Intermediate: Emergency Care and Transportation of the Sick and Injured

by Beck, Rhonda J.; Rahm, Stephen J.; Pollak, Andrew N.

• ISBN13: 9780763722449
• ISBN10: 0763722448
• Edition: 1st
• Format: Paperback
• Copyright: 2004-11-01
• Publisher: Jones & Bartlett

Summary

This text bridges the gap between the two curricula while still keeping them separate, making it user friendly for any instructor and students.

Table of Contents

Section 1 Preparing to be an EMT-I
Introduction to Emergency Medical Care	2	(22)
Introduction to Emergency Medical Care	6	(1)
Course Description	6	(1)
EMT-Intermediate Training: Focus and Requirements	7	(1)
Certification Requirements	8	(1)
Overview of the Emergency Medical Services System	9	(1)
History of EMS	9	(1)
Levels of Training	10	(2)
Public Basic Life Support and Immediate Aid	11	(1)
First Responders	11	(1)
EMT-Basic	11	(1)
EMT-Intermediate	12	(1)
EMT-Paramedic	12	(1)
Components of the EMS System	12	(6)
Access	12	(1)
Administration and Policy	13	(1)
Medical Direction and Control	13	(1)
Quality Control and Improvement	14	(1)
Other Physician Input	15	(1)
Regulation	15	(1)
Equipment	15	(1)
The Ambulance	15	(1)
Transport to Specialty Centers	15	(1)
Interfacility Transports	16	(1)
Working With Hospital Staff	16	(1)
Working With Public Safety Agencies	16	(1)
Training	17	(1)
Providing a Coordinated Continuum of Care	17	(1)
Roles and Responsibilities of the EMT-I	18	(1)
Professional Attributes	18	(1)
Continuing Education	19	(2)
Prep Kit	21	(3)
The Well-Being of the EMT-I	24	(50)
The Well-Being of the EMT-I	26	(1)
Emotional Aspects of Emergency Care	26	(1)
Death and Dying	26	(4)
Physical Signs of Death	27	(1)
Medical Examiner Cases	28	(1)
The Grieving Process	28	(1)
What Can the EMT-I Do?	29	(1)
Dealing With the Patient and Family Members	29	(1)
Initial Care of the Dying, Critically III, or Injured Patient	30	(1)
Anxiety	30	(1)
Pain and Fear	30	(1)
Anger and Hostility	30	(1)
Depression	30	(1)
Dependency	30	(1)
Guilt	31	(1)
Mental Health Problems	31	(1)
Receiving Unrelated Bad News	31	(1)
Caring for Critically III and Injured Patients	31	(1)
Avoid Sad and Grim Comments	31	(1)
Orient the Patient	31	(1)
Be Honest	32	(1)
Acknowledge the Seriousness of the Condition	32	(1)
Allow for Hope	32	(1)
Locate and Notify Family Members	32	(1)
Injured and Critically III Children	32	(1)
Dealing With the Death of a Child	32	(1)
Helping the Family	33	(1)
Stressful Situations	33	(1)
Uncertain Situations	34	(1)
Stress Warning Signs and the Work Environment	34	(7)
Stress and Nutrition	36	(1)
Stress Management	37	(3)
Critical Incident Stress Debriefing	40	(1)
Workplace Issues	41	(3)
Cultural Diversity on the Job	41	(1)
Your Effectiveness as an EMT-I	42	(1)
Avoiding Sexual Harassment	42	(1)
Substance Abuse	43	(1)
Scene Safety and Personal Protection	44	(1)
Communicable Diseases	45	(1)
Routes of Transmission	45	(1)
Risk Reduction and Prevention	45	(7)
Universal Precautions and Body Substance Isolation	45	(5)
Employer Responsibilities	50	(1)
Exposure Control Plan	51	(1)
Immunity	52	(1)
Immunizations	52	(1)
Duty to Act	53	(1)
Some Diseases of Special Concern	54	(3)
HIV Infection	54	(1)
Hepatitis	55	(1)
Meningitis	56	(1)
Tuberculosis	56	(1)
Other Diseases of Concern	57	(1)
General Postexposure Management	57	(1)
Establishing an Infection Control Routine	58	(1)
Illness and Injury Prevention	59	(1)
Prevention Strategies	59	(1)
Scene Hazards	60	(3)
Hazardous Materials	60	(1)
Electricity	61	(1)
Fire	62	(1)
Protective Clothing: Preventing Injury	63	(2)
Cold Weather Clothing	63	(1)
Turnout Gear	63	(1)
Gloves	64	(1)
Helmets	64	(1)
Boots	64	(1)
Eye Protection	65	(1)
Ear Protection	65	(1)
Skin Protection	65	(1)
Body Armor	65	(1)
Violent Situations	65	(1)
Behavioral Emergencies	66	(3)
Prep Kit	69	(5)
Medical, Legal, and Ethical Issues	74	(22)
Medical, Legal, and Ethical Issues	78	(1)
Scope of Practice	78	(1)
Standards of Care	78	(3)
Standards Imposed by Local Custom	78	(1)
Standards Imposed by Law	79	(1)
Professional and Institutional Standards	79	(1)
Standards Imposed by States	80	(1)
Laws	81	(1)
Legislative, Administrative, and Common	81	(1)
