugs Used to Affect the Nervous System
327(16)
Central Nervous System Medications
327(9)
Autonomic Nervous System Medications
336(7)
Drugs Used to Affect the Cardiovascular System
343(10)
Classes of Cardiovascular Drugs
343(10)
Drugs Used to Affect the Respiratory System
353(3)
Antiasthmatic Medications
353(2)
Drugs Used for Rhinitis and Cough
355(1)
Drugs Used to Affect the Gastrointestinal System
356(3)
Drugs Used to Treat Peptic Ulcer Disease
356(2)
Drugs Used to Treat Constipation
358(1)
Drugs Used to Treat Diarrhea
358(1)
Drugs Used to Treat Emesis
358(1)
Drugs Used to Aid Digestion
359(1)
Drugs Used to Affect the Eyes
359(1)
Drugs Used to Affect the Ears
360(1)
Drugs Used to Affect the Endocrine System
360(6)
Drugs Affecting the Pituitary Gland
360(1)
Drugs Affecting the Parathyroid and Thyroid Glands
360(1)
Drugs Affecting the Adrenal Cortex
361(1)
Drugs Affecting the Pancreas
361(3)
Drugs Affecting the Female Reproductive System
364(1)
Drugs Affecting the Male Reproductive System
365(1)
Drugs Affecting Sexual Behavior
365(1)
Drugs Used to Treat Cancer
366(1)
Drugs Used to Treat Infectious Diseases and Inflammation
366(2)
Drugs Used to Affect the Skin
368(1)
Drugs Used to Supplement the Diet
368(2)
Vitamins and Minerals
369(1)
Fluids and Electrolytes
369(1)
Drugs Used to Treat Poisoning and Overdoses
370(3)
Intravenous Access and Medication Administration
373(2)
Introduction
375(1)
Part 1: Principles and Routes of Medication Administration
375(30)
General Principles
375(3)
Medical Direction
376(1)
Body Substance Isolation
376(1)
Medical Asepsis
376(1)
Disposal of Contaminated Equipment and Sharps
377(1)
Medication Administration and Documentation
378(1)
Percutaneous Drug Administration
378(3)
Transdermal Administration
378(1)
Mucous Membranes
378(3)
Pulmonary Drug Administration
381(4)
Nebulizer
381(1)
Metered-Dose Inhaler
382(2)
Endotracheal Tube
384(1)
Enteral Drug Administration
385(5)
Oral Administration
386(1)
Gastric Tube Administration
387(2)
Rectal Administration
389(1)
Parenteral Drug Administration
390(15)
Syringes and Needles
390(1)
Medication Packaging
391(6)
Parenteral Routes
397(8)
Part 2: Intravenous Access, Blood Sampling, and Intraosseous Infusion
405(37)
Intravenous Access
405(30)
Types of Intravenous Access
406(1)
Equipment and Supplies for Venous Access
407(7)
Intravenous Access in the Hand, Arm, and Leg
414(2)
Intravenous Access in the External Jugular Vein
416(2)
Intravenous Access with a Measured Volume Administration Set
418(1)
Intravenous Access with Blood Tubing
418(2)
Factors Affecting Intravenous Flow Rates
420(1)
Complications of Peripheral Intravenous Access
421(1)
Changing an IV Bag or Bottle
422(1)
Intravenous Drug Administration
423(8)
Venous Blood Sampling
431(3)
Removing a Peripheral IV
434(1)
Intraosseous Infusion
435(7)
Access Site
435(1)
Equipment for Intraosseous Access
435(3)
Placing an Intraosseous Infusion
438(3)
Intraosseous Access Complications and Precautions
441(1)
Contraindications to Intraosseous Placement
442(1)
Part 3: Medical Mathematics
442(103)
Metric System
442(2)
Conversion between Prefixes
442(1)
Household and Apothecary Systems of Measure
443(1)
Weight Conversion
443(1)
Temperature
444(1)
Units
444(1)
Medical Calculations
444(10)
Desired Dose
445(1)
Dosage and Volume on Hand
445(1)
Calculating Dosages for Oral Medications
445(1)
Converting Prefixes
446(1)
Calculating Dosages for Parenteral Medications
446(1)
Calculating Weight-Dependent Dosages
447(1)
Calculating Infusion Rates
447(7)
Airway Management and Ventilation
454(78)
Introduction
456(1)
Respiratory Problems
456(2)
Airway Obstruction
456(2)
Inadequate Ventilation
458(1)
Respiratory System Assessment
458(11)
Initial Assessment
458(1)
Focused History and Physical Examination
459(3)
Noninvasive Respiratory Monitoring
462(7)
Basic Airway Management
469(5)
Manual Airway Maneuvers
469(2)
Basic Mechanical Airways
471(3)
Advanced Airway Management
474(46)
Endotracheal Intubation
475(26)
Nasotracheal Intubation
501(3)
Field Extubation
504(1)
Esophageal Tracheal CombiTube
504(3)
Pharyngo-Tracheal Lumen Airway
507(1)
Laryngeal Mask Airway
508(3)
Esophageal Gastric Tube Airway and Esophageal Obturator Airway
511(1)
Foreign Body Removal under Direct Laryngoscopy
511(1)
Surgical Airways
512(8)
Managing Patients with Stoma Sites
520(1)
Suctioning
521(1)
Suctioning Equipment
521(1)
Suctioning Techniques
522(1)
Gastric Distention and Decompression
522(1)
Oxygenation
523(2)
Oxygen Supply and Regulation
523(1)
Oxygen Delivery Devices
524(1)
Ventilation
525(7)
Mouth-to-Mouth/Mouth-to-Nose Ventilation
525(1)
Mouth-to-Mask Ventilation
525(1)
Bag-Valve Devices
526(1)
Demand Valve Device
527(1)
Automatic Transport Ventilator
528(4)
Therapeutic Communications
532(13)
Introduction
533(1)
Basic Elements of Communication
533(2)
Trust and Rapport
533(1)
Professional Behaviors
534(1)
Communication Techniques
535(10)
General Guidelines
535(2)
Interview Techniques
537(3)
Patients with Special Needs
540(3)
Transferring Patient Care
543(2)