Criminal Law	81	(1)
Civil (Tort) Law	81	(1)
Duty to Act	81	(1)
Negligence	81	(1)
Abandonment	82	(1)
Consent	82	(2)
Expressed Consent	83	(1)
Implied Consent	83	(1)
Minors and Consent	83	(1)
Mentally Incompetent Adults	84	(1)
Forcible Restraint	84	(1)
Assault and Battery	84	(1)
The Right to Refuse Treatment	85	(1)
Good Samaritan Laws and Immunity	85	(1)
Advance Directives	86	(1)
Ethical Responsibilities	87	(1)
Confidentiality	88	(1)
IIIPAA	88	(1)
Records and Reports	88	(1)
Special Reporting Requirements	89	(1)
Abuse of Children, Elderly People, and Others	89	(1)
Injury During the Commission of a Felony	89	(1)
Drug-Related Injuries	89	(1)
Childbirth	89	(1)
Other Reporting Requirements	89	(1)
Scene of a Crime	90	(1)
The Deceased	90	(1)
Special Situations	90	(2)
Organ Donors	90	(1)
Medical Identification Insignia	91	(1)
Prep Kit	92	(4)
Medical Terminology	96	(18)
Medical Terminology	98	(1)
Prefixes	98	(3)
Suffixes	101	(1)
Root Words	101	(3)
Abbreviations	104	(8)
Prep Kit	112	(2)
The Human Body	114	(128)
Introduction	118	(1)
The Structure of the Human Body	118	(1)
Cells	118	(1)
Tissues	118	(1)
Organs	118	(1)
Organ Systems	118	(1)
Homeostasis	118	(1)
Anatomic Terminology	119	(7)
The Anatomic Position	119	(1)
Anatomic Planes	120	(2)
Directional Terms	122	(1)
Abdominal Quadrants	123	(1)
Anatomic Positions	123	(1)
Movement and Positions	123	(3)
Cellular Transport Mechanisms	126	(3)
Permeability of the Cell Membrane	126	(2)
Cellular Metabolism	128	(1)
Cellular Respiration	128	(1)
Tissues	129	(1)
Epithelial Tissue and Glands	129	(1)
Connective Tissue	129	(1)
Muscle Tissue	130	(1)
Nerve Tissue	130	(1)
Integumentary System	130	(3)
Functions of the Skin	131	(1)
Anatomy of the Skin	132	(1)
Skeletal System	133	(25)
The Skull	134	(4)
The Neck	138	(1)
The Spine	139	(2)
The Thorax	141	(2)
The Abdomen	143	(2)
The Appendicular Skeleton	145	(3)
The Pelvic Girdle	148	(1)
The Lower Extremity	149	(3)
Cartilage, Tendons, and Ligaments	152	(1)
Bones: Their Growth and Organization	152	(4)
Joints	156	(2)
The Musculoskeletal System	158	(2)
Skeletal Muscle	158	(2)
Smooth Muscle	160	(1)
Cardiac Muscle	160	(1)
The Nervous System	160	(13)
The Central Nervous System	162	(6)
The Peripheral Nervous System	168	(3)
The Autonomic Nervous System	171	(2)
The Endocrine System	173	(5)
The Pituitary Gland and Hypothalamus	174	(1)
The Thyroid Gland	175	(1)
The Parathyroid Glands	176	(1)
The Pancreas	176	(1)
The Adrenal Glands	177	(1)
The Reproductive Glands and Hormones	178	(1)
Blood and Its Components	178	(3)
Plasma and Formed Elements (Cells)	178	(3)
The Heart	181	(7)
Location and Major Structures of the Heart	181	(1)
Valves of the Heart	182	(1)
Blood Flow Within the Heart	182	(2)
Electrical Properties of the Heart and Conduction System	184	(3)
The Cardiac Cycle	187	(1)
The Vascular System	188	(8)
The General Scheme of Blood Circulation	188	(1)
Circulation to the Heart	188	(1)
The Pulmonary Circulation	189	(1)
Systemic Arterial Circulation	189	(5)
The Systemic Venous Circulation	194	(2)
Physiology of the Circulatory System	196	(2)
Normal Circulation in Adults	197	(1)
Inadequate Circulation in Adults	198	(1)
The Lymphatic System	198	(3)
Lymphatic Vessels	198	(2)
Lymph Organs	200	(1)
The Respiratory System	201	(6)
The Upper Airway	201	(1)
The Lower Airway	202	(2)
Respiratory Physiology	204	(3)
The Digestive System	207	(2)
How Digestion Works	207	(1)
Anatomy of the Digestive System	208	(1)
The Urinary System	209	(1)
The Genital System	210	(1)
The Male Reproductive System and Organs	210	(1)
The Female Reproductive System and Organs	210	(2)
Fluids and Electrolytes	212	(1)
Body Fluid Balance	212	(1)
Acid-Base Balance	213	(3)
Buffer Systems	213	(3)
Prep Kit	216	(26)
Section 2 Pharmacology and Intravenous Therapy
Pharmacology	242	(42)
Pharmacology	244	(1)
How Medications Work	244	(1)
Medication Names	245	(1)
Methods of Drug Classification	246	(1)
Standardization of Drugs	246	(1)
The Scope of Practice	247	(1)
Nervous System Divisions	247	(3)
Drug Properties	250	(1)
Drug Forms	250	(4)
Solid Drugs	250	(1)
Liquid Drugs	251	(1)
Metered-Dose Inhalers	252	(1)
Topical Medications	252	(1)
Transcutaneous Medications	252	(1)
Gels	253	(1)
Gases	254	(1)
Overview of the Routes of Drug Administration	254	(1)
Mechanism of Action	255	(2)
Pharmacokinetics: Movement of Drugs Through the Body	257	(2)
Drug Absorption	257	(1)
Drug Distribution	258	(1)
Biotransformation	258	(1)
Drug Elimination	258	(1)
Pharmacodynamics: Drug Actions	259	(1)
Drug-response Relationship	259	(1)
Predictable Responses	259	(1)
Iatrogenic Responses	259	(1)
Unpredictable Adverse Responses	259	(1)
Factors Influencing Drug Interactions	260	(2)
Drug Storage and Security of Controlled Substances	262	(1)
Activated Charcoal	262	(1)
General Steps in Administering Medication	263	(17)
Prep Kit	280	(4)
Intravenous Access	284	(42)
Intravenous Access	286	(1)
Basic Cell Physiology	286	(5)
Electrolytes	286	(1)
Fluid and Electrolyte Movement	287	(2)
Fluid Compartments	289	(1)
Fluid Balance	290	(1)
Principles of Fluid Balance	291	(5)
Internal Environment of the Cell	291	(1)
Body Fluid Composition	292	(1)
IV Fluid Composition	293	(1)
Types of IV Solutions	293	(3)
IV Techniques and Administration	296	(17)
Assembling Your Equipment	296	(1)
Choosing an IV Solution	297	(1)
Choosing an Administration Set	297	(1)
Choosing an IV Site	298	(3)
Choosing a Catheter	301	(2)
Inserting the IV Catheter	303	(1)
Drawing Blood	304	(1)
Securing the Line	305	(1)
Discontinuing the IV Line	306	(1)
Alternative IV Sites and Techniques	306	(6)
Dimensional Analysis	312	(1)
Drip Rates	312	(1)
Drops per Minute	313	(1)
Possible Complications of IV Therapy	313	(5)
Local IV Site Reactions	313	(3)
Systemic Complications	316	(2)
Troubleshooting	318	(1)
Pediatric Considerations	318	(1)
Catheters	318	(1)
Volutrol IV Sets	318	(1)
IV Locations	318	(1)
Geriatric Considerations	319	(2)
Catheters	319	(1)
IV Sets	319	(1)
Locations	319	(2)
Prep Kit	321	(5)
Medication Administration	326	(36)
Medication Administration	328	(1)
Mathematical Principles Used in Pharmacology	328	(1)
The Metric System	328	(1)
Weight and Volume Conversion	329	(1)
Weight Conversion	329	(1)
Volume Conversion	330	(1)
Converting Pounds to Kilograms	330	(1)
The Apothecary System	331	(1)
Fahrenheit and Celsius Scales	331	(1)
Calculating Medication Doses	331	(2)
Desired Dose	331	(1)
Drug Concentrations	332	(1)
Volume to be Administered	332	(1)
Weight-Based Drug Doses	333	(1)
Calculating the Dose and Rate for a Medication Infusion	333	(1)
Pediatric Doses	334	(1)
Medical Direction	334	(1)
Principles of Medication Administration	335	(1)
Medications Administered by the Inhalation Route	336	(1)
Enteral Medication Administration	337	(3)
Oral Administration	337	(1)
Rectal Administration	338	(2)
Parenteral Administration of Medications	340	(3)
Equipment	340	(1)
Packaging of Parenteral Medications	340	(3)
Administration of Medication by the Subcutaneous Route	343	(4)
Administration of Medication Via the Intramuscular Route	347	(2)
Administration of Medication Via Intravenous Bolus	349	(2)
Administration of Medication Via the IO Route	351	(1)
Administering Medications Via the Sublingual Route	352	(5)
Prep Kit	357	(5)
Section 3 Airway
Airway Management and Ventilation	362	(126)
Airway	368	(1)
Anatomy of the Upper Airway	368	(2)
Nasopharynx	368	(1)
Oropharynx	369	(1)
Larynx	369	(1)
Anatomy of the Lower Airway	370	(1)
Lung and Respiratory Volumes	370	(2)
Ventilation	372	(1)
Inspiration	372	(1)
Expiration	372	(1)
Respiration	372	(1)
Causes of Decreased Oxygen Concentrations in the Blood	373	(1)
Carbon Dioxide in the Blood	373	(1)
The Measurement of Gases	373	(1)
Respiratory Rate	374	(2)
Neural Control	374	(1)
Chemical Stimuli	374	(1)
Control of Respiration by Other Factors	375	(1)
Airway Evaluation	376	(2)
Essential Parameters	376	(1)
Recognition of Airway Problems	376	(2)
Acid-Base Balance	378	(5)
Defining the Acidity of a Solution	378	(1)
Ion Shifts	378	(1)
Buffers	378	(2)
Compensatory Mechanisms	380	(1)
Clinical Presentations	380	(3)
Maintaining the Airway	383	(1)
Airway Management	384	(4)
Manual Maneuvers	385	(3)
Airway Obstructions	388	(9)
Possible Causes of Airway Obstruction	389	(2)
Recognition	391	(1)
Emergency Medical Care for Foreign Body Airway Obstruction	392	(5)