DIVISION 2 PATIENT ASSESSMENT
545(214)
History Taking
546(18)
Introduction
547(1)
Establishing Patient Rapport
547(3)
Setting the Stage
547(1)
Language and Communication
548(1)
Taking a History on Sensitive Topics
549(1)
The Comprehensive Patient History
550(8)
Preliminary Data
550(1)
The Chief Complaint
551(1)
The Present Illness
551(2)
The Past History
553(1)
Current Health Status
554(2)
Review of Systems
556(2)
Special Challenges
558(6)
Silence
558(1)
Overly Talkative Patients
559(1)
Patients with Multiple Symptoms
559(1)
Anxious Patients
559(1)
Patients Needing Reassurance
559(1)
Anger and Hostility
559(1)
Intoxication
560(1)
Crying
560(1)
Depression
560(1)
Sexually Attractive or Seductive Patients
560(1)
Confusing Behaviors or Histories
560(1)
Limited Intelligence
561(1)
Language Barriers
561(1)
Hearing Problems
561(1)
Blindness
561(1)
Talking with Families or Friends
561(3)
Physical Exam Techniques
564(87)
Introduction to Physical Examination
565(1)
Approach and Overview
565(11)
Examination Techniques
566(7)
Equipment
573(2)
The General Approach
575(1)
Overview of a Comprehensive Examination
576(9)
The General Survey
576(9)
Anatomical Regions
585(57)
The Skin
585(3)
The Hair
588(2)
The Nails
590(1)
The Head
590(1)
The Eyes
590(6)
The Ears
596(4)
The Nose
600(1)
The Mouth
600(3)
The Neck
603(2)
The Chest and Lungs
605(4)
The Cardiovascular System
609(3)
The Abdomen
612(3)
The Female Genitalia
615(1)
The Male Genitalia
615(1)
The Anus
615(1)
The Musculoskeletal System
616(9)
The Peripheral Vascular System
625(4)
The Nervous System
629(13)
Physical Examination of Infants and Children
642(5)
Building Patient and Family Rapport
642(1)
Anatomy and the Physical Exam
643(4)
Recording Examination Findings
647(4)
Patient Assessment in the Field
651(53)
Introduction
653(1)
Scene Size-Up
654(9)
Body Substance Isolation
655(1)
Scene Safety
656(5)
Location of All Patients
661(1)
Mechanism of Injury
662(1)
Nature of the Illness
663(1)
The Initial Assessment
663(10)
Forming a General Impression
664(1)
Mental Status
665(1)
Airway Assessment
666(1)
Breathing Assessment
667(1)
Circulation Assessment
668(1)
Priority Determination
669(4)
The Focused History and Physical Exam
673(19)
The Major Trauma Patient
673(9)
The Isolated-Injury Trauma Patient
682(1)
The Responsive Medical Patient
683(7)
The Unresponsive Medical Patient
690(2)
The Detailed Physical Exam
692(6)
Components of the Comprehensive Exam
692(6)
Vital Signs
698(1)
Recording Exam Findings
698(1)
Ongoing Assessment
698(6)
Mental Status
698(1)
Airway Patency
699(1)
Breathing Rate and Quality
699(1)
Pulse Rate and Quality
699(1)
Skin Condition
699(1)
Transport Priorities
699(2)
Vital Signs
701(1)
Focused Assessment
701(1)
Effects of Interventions
701(1)
Management Plans
701(3)
Clinical Decision Making
704(12)
Introduction
705(1)
Clinical Judgment
705(1)
Paramedic Practice
705(3)
Patient Acuity
706(1)
Protocols and Algorithms
706(2)
Critical Thinking Skills
708(2)
Fundamental Knowledge and Abilities
708(1)
Useful Thinking Styles
709(1)
Thinking Under Pressure
710(1)
Mental Checklist
711(1)
The Critical Decision Process
711(5)
Form a Concept
712(1)
Interpret the Data
712(1)
Apply the Principles
712(1)
Evaluate the Results
713(1)
Reflect on the Incident
713(1)
Putting It All Together
713(3)
Communications
716(19)
Introduction
717(1)
Verbal Communication
717(1)
Written Communication
717(3)
Terminology
719(1)
The EMS Response
720(6)
Response Sequence
720(6)
Communication Technology
726(4)
Radio Communication
726(2)
Alternative Technologies
728(1)
New Technology
729(1)
Reporting Procedures
730(2)
Standard Format
730(1)
General Radio Procedures
731(1)
Model Verbal Reports
732(1)
Regulation
732(3)
Documentation
735(24)
Introduction
736(1)
Uses for Documentation
736(2)
Medical
736(1)
Administrative
737(1)
Research
737(1)
Legal
737(1)
General Considerations
738(7)
Medical Terminology
738(1)
Abbreviations and Acronyms
738(5)
Times
743(1)
Communications
744(1)
Pertinent Negatives
744(1)
Oral Statements
744(1)
Additional Resources
744(1)
Elements of Good Documentation
745(3)
Completeness and Accuracy
745(1)
Legibility
745(2)
Timeliness
747(1)
Absence of Alterations
747(1)
Professionalism
747(1)
Narrative Writing
748(5)
Narrative Sections
748(2)
General Formats
750(3)
Special Considerations
753(2)
Patient Refusals
753(2)
Services Not Needed
755(1)
Multiple-Casualty Incidents
755(1)
Consequences of Inappropriate Documentation
755(1)
Closing
756(3)
DIVISION 3 TRAUMA EMERGENCIES
759(320)
Trauma and Trauma Systems
760(10)
Introduction
761(1)
Trauma
761(1)
The Trauma Care System
762(1)
Trauma Center Designation
762(2)
Specialty Centers
764(1)
Your Role as an EMT-Paramedic
764(6)
Mechanism of Injury Analysis
765(1)
Index of Suspicion
765(1)
The Golden Hour
765(1)
The Decision to Transport
766(1)
Injury Prevention
766(1)
Data and the Trauma Registry
767(1)
Quality Improvement
767(3)
Blunt Trauma
770(32)
Introduction
771(1)
Kinetics of Blunt Trauma
771(3)
Inertia
771(1)
Conservation of Energy
772(1)
Kinetic Energy
772(1)
Force