Suctioning	397	(9)
Suctioning Equipment	398	(1)
Techniques of Suctioning	398	(4)
Airway Adjuncts	402	(3)
Nasal Airway	405	(1)
Supplemental Oxygen	406	(4)
Liquid Oxygen	408	(1)
Pin-Indexing System	408	(1)
Regulators	409	(1)
Flowmeters	409	(1)
Operating Procedures	410	(2)
Hazards of Supplemental Oxygen	411	(1)
Supplemental Oxygen-Delivery Devices	412	(2)
Nonrebreathing Mask	412	(1)
Nasal Cannula	412	(1)
Simple Face Mask	413	(1)
Partial Rebreathing Mask	413	(1)
Venturi Mask	413	(1)
Small Volume Nebulizer	413	(1)
Oxygen Humidifiers	413	(1)
Assisted and Artificial Ventilation	414	(9)
Mouth-to-Mouth, Mouth-to-Nose, and Mouth-to-Mask Ventilation	414	(1)
One-Person BVM Device	415	(2)
Two-Person BVM Ventilation Method	417	(1)
Three-Person BVM Ventilation	418	(1)
Technique	418	(2)
Flow-Restricted, Oxygen-Powered Ventilation Devices	420	(2)
Automatic Transport Ventilators	422	(1)
Cricoid Pressure/Sellick Maneuver	422	(1)
Gastric Distention	423	(7)
Gastric Tubes	423	(5)
Dental Appliances	428	(2)
Facial Bleeding	430	(1)
Multilumen Airways	430	(8)
Advantages and Disadvantages of Multilumen Airways	431	(1)
Indications for Multilumen Airways	431	(1)
Contraindications for Multilumen Airways	431	(1)
Complications of Multilumen Airways	431	(1)
Equipment for Multilumen Airways	431	(5)
Technique for Multilumen Airway Insertion	436	(2)
Advanced Airway Management	438	(28)
Endotracheal Intubation	438	(2)
Orotracheal Intubation by Direct Laryngoscopy	440	(11)
Tracheobronchial Suctioning	451	(2)
Pediatric Endotracheal Intubation	453	(3)
Intubation Technique	456	(5)
Esophageal Obturator Airway (EOA)	461	(2)
The Laryngeal Mask Airway	463	(3)
Tracheostomy, Stoma, and Tracheostomy Tubes	466	(5)
Ventilation of Stoma Patients	467	(4)
Special Patient Considerations	471	(6)
Prep Kit	477	(11)
Section 4 Patient Assessment
Patient Assessment	488	(88)
About This Chapter	495	(2)
Patient Assessment	495	(2)
Scene Size-up	497	(1)
Body Substance Isolation	497	(1)
Scene Safety	497	(1)
Personal Protection	497	(1)
Making the Unsafe Scene Safe	498	(1)
Determine the Mechanism of Injury or Nature of the Illness	498	(7)
Mechanism of Injury	499	(2)
Nature of the Illness	501	(1)
Determine the Number of Patients	502	(3)
Initial Assessment	505	(1)
Form a General Impression of the Patient's Condition	505	(1)
Distinguishing Between Medical and Trauma Patients	506	(2)
Approach to the Assessment Process	508	(1)
Assess Mental Status	508	(1)
Assess the Airway	509	(2)
Responsive Patients	510	(1)
Unresponsive Patients	511	(1)
Assess Breathing	511	(1)
Assess Circulation	512	(2)
Assess the Pulse	512	(1)
Assess and Control External Bleeding	512	(1)
Evaluate Skin Color, Temperature, and Condition	513	(1)
Identify Priority Patients	514	(3)
Focused History and Physical Exam: Trauma Patients	517	(3)
Goals of the Focused History and Physical Exam	517	(1)
Reconsider the MOI	518	(1)
Significant Mechanisms of Injury	518	(1)
Infant and Child Considerations	518	(1)
Hidden Injuries	518	(2)
Trauma Patients With a Significant MOI	520	(1)
Rapid Trauma Assessment	520	(6)
Head, Neck, and Cervical Spine	520	(1)
Chest	521	(3)
Abdomen	524	(1)
Pelvis	524	(1)
Extremities	524	(1)
Back	524	(1)
Baseline Vital Signs and Sample History	525	(1)
Transport	526	(1)
Trauma Patients With No Significant MOI	526	(5)
Focused Assessment: Chief Complaint	526	(2)
Baseline Vital Signs and Sample History	528	(1)
Transport	528	(1)
Documentation	528	(1)
Other Considerations	529	(2)
Focused History and Physical Exam: Medical Patients	531	(5)
Evaluate Responsiveness	531	(1)
History of Present Illness	531	(1)
OPQRST-I	532	(2)
The Sample History	534	(1)
The Focused Physical Exam	535	(1)
Baseline Vital Signs	536	(1)
Reevaluate the Transport Decision	536	(1)
Documentation	536	(1)
Evaluating the Unresponsive Patient	536	(5)
Rapid Medical Assessment	537	(1)
Baseline Vital Signs	537	(1)
History of Present Illness/Sample History	537	(1)
Reevaluate the Transport Decision	538	(1)
Documentation	538	(3)
Detailed Physical Exam	541	(1)
Steps of the Detailed Physical Exam	542	(11)
Head, Neck, and Cervical Spine	543	(3)
Chest	546	(1)