773(1)
Blunt Trauma
774(28)
Automobile Collisions
774(13)
Motorcycle Collisions
787(1)
Pedestrian Collisions
788(1)
Recreational Vehicle Collisions
788(2)
Blast Injuries
790(6)
Other Types of Blunt Trauma
796(6)
Penetrating Trauma
802(19)
Introduction
803(1)
Physics of Penetrating Trauma
803(8)
Ballistics
804(2)
Specific Weapon Characteristics
806(3)
Damage Pathway
809(2)
Low-Velocity Wounds
811(1)
Specific Tissue/Organ Injuries
811(5)
Connective Tissue
811(1)
Organs
812(1)
Lungs
812(1)
Bone
813(1)
General Body Regions
813(3)
Special Concerns with Penetrating Trauma
816(5)
Scene Size-Up
816(1)
Penetrating Wound Assessment
817(1)
Penetrating Wound Care
817(4)
Hemorrhage and Shock
821(31)
Introduction
822(1)
Hemorrhage
822(15)
Clotting
823(2)
Factors Affecting the Clotting Process
825(1)
Hemorrhage Control
825(4)
Stages of Hemorrhage
829(2)
Hemorrhage Assessment
831(3)
Hemorrhage Management
834(3)
Shock
837(15)
The Body's Response to Blood Loss
838(1)
Stages of Shock
839(2)
Shock Assessment
841(2)
Shock Management
843(9)
Soft-Tissue Trauma
852(39)
Introduction
854(1)
Epidemiology
854(1)
Pathophysiology of Soft-Tissue Injury
854(15)
Closed Wounds
855(2)
Open Wounds
857(4)
Hemorrhage
861(1)
Wound Healing
861(3)
Infection
864(2)
Other Wound Complications
866(1)
Crush Injury
867(1)
Injection Injury
868(1)
Dressing and Bandage Materials
869(2)
Types of Dressings and Bandages
869(2)
Assessment of Soft-Tissue Injuries
871(4)
Scene Size-up
871(1)
Initial Assessment
872(1)
Focused History and Physical Exam
872(2)
Detailed Physical Exam
874(1)
Assessment Techniques
874(1)
Ongoing Assessment
875(1)
Management of Soft-Tissue Injury
875(16)
Objectives of Wound Dressing and Bandaging
875(4)
Anatomical Considerations for Bandaging
879(2)
Complications of Bandaging
881(1)
Care of Specific Wounds
882(4)
Special Anatomical Sites
886(2)
Wounds Requiring Transport
888(1)
Soft-Tissue Treatment and Refer/Release
888(3)
Burns
891(33)
Introduction
892(1)
Pathophysiology of Burns
892(14)
Types of Burns
892(10)
Depth of Burn
902(1)
Body Surface Area
903(1)
Systemic Complications
904(2)
Assessment of Thermal Burns
906(6)
Scene Size-up
906(2)
Initial Assessment
908(1)
Focused and Rapid Trauma Assessment
909(3)
Ongoing Assessment
912(1)
Management of Thermal Burns
912(3)
Local and Minor Burns
912(1)
Moderate to Severe Burns
913(1)
Inhalation Injury
914(1)
Assessment and Management of Electrical, Chemical, and Radiation Burns
915(9)
Electrical Injuries
915(2)
Chemical Burns
917(2)
Radiation Burns
919(2)
Ongoing Assessment
921(3)
Musculoskeletal Trauma
924(34)
Introduction
925(1)
Prevention Strategies
926(1)
Pathophysiology of the Musculoskeletal System
926(7)
Muscular Injury
926(1)
Joint Injury
927(1)
Bone Injury
928(3)
General Considerations with Musculoskeletal Injuries
931(1)
Bone Repair Cycle
932(1)
Inflammatory and Degenerative Conditions
932(1)
Musculoskeletal Injury Assessment
933(5)
Scene Size-up
933(1)
Initial Assessment
933(1)
Rapid Trauma Assessment
934(1)
Focused History and Physical Exam
935(2)
Detailed Physical Exam
937(1)
Ongoing Assessment
937(1)
Sports Injury Considerations
937(1)
Musculoskeletal Injury Management
938(20)
General Principles of Musculoskeletal Injury Management
938(2)
Splinting Devices
940(2)
Fracture Care
942(2)
Joint Care
944(1)
Muscular and Connective Tissue Care
944(1)
Care for Specific Fractures
945(3)
Care for Specific Joint Injuries
948(4)
Soft and Connective Tissue Injuries
952(1)
Medications
953(1)
Other Musculoskeletal Injury Considerations
954(4)
Head, Facial, and Neck Trauma
958(42)
Introduction
959(1)
Pathophysiology of Head, Facial, and Neck Injury
959(19)
Mechanisms of Injury
960(1)
Head Injury
961(11)
Facial Injury
972(5)
Neck Injury
977(1)
Assessment of Head, Facial, and Neck Injuries
978(7)
Scene Size-up
978(1)
Initial Assessment
979(1)
Rapid Trauma Assessment
980(4)
Focused History and Physical Exam
984(1)
Detailed Assessment
985(1)
Ongoing Assessment
985(1)
Head, Facial, and Neck Injury Management
985(15)
Airway
985(5)
Breathing
990(1)
Circulation
991(1)
Hypoxia
991(1)
Hypovolemia
992(1)
Medications
992(3)
Transport Considerations
995(1)
Emotional Support
995(1)
Special Injury Care
996(4)
Spinal Trauma
1000(30)
Introduction
1001(1)
Pathophysiology of Spinal Injury
1001(6)
Mechanisms of Spinal Injury
1001(3)
Results of Trauma to the Spinal Column
1004(3)
Assessment of the Spinal Injury Patient
1007(7)
Scene Size-up
1007(1)
Initial Assessment
1008(2)
Rapid Trauma Assessment
1010(3)
Ongoing Assessment
1013(1)
Management of the Spinal Injury Patient
1014(16)
Spinal Alignment
1015(1)
Manual Cervical Immobilization
1016(2)
Cervical Collar Application
1018(1)
Standing Takedown
1018(1)
Helmet Removal
1019(1)
Moving the Spinal Injury Patient
1020(6)
Medications
1026(4)
Thoracic Trauma
1030(31)
Introduction
1031(1)
Pathophysiology of Thoracic Trauma
1032(16)
Blunt Trauma
1032(1)
Penetrating Trauma
1033(2)
Chest Wall Injuries
1035(3)
Pulmonary Injuries
1038(5)
Cardiovascular Injuries
1043(4)
Other Vascular Injuries
1047(1)