Chest: Chest Wall	546	(1)
Chest: Breath Sounds	547	(1)
Chest: Heart Sounds	548	(1)
Abdomen	548	(1)
Pelvis	549	(1)
Extremities	549	(1)
Cranial Nerve Assessment	550	(1)
Back	550	(1)
Cardiovascular System	550	(1)
Baseline Vital Signs	551	(1)
Mental Status	551	(2)
Ongoing Assessment	553	(4)
Steps of the Ongoing Assessment	553	(1)
Repeat the Initial Assessment	554	(1)
Reassess Vital Signs	554	(1)
Repeat the Focused Assessment	554	(1)
Check Interventions	555	(1)
Transportation Considerations	555	(2)
Clinical Decision Making	557	(1)
The Prehospital Environment	557	(1)
The Spectrum of Prehospital Patients	558	(1)
Levels of Patient Acuity	558	(1)
Protocols, Standing Orders, and Algorithms	559	(1)
Critical Thinking and the EMT-I	559	(2)
Concept Formation	559	(1)
Data Interpretation	560	(1)
Application of Principles	560	(1)
Evaluation	560	(1)
Reflection on Action	560	(1)
Fundamental Elements of Critical Thinking	561	(1)
Field Application of Assessment-Based Management	561	(2)
The Spectrum of Patient Acuity	561	(1)
Thinking Under Pressure	561	(1)
Mental Checklist for Thinking Under Pressure	562	(1)
Facilitating Behaviors	562	(1)
Situational Awareness	562	(1)
Putting It All Together: ``The Six Rs''	563	(5)
Read the Patient	563	(1)
Read the Scene	564	(1)
React	564	(1)
Reevaluate	564	(1)
Revise the Management Plan	564	(1)
Review Performance at the Run Critique	564	(4)
Prep Kit	568	(8)
Communications and Documentation	576	(40)
Communications and Documentation	580	(1)
Communications Systems and Equipment	580	(4)
Base Station Radios	580	(1)
Mobile and Portable Radios	581	(1)
Repeater-Based Systems	582	(1)
Digital Equipment	582	(1)
Cellular Telephones	583	(1)
Other Communications Equipment	584	(1)
Components of the Local Dispatch Communications System and Function	584	(2)
Radio Communications	586	(7)
Responding to the Scene	586	(2)
Communicating With Medical Control and Hospitals	588	(3)
Standard Procedures and Protocols	591	(1)
Reporting Requirements	591	(1)
Maintenance of Radio Equipment	591	(2)
Verbal Communications	593	(7)
Communicating With Other Health Care Professionals	593	(1)
Communicating With Patients	594	(2)
Communicating With Older Patients	596	(1)
Communicating With Children	597	(1)
Communicating With Hearing-Impaired Patients	598	(1)
Communicating With Visually Impaired Patients	598	(2)
Communicating With Non-English-Speaking Patients	600	(1)
Written Communications and Documentation	600	(10)
Minimum Data Set	600	(1)
Prehospital Care Report	600	(2)
Types of Forms	602	(1)
General Considerations	603	(1)
Elements of a Properly Written EMS Document	603	(1)
Reporting Errors	604	(1)
Documenting Refusal of Care	604	(1)
Systems of Narrative Writing	604	(2)
Data Collection	606	(1)
Special Reporting Situations	606	(1)
Consequences of Errors, Omissions, and Inappropriate Documentation	606	(4)
Prep Kit	610	(6)
Section 5 Trauma
Trauma Systems and Mechanism of Injury	616	(26)
Kinematics of Trauma	618	(1)
Trauma Systems	618	(2)
Components	618	(1)
Trauma Centers	619	(1)
Transport Considerations	619	(1)
Energy and Trauma	620	(2)
Energy Exchange	622	(1)
Blunt and Penetrating Trauma	622	(1)
Mechanism of Injury Profiles	623	(1)
Blunt Trauma	623	(10)
Blunt Trauma: Vehicular Collisions	623	(3)
Frontal Collisions	626	(4)
Rear-End Collisions	630	(1)
Lateral Collisions	630	(1)
Rollover Crashes	631	(1)
Rotational Impacts	632	(1)
Restraints	633	(1)
Lap Belts	633	(1)
Shoulder Restraints	633	(1)
Air Bags	633	(1)
Child Safety Seats	634	(1)
Motorcycle Collisions	634	(1)
Pedestrian Versus Motor Vehicle	635	(1)
Falls	635	(1)
Penetrating Trauma	636	(2)
Blast Injuries	638	(2)
Prep Kit	640	(2)
Hemorrhage and Shock	642	(32)
Hemorrhage and Shock	646	(1)
Physiology and Perfusion	646	(2)
Hemorrhage	648	(11)
The Significance of Bleeding	648	(1)
Physiologic Response to Hemorrhage	649	(2)
Assessment	651	(1)
Management	651	(7)
Bleeding from the Nose, Ears, and Mouth	658	(1)
Shock	659	(11)
Pathophysiology of Shock	659	(1)
Compensation for Decreased Perfusion	660	(1)
Stages of Shock	661	(2)
Etiologic Classifications	663	(3)
Differential Shock Assessment Findings	666	(1)
Management	666	(4)