Other Thoracic Injuries
1047(1)
Assessment of the Chest Injury Patient
1048(5)
Scene Size-up
1049(1)
Initial Assessment
1049(1)
Rapid Trauma Assessment
1049(4)
Ongoing Assessment
1053(1)
Management of the Thoracic Trauma Patient
1053(8)
Rib Fractures
1054(1)
Sternoclavicular Dislocation
1055(1)
Flail Chest
1055(1)
Open Pneumothorax
1055(1)
Tension Pneumothorax
1056(1)
Hemothorax
1057(1)
Myocardial Contusion
1057(1)
Pericardial Tamponade
1058(1)
Aortic Aneurysm
1058(1)
Tracheobronchial Injury
1058(1)
Traumatic Asphyxia
1058(3)
Abdominal Trauma
1061(18)
Introduction
1062(1)
Pathophysiology of Abdominal Injury
1062(7)
Mechanism of Injury
1062(2)
Injury to the Abdominal Wall
1064(1)
Injury to the Hollow Organs
1065(1)
Injury to the Solid Organs
1065(1)
Injury to the Vascular Structures
1066(1)
Injury to the Mesentery and Bowel
1066(1)
Injury to the Peritoneum
1067(1)
Injury to the Pelvis
1067(1)
Injury During Pregnancy
1067(2)
Injury to Pediatric Patients
1069(1)
Assessment of the Abdominal Injury Patient
1069(5)
Scene Size-up
1069(2)
Initial Assessment
1071(1)
Rapid Trauma Assessment
1072(2)
Ongoing Assessment
1074(1)
Management of the Abdominal Injury Patient
1074(5)
Management of the Pregnant Patient
1075(4)
DIVISION 4 MEDICAL EMERGENCIES
1079(48)
Pulmonology
1080(41)
Introduction
1081(3)
Physiological Processes
1081(3)
Pathophysiology
1084(2)
Disruption in Ventilation
1084(2)
Disruption in Diffusion
1086(1)
Disruption in Perfusion
1086(1)
Assessment of the Respiratory System
1086(12)
Scene Size-up
1086(1)
Initial Assessment
1087(2)
Focused History and Physical Examination
1089(9)
Management of Respiratory Disorders
1098(1)
Management Principles
1098(1)
Specific Respiratory Diseases
1098(23)
Upper Airway Obstruction
1098(2)
Noncardiogenic Pulmonary Edema/Adult Respiratory Distress Syndrome
1100(1)
Obstructive Lung Disease
1101(1)
Emphysema
1102(2)
Chronic Bronchitis
1104(1)
Asthma
1105(3)
Upper Respiratory Infection
1108(1)
Pneumonia
1109(2)
Severe Acute Respiratory Syndrome (SARS)
1111(1)
Lung Cancer
1112(1)
Toxic Inhalation
1113(1)
Carbon Monoxide Inhalation
1114(1)
Pulmonary Embolism
1114(2)
Spontaneous Pneumothorax
1116(1)
Hyperventilation Syndrome
1116(1)
Central Nervous System Dysfunction
1117(1)
Dysfunction of the Spinal Cord, Nerves, or Respiratory Muscles
1118(3)
Cardiology
1121(6)
Introduction
1126(1)
Part 1: Cardiovascular Anatomy, Physiology, ECG Monitoring, and Dysrhythmia Analysis
1127(59)
Review of Cardiovascular Anatomy and Physiology
1127(3)
Cardiovascular Anatomy
1127(1)
Cardiac Physiology
1128(1)
Electrophysiology
1129(1)
Electrocardiographic Monitoring
1130(12)
The Electrocardiogram
1131(3)
Relationship of the ECG to Electrical Events in the Heart
1134(7)
Interpretation of Rhythm Strips
1141(1)
Dysrhythmias
1142(44)
Mechanism of Impulse Formation
1143(1)
Classification of Dysrhythmias
1144(1)
Dysrhythmias Originating in the SA Node
1144(6)
Dysrhythmias Originating in the Atria
1150(9)
Dysrhythmias Originating within the AV Junction (AV Blocks)
1159(6)
Dysrhythmias Sustained or Originating in the AV Junction
1165(6)
Dysrhythmias Originating in the Ventricles
1171(11)
Pulseless Electrical Activity
1182(2)
Dysrhythmias Resulting from Disorders of Conduction
1184(1)
ECG Changes Due to Electrolyte Abnormalities and Hypothermia
1185(1)
Part 2: Assessment and Management of the Cardiovascular Patient
1186(367)
Assessment of the Cardiovascular Patient
1186(8)
Scene Size-Up and Initial Assessment
1186(1)
Focused History
1187(4)
Physical Examination
1191(3)
Management of Cardiovascular Emergencies
1194(17)
Basic Life Support
1194(1)
Advanced Life Support
1195(1)
Monitoring ECG in the Field
1195(3)
Vagal Maneuvers
1198(1)
Precordial Thump
1198(1)
Pharmacological Management
1199(1)
Defibrillation
1199(5)
Emergency Synchronized Cardioversion
1204(2)
Transcutaneous Cardiac Pacing
1206(1)
Carotid Sinus Massage
1206(5)
Support and Communication
1211(1)
Managing Specific Cardiovascular Emergencies
1211(26)
Acute Coronary Syndrome
1211(1)
Angina Pectoris
1211(3)
Myocardial Infarction
1214(6)
Heart Failure
1220(4)
Cardiac Tamponade
1224(1)
Hypertensive Emergencies
1225(1)
Cardiogenic Shock
1226(3)
Cardiac Arrest
1229(4)
Peripheral Vascular and Other Cardiovascular Emergencies
1233(4)
Prehospital ECG Monitoring
1237(6)
Prehospital 12-Lead ECG Monitoring
1237(6)
Neurology
1243(37)
Introduction
1244(1)
Pathophysiology
1245(2)
Alteration in Cognitive Systems
1245(1)
Central Nervous System Disorders
1245(1)
Cerebral Homeostasis
1246(1)
Peripheral Nervous System Disorders
1246(1)
General Assessment Findings
1247(8)
Scene Size-up and Initial Assessment
1247(2)
Focused History and Physical Exam
1249(6)
Ongoing Assessment
1255(1)
Management of Specific Nervous System Emergencies
1255(25)
Altered Mental Status
1256(1)
Stroke and Intracranial Hemorrhage
1257(7)
Seizures and Epilepsy
1264(3)
Syncope
1267(1)
Headache
1268(2)
``Weak and Dizzy''
1270(1)
Neoplasms
1270(2)
Brain Abscess
1272(1)
Degenerative Neurological Disorders
1272(3)
Back Pain and Nontraumatic Spinal Disorders