Prep Kit	670	(4)
Burns and Soft-Tissue Injuries	674	(38)
Burns and Soft-Tissue Injuries	678	(1)
The Anatomy and Function of the Skin	678	(1)
Anatomy of the Skin	678	(1)
Functions of the Skin	679	(1)
Types of Soft-Tissue Injuries	679	(1)
Closed Injuries	680	(1)
Emergency Medical Care	681	(1)
Open Injuries	681	(5)
Emergency Medical Care	684	(2)
Chest Wounds	686	(2)
Abdominal Wounds	688	(1)
Impaled Objects	689	(1)
Amputations	690	(1)
Neck Injuries	690	(1)
Burns	691	(16)
Pathophysiology	691	(1)
Management	692	(1)
Burn Severity	692	(2)
Mechanisms of Burn Injuries	694	(1)
Signs and Symptoms of Burn Injuries	694	(1)
Emergency Medical Care	695	(3)
Inhalation Burns	698	(1)
Chemical Burns	699	(3)
Electrical Burns	702	(3)
Radiation Exposure	705	(2)
Dressing and Bandaging	707	(2)
Sterile Dressings	707	(1)
Bandages	707	(2)
Prep Kit	709	(3)
Thoracic Trauma	712	(30)
Thoracic Injuries	716	(1)
Anatomy and Physiology Review of the Thorax	716	(3)
Anatomy	716	(2)
Physiology	718	(1)
Injuries of the Chest	719	(4)
Pathophysiology of Thoracic Trauma	720	(2)
Management	722	(1)
Chest Wall Injuries	723	(2)
Rib Fractures	723	(1)
Flail Chest	724	(1)
Sternal Fracture	725	(1)
Injury to the Lung	725	(7)
Simple Pneumothorax	725	(1)
Open Pneumothorax	726	(1)
Tension Pneumothorax	727	(3)
Hemothorax	730	(1)
Pulmonary Contusion	731	(1)
Myocardial Injuries	732	(1)
Pericardial Tamponade	732	(1)
Myocardial Contusion	733	(1)
Vascular Injuries	733	(1)
Aortic Dissection and Rupture	733	(1)
Penetrating Wounds of the Great Vessels	733	(1)
Other Thoracic Injuries	734	(1)
Diaphragmatic Injury	734	(1)
Esophageal Injury	734	(1)
Tracheobronchial Injuries	734	(1)
Traumatic Asphyxia	734	(1)
Management of Thoracic Injuries	735	(4)
Prep Kit	739	(3)
Abdomen and Genitalia Injuries	742	(16)
Abdomen and Genitalia Injuries	744	(1)
Anatomy of the Abdomen	744	(1)
Injuries to the Abdomen	745	(2)
Signs and Symptoms	746	(1)
Evaluating Abdominal Injuries	746	(1)
Types of Abdominal Injuries	747	(4)
Blunt Abdominal Wounds	747	(1)
Injuries From Seat Belts and Airbags	748	(1)
Penetrating Abdominal Injuries	749	(1)
Abdominal Evisceration	750	(1)
Management of Abdominal Injuries	751	(1)
Anatomy of the Genitourinary System	751	(1)
Injuries to the Genitourinary System	751	(5)
Injuries to the Kidney	751	(2)
Injuries to the Urinary Bladder	753	(1)
Injuries to the External Male Genitalia	754	(1)
Injuries to the Female Genitalia	754	(2)
Prep Kit	756	(2)
Head and Spine Injuries	758	(40)
Head and Spine Injuries	762	(1)
Anatomy and Physiology of the Nervous System	762	(4)
Central Nervous System	762	(1)
Protective Coverings	762	(2)
Peripheral Nervous System	764	(1)
How the Nervous System Works	765	(1)
Anatomy and Physiology of the Skeletal System	766	(1)
Injuries of the Spine	767	(4)
Assessment of Spinal Injuries	767	(2)
Emergency Medical Care	769	(2)
Preparation for Transport	771	(4)
Supine Patients	771	(2)
Sitting Patients	773	(1)
Standing Patients	774	(1)
Head Injuries	775	(6)
Scalp Lacerations	775	(2)
Skull Fracture	777	(2)
Brain Injuries	779	(1)
Other Brain Injuries	780	(1)
Complications of Head Injury	781	(1)
Assessing Head Injuries	781	(7)
Types of Head Injuries	781	(1)
Signs and Symptoms of Head Injury	782	(1)
Emergency Medical Care	783	(2)
Immobilization Devices	785	(3)
Helmet Removal	788	(6)
Preferred Method	789	(1)
Alternative Method	789	(5)
Prep Kit	794	(4)
Musculoskeletal Care	798	(50)
Musculoskeletal Care	800	(1)
Anatomy and Physiology of the Musculoskeletal System	800	(2)
Muscles	800	(1)
The Skeleton	801	(1)
Musculoskeletal Injuries	802	(6)
Mechanism of Injury	804	(1)
Fractures	804	(3)
Dislocations	807	(1)
Sprains	807	(1)
Assessing Musculoskeletal Injuries	808	(4)
Assessing Pulse, Motor, and Sensory Function	809	(3)
Assessing the Severity of Injury	812	(1)
Emergency Medical Care	812	(12)
Splinting	813	(11)
Transportation	824	(1)
Specific Musculoskeletal Injuries	824	(18)
Injuries of the Clavicle and Scapula	824	(2)
Dislocation of the Shoulder	826	(1)
Fracture of the Humerus	827	(2)
Elbow Injuries	829	(1)
Fractures of the Forearm	830	(1)
Injuries of the Wrist and Hand	830	(1)
Fractures of the Pelvis	831	(3)