1275(5)
Endocrinology
1280(15)
Introduction
1281(1)
Endocrine Disorders and Emergencies
1282(13)
Disorders of the Pancreas
1282(7)
Disorders of the Thyroid Gland
1289(2)
Disorders of the Adrenal Glands
1291(4)
Allergies and Anaphylaxis
1295(11)
Introduction
1296(1)
Pathophysiology
1296(3)
The Immune System
1296(2)
Allergies
1298(1)
Anaphylaxis
1299(1)
Assessment Findings in Anaphylaxis
1299(2)
Management of Anaphylaxis
1301(2)
Protect the Airway
1301(1)
Administer Medications
1301(2)
Offer Psychological Support
1303(1)
Assessment Findings in Allergic Reaction
1303(1)
Management of Allergic Reaction
1303(3)
Gastroenterology
1306(22)
Introduction
1307(1)
General Pathophysiology, Assessment, and Treatment
1307(4)
General Pathophysiology
1308(1)
General Assessment
1308(2)
General Treatment
1310(1)
Specific Illnesses
1311(17)
Upper Gastrointestinal Diseases
1311(6)
Lower Gastrointestinal Diseases
1317(5)
Accessory Organ Diseases
1322(6)
Urology and Nephrology
1328(21)
Introduction
1329(1)
General Mechanisms of Nontraumatic Tissue Problems
1330(1)
General Pathophysiology, Assessment, and Management
1331(4)
Pathophysiologic Basis of Pain
1331(1)
Assessment and Management
1331(4)
Renal and Urologic Emergencies
1335(14)
Acute Renal Failure
1335(3)
Chronic Renal Failure
1338(5)
Renal Calculi
1343(2)
Priapism
1345(1)
Urinary Tract Infection
1345(4)
Toxicology and Substance Abuse
1349(40)
Introduction
1350(1)
Epidemiology
1351(1)
Poison Control Centers
1351(1)
Routes of Toxic Exposure
1352(1)
Ingestion
1352(1)
Inhalation
1352(1)
Surface Absorption
1352(1)
Injection
1353(1)
General Principles of Toxicologic Assessment and Management
1353(3)
Scene Size-up
1353(1)
Initial Assessment
1353(1)
History, Physical Exam, and Ongoing Assessment
1353(1)
Treatment
1354(1)
Suicidal Patients and Protective Custody
1355(1)
Ingested Toxins
1356(1)
Inhaled Toxins
1357(1)
Surface-Absorbed Toxins
1358(1)
Specific Toxins
1359(13)
Cyanide
1359(1)
Carbon Monoxide
1359(4)
Cardiac Medications
1363(1)
Caustic Substances
1363(1)
Hydrofluoric Acid
1364(1)
Alcohol
1364(1)
Hydrocarbons
1365(1)
Tricyclic Antidepressants
1365(1)
MAO Inhibitors
1366(1)
Newer Antidepressants
1366(1)
Lithium
1367(1)
Salicylates
1368(1)
Acetaminophen
1368(1)
Other Nonprescription Pain Medications
1369(1)
Theophylline
1369(1)
Metals
1369(1)
Contaminated Food
1370(1)
Poisonous Plants and Mushrooms
1371(1)
Injected Toxins
1372(8)
General Principles of Management
1372(1)
Insect Bites and Stings
1373(3)
Snakebites
1376(3)
Marine Animal Injection
1379(1)
Substance Abuse and Overdose
1380(1)
Drugs of Abuse
1381(1)
Alcohol Abuse
1381(8)
Physiological Effects
1381(3)
General Alcoholic Profile
1384(1)
Consequences of Chronic Alcohol Ingestion
1384(5)
Hematology
1389(16)
Introduction
1390(2)
Blood Products and Blood Typing
1390(2)
Transfusion Reactions
1392(1)
General Assessment and Management
1392(5)
Scene Size-up
1393(1)
Initial Assessment
1393(1)
Focused History and Physical Exam
1393(3)
General Management of Hematopoietic Emergencies
1396(1)
Managing Specific Patient Problems
1397(8)
Diseases of the Red Blood Cells
1397(2)
Diseases of the White Blood Cells
1399(2)
Diseases of the Platelets/Blood Clotting Abnormalities
1401(1)
Other Hematopoietic Disorders
1402(3)
Environmental Emergencies
1405(34)
Introduction
1407(1)
Pathophysiology of Heat and Cold Disorders
1407(4)
Mechanisms of Heat Gain and Loss
1407(1)
Thermogenesis (Heat Generation)
1408(1)
Thermolysis (Heat Loss)
1408(1)
Thermoregulation
1408(3)
Heat Disorders
1411(5)
Hyperthermia
1411(1)
Predisposing Factors
1411(1)
Preventive Measures
1412(1)
Specific Heat Disorders
1412(3)
Role of Dehydration in Heat Disorders
1415(1)
Fever (Pyrexia)
1415(1)
Cold Disorders
1416(7)
Hypothermia
1416(1)
Mechanisms of Heat Conservation and Loss
1416(1)
Predisposing Factors
1416(1)
Preventive Measures
1417(1)
Degrees of Hypothermia
1417(1)
Assessment and Management of Hypothermia
1417(5)
Frostbite
1422(1)
Trench Foot
1423(1)
Near-Drowning and Drowning
1423(3)
Pathophysiology of Drowning and Near-Drowning
1423(2)
Treatment for Near-Drowning
1425(1)
Diving Emergencies
1426(7)
The Effects of Air Pressure on Gases
1426(1)
Pathophysiology of Diving Emergencies
1427(1)
Classification of Diving Injuries
1427(1)
General Assessment of Diving Emergencies
1428(1)
Pressure Disorders
1429(3)
Other Diving-Related Illnesses
1432(1)
Divers Alert Network
1433(1)
High Altitude Illness
1433(6)
Prevention
1433(1)
Types of High Altitude Illness
1434(5)
Infectious Disease
1439(47)
Introduction
1441(1)
Public Health Principles
1441(1)
Public Health Agencies
1442(1)
Microorganisms
1443(3)
Bacteria
1443(1)
Viruses
1444(1)
Other Microorganisms
1445(1)
Contraction, Transmission, and Stages of Disease
1446(3)
Phases of the Infectious Process
1448(1)
Infection Control in Prehospital Care
1449(5)
Preparation for Response
1449(1)
Response
1450(1)
Patient Contact
1450(1)
Recovery
1451(2)
Infectious Disease Exposures
1453(1)
Assessment of the Patient with Infectious Disease
1454(1)
Past Medical History
1454(1)
The Physical Examination
1455(1)
Selected Infectious Diseases
1455(28)
Diseases of Immediate Concern to EMS Providers
1455(17)
Other Infectious Conditions of the Respiratory System
1472(1)
GI System Infections
1473(2)
Nervous System Infections
1475(3)
Sexually Transmitted Diseases
1478(3)
Diseases of the Skin
1481(1)
Nosocomial Infections
1482(1)
Preventing Disease Transmission
1483(3)
Psychiatric and Behavioral Disorders
1486(23)
Introduction
1487(1)
Behavioral Emergencies
1487(1)
Pathophysiology of Psychiatric Disorders
1488(1)
Biological
1488(1)
Psychosocial
1488(1)
Sociocultural
1489(1)
Assessment of Behavioral Emergency Patients
1489(3)
Scene Size-Up
1489(1)
Initial Assessment
1489(1)
Focused History and Physical Examination
1490(1)
Mental Status Examination
1491(1)
Psychiatric Medications
1492(1)
Specific Psychiatric Disorders
1492(10)
Cognitive Disorders
1493(1)
Schizophrenia
1493(1)
Anxiety and Related Disorders
1494(1)
Mood Disorders
1495(2)
Substance-Related Disorders
1497(1)
Somatoform Disorders
1497(1)
Factitious Disorders
1498(1)
Dissociative Disorders
1498(1)
Eating Disorders
1498(1)
Personality Disorders
1499(1)
Impulse Control Disorders
1500(1)
Suicide
1500(1)
Age-Related Conditions
1501(1)
Crisis in the Pediatric Patient
1502(1)
Management of Behavioral Emergencies
1502(2)
Medical
1502(1)
Psychological
1503(1)
Violent Patients and Restraint
1504(5)
Methods of Restraint
1504(5)
Gynecology
1509(9)
Introduction
1510(1)
Assessment of the Gynecological Patient
1510(2)
History
1510(1)
Physical Exam
1511(1)
Management of Gynecological Emergencies
1512(1)
Specific Gynecological Emergencies
1512(6)
Medical Gynecological Emergencies
1512(2)
Traumatic Gynecological Emergencies
1514(4)
Obstetrics
1518(35)
Introduction
1519(1)
The Prenatal Period
1519(6)
Anatomy and Physiology of the Obstetric Patient
1519(3)
Fetal Development
1522(1)
Fetal Circulation
1523(2)
General Assessment of the Obstetric Patient
1525(2)
Initial Assessment
1525(1)
History
1525(1)
Physical Examination
1526(1)
General Management of the Obstetric Patient
1527(1)
Complications of Pregnancy
1527(10)
Trauma
1527(1)
Medical Conditions
1528(1)
Bleeding in Pregnancy
1528(4)
Medical Complications of Pregnancy
1532(4)
Braxton-Hicks Contractions
1536(1)
Preterm Labor
1536(1)
The Puerperium
1537(7)
Labor
1537(1)
Management of a Patient in Labor
1538(1)
Field Delivery
1539(3)
Neonatal Care
1542(2)
Abnormal Delivery Situations
1544(4)
Other Delivery Complications
1548(1)
Maternal Complications of Labor and Delivery
1549(4)
DIVISION 5 SPECIAL CONSIDERATIONS/OPERATIONS
1553(245)
Neonatology
1554(31)
Introduction
1555(1)
General Pathophysiology, Assessment, and Management
1556(7)
Epidemiology
1556(1)
Pathophysiology
1557(2)
Assessment
1559(1)
Treatment
1560(3)
The Distressed Newborn
1563(11)
Resuscitation
1563(1)
Inverted Pyramid for Resuscitation
1564(9)
Maternal Narcotic Use
1573(1)
Neonatal Transport
1573(1)
Specific Neonatal Situations
1574(11)
Meconium-Stained Amniotic Fluid
1574(1)
Apnea
1575(1)
Diaphragmatic Hernia
1575(1)
Bradycardia
1576(1)
Prematurity
1576(1)
Respiratory Distress/Cyanosis
1577(1)
Hypovolemia
1578(1)
Seizures
1578(1)
Fever
1579(1)
Hypothermia
1579(1)
Hypoglycemia
1580(1)
Vomiting
1580(1)
Diarrhea
1581(1)
Common Birth Injuries
1581(1)
Cardiac Resuscitation, Postresuscitation, and Stabilization
1582(3)
Pediatrics
1585(82)
Introduction
1587(1)
Role of Paramedics in Pediatric Care
1587(2)
Continuing Education and Training
1587(1)
Improved Health Care and Injury Prevention
1588(1)
General Approach to Pediatric Emergencies
1589(8)
Communication and Psychological Support
1589(1)
Growth and Development
1590(3)
Anatomy and Physiology
1593(4)
General Approach to Pediatric Assessment
1597(9)
Basic Considerations
1597(1)
Scene Size-up
1598(1)
Initial Assessment
1598(5)
Focused History and Physical Exam
1603(3)
Ongoing Assessment
1606(1)
General Management of Pediatric Patients
1606(17)
Basic Airway Management
1606(5)
Advanced Airway and Ventilatory Management
1611(8)
Circulation
1619(2)
C-Spine Immobilization
1621(2)
Transport Guidelines
1623(1)
Specific Medical Emergencies
1623(25)
Infections
1624(1)
Respiratory Emergencies
1624(2)
Specific Respiratory Emergencies
1626(6)
Shock (Hypoperfusion)
1632(4)
Congenital Heart Disease
1636(4)
Neurologic Emergencies
1640(3)
Gastrointestinal Emergencies
1643(1)
Metabolic Emergencies
1644(2)
Poisoning and Toxic Exposure
1646(2)
Trauma Emergencies
1648(8)
Mechanisms of Injury
1649(2)
Special Considerations
1651(3)
Specific Injuries
1654(2)
Sudden Infant Death Syndrome (SIDS)
1656(1)
Child Abuse and Neglect
1657(4)
Perpetrators of Abuse or Neglect
1657(1)
Types of Abuse
1658(1)
Assessment of the Potentially Abused or Neglected Child
1659(1)
Management of the Potentially Abused or Neglected Child
1660(1)
Resources for Abuse and Neglect
1661(1)
Infants and Children with Special Needs
1661(6)
Common Home-Care Devices
1661(2)
General Assessment and Management Practices
1663(4)
Geriatric Emergencies
1667(48)