Dislocation of the Hip	834	(1)
Fractures of the Proximal Femur	834	(2)
Femoral Shaft Fractures	836	(1)
Injuries of Knee Ligaments	836	(1)
Dislocation of the Knee	836	(1)
Fractures About the Knee	837	(1)
Dislocation of the Patella	838	(1)
Injuries of the Tibia and Fibula	838	(1)
Ankle Injuries	839	(1)
Foot Injuries	839	(3)
Prep Kit	842	(6)
Section 6 Medical Emergencies
Respiratory Emergencies	848	(32)
Respiratory Emergencies	850	(1)
Anatomy and Function of the Lungs	851	(3)
Causes of Dyspnea	854	(12)
Upper or Lower Airway Infection	854	(1)
Acute Pulmonary Edema	854	(4)
Obstructive Airway Disease	858	(3)
Assessment Findings	861	(1)
Spontaneous Pneumothorax	862	(1)
Pneumonia	863	(1)
Pleural Effusions	863	(1)
Mechanical Obstruction of the Airway	863	(1)
Pulmonary Thromboembolism	864	(1)
Hyperventilation Syndrome	865	(1)
Emergency Care of Respiratory Emergencies	866	(10)
Scene Size-Up and Initial Assessment	867	(1)
Approach to the Patient in Respiratory Distress	868	(3)
Prescribed Inhalers	871	(5)
Prep Kit	876	(4)
Cardiovascular Emergencies	880	(104)
Cardiovascular Emergencies	884	(1)
Cardiovascular Anatomy and Physiology	884	(4)
The Heart	884	(1)
Valves of the Heart	885	(1)
Blood Flow Within the Heart	885	(3)
Electrical Properties of the Heart and the Conduction System	888	(7)
Pacemaker Function	888	(1)
Pacemaker Settings	888	(1)
The SA Node	889	(1)
The Internodal Pathways	889	(1)
The AV Node	889	(1)
The Bundle of His	890	(1)
The Left Bundle Branch (LBB)	890	(1)
The Right Bundle Branch (RBB)	890	(1)
The LAF	891	(1)
The LPF	891	(1)
The Purkinje System	891	(1)
Special Electrical Properties of Cardiac Cells	891	(1)
Regulation of Heart Function	891	(1)
Electrolytes (Ions) and the Heart	892	(1)
The Electrical Potential	892	(1)
Depolarization and Cardiac Contraction	892	(1)
Repolarization	893	(2)
The Cardiac Cycle	895	(1)
The Blood Vessels	896	(5)
The General Scheme of Blood Circulation	896	(1)
Circulation to the Heart	897	(1)
The Pulmonary Circulation	898	(1)
Systemic Arterial Circulation	898	(1)
Venous Return	899	(1)
Atherosclerosis	899	(1)
Angina Pectoris	900	(1)
Acute Myocardial Infarction	901	(11)
Initial Assessment Findings	901	(1)
Consequences of AMI	902	(4)
Hypertensive Emergencies	906	(1)
Initial Cardiovascular Assessment	907	(5)
Cardiac Surgery and Pacemakers	912	(3)
Automatic Implantable Cardiac Defibrillators	913	(2)
Cardiac Arrest	915	(10)
Termination of Resuscitation	915	(1)
Automated External Defibrillation	916	(9)
ECG Monitoring	925	(3)
Introduction to Basic Components	926	(1)
Wave Nomenclature	927	(1)
Individual Components of the ECG Complex	928	(5)
The P Wave	928	(1)
The Tp Wave	928	(1)
The P-R Segment	929	(1)
The P-R Interval	929	(1)
The QRS Complex	929	(1)
The ST Segment	930	(1)
The T Wave	931	(1)
The Q-T Interval	931	(1)
The U Wave	932	(1)
Additional Intervals	932	(1)
Boxes and Sizes	933	(1)
ECG Tools	934	(2)
Calipers: The Clinician's Best Friend	934	(1)
ECG Rulers	935	(1)
Straight Edge	935	(1)
The Rate	936	(1)
Establishing the Rate	936	(1)
Artifact	937	(1)
Major Concepts: Interpreting a Cardiac Rhythm	938	(2)
General	939	(1)
P Waves	939	(1)
QRS Complexes	939	(1)
Individual Rhythms	940	(11)
Supraventricular Rhythms	940	(4)
Junctional Rhythms	944	(1)
Ventricular Rhythms	945	(4)
Heart Blocks	949	(2)
Premature Complexes	951	(1)
An Arrhythmia vs an Event	951	(1)
Escape Complexes and Rhythms	952	(1)
Ectopic Foci and Their Morphologic Features	952	(4)
Ectopic Foci in the Ventricles	955	(1)
Aberrancy	956	(1)
Premature Junctional Contraction	957	(3)
PAC With Aberrancy vs PJC With Aberrancy	958	(2)
Premature Ventricular Contraction	960	(3)
Coupling Interval	960	(1)
R-on-T Phenomenon	960	(1)
End-diastolic PVC	960	(1)
Compensatory vs Noncompensatory Pauses	961	(1)
Unifocal vs Multifocal PVCs	961	(1)
Bigeminy, Trigeminy, and More	962	(1)
Couplets, Triplets, and Salvos	962	(1)
Interpolated PVC	963	(1)
Bundle Branch Blocks	963	(2)
What Happens If One Side Is Blocked?	964	(1)
Electrical Interventions	965	(2)
Defibrillation	965	(2)
Transcutaneous Pacing	967	(1)
Management	967	(8)
Chest Pain and Stroke	967	(2)
Tachycardias	969	(1)