Introduction
1669(1)
Epidemiology and Demographics
1669(2)
Population Characteristics
1669(1)
Societal Issues
1670(1)
General Pathophysiology, Assessment, and Management
1671(9)
Pathophysiology of the Elderly Patient
1672(3)
Assessment Considerations
1675(4)
Management Considerations
1679(1)
System Pathophysiology in the Elderly
1680(5)
Respiratory System
1680(1)
Cardiovascular System
1681(1)
Nervous System
1682(1)
Endocrine System
1683(1)
Gastrointestinal System
1683(1)
Thermoregulatory System
1684(1)
Integumentary System
1684(1)
Musculoskeletal System
1684(1)
Renal System
1685(1)
Genitourinary System
1685(1)
Immune System
1685(1)
Hematology System
1685(1)
Common Medical Problems in the Elderly
1685(23)
Pulmonary/Respiratory Disorders
1686(3)
Cardiovascular Disorders
1689(4)
Neurologi Disorders
1693(3)
Metabolic and Endocrine Disorders
1696(1)
Gastrointestinal Disorders
1697(2)
Skin Disorders
1699(1)
Musculoskeletal Disorders
1700(1)
Renal Disorders
1701(1)
Urinary Disorders
1702(1)
Environmental Emergencies
1702(1)
Toxicological Emergencies
1703(2)
Substance Abuse
1705(2)
Behavioral/Psychological Disorders
1707(1)
Trauma in the Elderly Patient
1708(7)
Contributing Factors
1709(1)
General Assessment
1709(1)
General Management
1710(2)
Specific Injuries
1712(3)
Abuse and Assault
1715(14)
Introduction
1716(1)
Partner Abuse
1716(2)
Reasons for Not Reporting Abuse
1716(1)
Identification of Partner Abuse
1717(1)
Characteristics of Partner Abusers
1717(1)
Characteristics of Abused Partners
1717(1)
Approaching the Battered Patient
1718(1)
Elder Abuse
1718(2)
Identification of Elder Abuse
1719(1)
Theories about Domestic Elder Abuse
1719(1)
Characteristics of Abused Elders
1719(1)
Characteristics of Elder Abusers
1719(1)
Child Abuse
1720(4)
Characteristics of Child Abusers
1720(1)
Characteristics of Abused Children
1721(1)
Identification of the Abused Child
1721(2)
Recording and Reporting Child Abuse
1723(1)
Sexual Assault
1724(5)
Characteristics of Victims of Sexual Assault/Rape
1724(1)
Characteristics of Sexual Assailants
1725(1)
Date Rape Drugs
1725(1)
EMS Responsibilities
1726(1)
Legal Considerations
1726(3)
The Challenged Patient
1729(17)
Introduction
1730(1)
Physical Challenges
1730(6)
Hearing Impairments
1730(2)
Visual Impairments
1732(1)
Speech Impairments
1733(1)
Obesity
1734(2)
Paralysis
1736(1)
Mental Challenges and Emotional Impairments
1736(1)
Developmental Disabilities
1736(2)
Accommodations for Developmental Disabilities
1737(1)
Down Syndrome
1737(1)
Fetal Alcohol Syndrome
1738(1)
Pathological Challenges
1738(5)
Arthritis
1738(1)
Cancer
1739(1)
Cerebral Palsy
1740(1)
Cystic Fibrosis (Mucoviscidosis)
1741(1)
Multiple Sclerosis
1741(1)
Muscular Dystrophy
1741(1)
Poliomyelitis
1742(1)
Previous Head Injuries
1742(1)
Spina Bifida
1742(1)
Myasthenia Gravis
1743(1)
Other Challenges
1743(3)
Culturally Diverse Patients
1743(1)
Terminally Ill Patients
1744(1)
Patients with Communicable Diseases
1744(1)
Patients with Financial Challenges
1744(2)
Acute Interventions for the Chronic-Care Patient
1746(32)
Introduction
1747(1)
Epidemiology of Home Care
1747(6)
ALS Response to Home Care Patients
1748(5)
General System Pathophysiology, Assessment, and Management
1753(4)
Assessment
1753(4)
Transport and Management Treatment Plan
1757(1)
Specific Acute Home Health Situations
1757(21)
Respiratory Disorders
1757(10)
Vascular Access Devices
1767(1)
Cardiac Conditions
1768(1)
GI/GU Crisis
1769(3)
Acute Infections
1772(1)
Maternal and Newborn Care
1773(1)
Hospice and Comfort Care
1774(4)
Assessment-Based Management
1778(15)
Introduction
1779(1)
Effective Assessment
1779(5)
Importance of Accurate Information
1780(1)
Factors Affecting Assessment and Decision Making
1781(2)
Assessment/Management Choreography
1783(1)
The Right Equipment
1784(1)
General Approach to the Patient
1785(3)
Scene Size-up
1785(1)
Initial Assessment
1786(1)
Focused History and Physical Exam
1786(1)
The Ongoing Assessment and the Detailed Physical Exam
1787(1)
Identification of Life-Threatening Problems
1788(1)
Presenting the Patient
1788(2)
Establishing Trust and Credibility
1788(1)
Developing Effective Presentation Skills
1789(1)
Review of Common Complaints
1790(3)
Practice Sessions
1790(1)
Laboratory-Based Simulations
1791(1)
Self-Motivation
1791(2)
Operations
1793(5)
Introduction
1798(1)
Part 1: Ambulance Operations
1798(11)
Ambulance Standards
1798(2)
Ambulance Design
1799
Medical Equipment Standards
1798(2)
Additional Guidelines
1800(1)
Checking and Maintaining Ambulances
1800(1)
Ambulance Deployment and Staffing
1801(1)
Traffic Congestion
1801(1)
Operational Staffing
1802(1)
Safe Ambulance Operations
1802(4)
Educating Providers
1802(1)
Reducing Ambulance Collisions
1803(1)
Standard Operating Procedures
1803(1)
The Due Regard Standard
1804(1)
Lights and Siren: A False Sense of Security
1804(1)
Escorts and Multiple-Vehicle Responses
1805(1)
Parking and Loading the Ambulance
1805(1)
The Deadly Intersection
1806(1)
Utilizing Air Medical Transport
1806(3)
Fixed-Wing Aircraft
1806(1)
Rotorcraft
1806(1)
Advantages and Disadvantages of Air Transport
1807(1)
Activation
1807(1)
Indications for Patient Use
1807(1)
Patient Preparation and Transfer
1808(1)
Scene Safety and the Landing Zone
1809(1)
Part 2: Medical Incident Management
1809(21)
Origins of Emergency Incident Management
1810(1)
Regulations and Standards
1810(1)
A Uniform, Flexible System
1810(1)
Command
1811(5)
Establishing Command
1811(1)
Incident Size-Up
1812(1)
Singular versus Unified Command
1813(1)
Identifying a Staging Area
1814(1)
Incident Communications
1814(1)
Resource Utilization
1815(1)
Command Procedures
1815(1)
Termination of Command
1816(1)
Support of Incident Command
1816(3)
Command Staff
1816(2)
Finance/Administration
1818(1)
Logistics
1818(1)
Operations
1818(1)
Planning
1819(1)
Division of Operations Functions
1819(1)
Branches
1819(1)
Groups and Divisions
1819(1)
Units
1819(1)
Sectors
1819(1)
Functional Groups with an EMS Branch
1820(7)
Triage
1820(4)
Morgue
1824(1)
Treatment
1824(1)
On-Scene Physicians
1825(1)
Staging
1825(1)
Transport Unit
1825(1)
Extrication/Rescue Unit
1826(1)
Rehabilitation Unit
1826(1)
Communications
1826(1)
Disaster Management
1827(1)
Mitigation
1827(1)
Planning
1827(1)
Response
1828(1)
Recovery
1828(1)
Meeting the Challenge of Multiple-Casualty Incidents
1828(2)
Common Problems
1828(1)
Preplanning, Drills, and Critiques
1829(1)
Disaster Mental Health Services
1829(1)
Part 3: Rescue Awareness and Operations
1830(27)
Role of the Paramedic
1830(1)
Protective Equipment
1831(2)
Rescuer Protection
1831(2)
Patient Protection
1833(1)
Safety Procedures
1833(2)
Rescue SOPs
1833(1)
Crew Assignments
1834(1)
Preplanning
1834(1)
Rescue Operations
1835(3)
Phase One: Arrival and Size-Up
1835(1)
Phase Two: Hazard Control
1835(1)
Phase Three: Patient Access
1835(1)
Phase Four: Medical Treatment
1836(1)
Phase Five: Disentanglement
1837(1)
Phase Six: Patient Packaging
1838(1)
Phase Seven: Removal/Transport
1838(1)
Surface Water Rescues
1838(7)
General Background
1839(2)
Moving Water
1841(2)
Flat Water
1843(2)
Hazardous Atmosphere Rescues
1845(2)
Confined-Space Hazards
1846(1)
Confined-Space Protections in the Workplace
1846(1)
Cave-Ins and Structural Collapses
1847(1)
Highway Operations and Vehicle Rescues
1847(4)
Hazards in Highway Operations
1847(2)
Auto Anatomy
1849(1)
Rescue Strategies
1850(1)
Rescue Skills Practice
1851(1)
Hazardous Terrain Rescues
1851(6)
Types of Hazardous Terrain
1851(1)
Patient Access in Hazardous Terrain
1852(1)
Patient Packaging for Rough Terrain
1852(2)
Patient Removal from Hazardous Terrain
1854(1)
Extended Care Assessment and Environmental Issues
1855(2)
Part 4: Hazardous Materials Incidents
1857(15)
Role of the Paramedic
1857(1)
Requirements and Standards
1857(1)
Levels of Training
1858(1)
Incident Size-Up
1858(5)
IMS and Hazmat Emergencies
1858(1)
Incident Awareness
1858(2)
Recognition of Hazards
1860(2)
Identification of Substances
1862(1)
Hazardous Materials Zones
1863(1)
Specialized Terminology
1863(2)
Terms for Medical Hazmat Operations
1863(2)
Toxicological Terms
1865(1)
Contamination and Toxicology Review
1865(3)
Types of Contamination
1865(1)
Routes of Exposure
1865(1)
Cycles and Actions of Poisons
1866(1)
Treatment of Common Exposures
1866(2)
Approaches to Decontamination
1868(3)
Methods of Decontamination
1868(1)
Decontamination Decision Making
1869(1)
Field Decontamination
1870(1)
Hazmat Protection Equipment
1871(1)
Medical Monitoring and Rehabilitation
1872(1)
Entry Readiness
1872(1)
Postexit ``Rehab''
1872(1)
Heat Stress Factors
1872(1)
Importance of Practice
1872(1)
Part 5: Crime Scene Awareness
1872(33)
Approach to the Scene
1873(2)
Possible Scenarios
1873(2)
Specific Dangerous Scenes
1875(4)
Highway Encounters
1876(1)
Violent Street Incidents
1877(1)
Drug-Related Crimes
1878(1)
Clandestine Drug Laboratories
1879(1)
Domestic Violence
1879(1)
Tactical Considerations
1879(4)
Safety Tactics
1880(2)
Tactical Patient Care
1882(1)
EMS at Crime Scenes
1883(7)
EMS and Police Operations
1883(1)
Preserving Evidence
1884(6)
Responding to Terrorist Acts
1890(15)
Introduction
1891(1)
Explosive Agents
1892(1)
Nuclear Detonation
1893(2)
A Nuclear Incident Response
1894(1)
Radioactive Contamination
1894(1)
Chemical Agents
1895(5)
Nerve Agents
1895(1)
Vesicants (Blistering Agents)
1896(1)
Pulmonary Agents
1897(1)
Biotoxins
1897(1)
Incapacitating Agents
1897(1)
Other Hazardous Chemicals
1898(1)
Recognition of a Chemical Agent Release
1898(1)
Management of a Chemical Agent Release
1898(2)
Biological Agents
1900(2)
Pneumonia-like Agents
1901(1)
Encephalitis-like Agents
1901(1)
Other Agents
1901(1)
Protection against Biological Agent Transmission
1901(1)
General Considerations Regarding Terrorist Attacks
1902(3)
Scene Safety
1902(1)
Recognizing a Terrorist Attack
1902(1)
Responding to a Terrorist Attack
1903(2)
Precautions on Bloodborne Pathogens and Infectious Diseases 1905(2)
Answers to Review Questions 1907(6)
Further Reading 1913(10)
Glossary 1923(42)
Index 1965


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