Bradycardias	970	(1)
V-fib and Pulseless V-tach	971	(4)
Prep Kit	975	(9)
Diabetic Emergencies	984	(20)
Diabetic Emergencies	986	(1)
Diabetes	986	(10)
Defining Diabetes	986	(1)
Types of Diabetes	986	(1)
The Role of Glucose and Insulin	987	(2)
Hyperglycemia	989	(1)
Hyperglycemia and Hypoglycemia	990	(2)
Emergency Medical Care	992	(1)
Giving Oral Glucose	993	(3)
Administering 50% Dextrose	996	(1)
Complications of Diabetes	996	(4)
Seizures	997	(1)
Altered Mental Status	998	(1)
Alcoholism	998	(1)
Relationship to Airway Management	998	(2)
Prep Kit	1000	(4)
Allergic Reactions and Envenomations	1004	(28)
Allergic Reactions and Envenomations	1006	(1)
Allergic Reactions	1006	(4)
Insect Stings	1008	(2)
Anaphylactic Reaction to Stings	1010	(1)
Patient Assessment	1010	(1)
Emergency Medical Care	1011	(6)
Specific Bites and Envenomations	1017	(11)
Spider Bites	1017	(1)
Snake Bites	1018	(4)
Scorpion Stings	1022	(1)
Tick Bites	1023	(1)
Dog Bites and Rabies	1024	(1)
Human Bites	1024	(1)
Injuries From Marine Animals	1025	(3)
Prep Kit	1028	(4)
Poisonings and Overdose Emergencies	1032	(26)
Substance Abuse and Poisoning	1034	(1)
Identifying the Patient and the Poison	1035	(2)
How Poisons Get Into the Body	1037	(3)
Ingested Poisons	1037	(1)
Inhaled Poisons	1038	(1)
Injected Poisons	1039	(1)
Absorbed (Surface Contact) Poisons	1039	(1)
Emergency Medical Care	1040	(1)
Geography-specific Toxic Emergencies	1041	(1)
Specific Poisons	1041	(1)
Grouping Toxicologically Similar Agents	1041	(8)
Alcohol	1041	(1)
Narcotics and Opiates	1042	(1)
Sedative-Hypnotic Drugs	1043	(1)
Psychiatric Medications	1044	(1)
Abused Inhalants	1044	(1)
Carbon Monoxide	1045	(1)
Sympathomimetics	1045	(1)
Marijuana	1046	(1)
Hallucinogens	1046	(1)
Anticholinergic Agents	1047	(1)
Cholinergic Agents	1048	(1)
Miscellaneous Drugs	1048	(1)
Food Poisoning	1049	(1)
Plant Poisoning	1050	(4)
Prep Kit	1054	(4)
Neurologic Emergencies	1058	(24)
Neurologic Emergencies	1060	(1)
Brain Structure and Function	1060	(1)
Common Causes of Brain Disorders	1061	(7)
Stroke	1061	(3)
Seizures	1064	(2)
Altered Mental Status	1066	(2)
Signs and Symptoms of Brain Disorders	1068	(1)
Stroke	1068	(1)
Other Conditions	1069	(1)
Assessing the Patient	1069	(5)
Stroke	1069	(3)
Seizures	1072	(1)
Syncopal Episodes	1073	(1)
Altered Mental Status	1073	(1)
Emergency Medical Care	1074	(4)
Stroke	1074	(1)
Seizures	1075	(3)
Prep Kit	1078	(4)
Nontraumatic Abdominal Emergencies	1082	(16)
Nontraumatic Abdominal Emergencies	1084	(1)
Physiology of the Acute Abdomen	1084	(1)
Signs and Symptoms of Acute Abdomen	1084	(4)
Causes of Abdominal Pain	1088	(3)
Gastrointestinal and Urinary Tract	1088	(1)
Uterus and Ovaries	1089	(1)
Other Organ Systems	1090	(1)
Emergency Medical Care	1091	(3)
Prep Kit	1094	(4)
Environmental Emergencies	1098	(32)
Environmental Emergencies	1102	(1)
Cold Exposure	1102	(9)
Hypothermia	1103	(4)
Advanced Cardiac Life Support Considerations	1107	(1)
Management of Cold Exposure in a Sick or Injured Person	1107	(1)
Local Cold Injuries	1108	(2)
Cold Exposure and You	1110	(1)
Heat Exposure	1111	(5)
Heat Cramps	1111	(2)
Heat Exhaustion	1113	(2)
Heatstroke	1115	(1)
Lightning Injuries	1116	(1)
Emergency Medical Care	1117	(1)
Drowning and Near Drowning	1117	(5)
Emergency Medical Care	1118	(2)
Spinal Injuries in Submersion Incidents	1120	(1)
Recovery Techniques	1120	(2)
Resuscitation Efforts	1122	(1)
Diving Emergencies	1122	(2)
Descent Emergencies	1122	(1)
Emergencies at the Bottom	1123	(1)
Ascent Emergencies	1123	(1)
Other Water Hazards	1124	(1)
Prevention	1125	(2)
Prep Kit	1127	(3)
Behavioral Emergencies	1130	(20)
Behavioral Emergencies	1132	(1)
Myth and Reality	1132	(1)
Defining Behavioral Emergencies	1132	(1)
The Magnitude of Mental Health Problems	1133	(1)
Pathology: Causes of Behavioral Emergencies	1134	(1)
Safe Approach to a Behavioral Emergency	1134	(1)
Assessing a Behavioral Emergency	1134	(4)
Initial Assessment	1137	(1)
Focused History and Physical Exam	1138	(1)
Suicide	1138	(1)
Management Considerations	1139	(1)
Medicolegal Considerations	1140	(3)
Consent	1141	(1)
Limited Legal Authority	1141	(1)
Restraint	1141	(2)
The Potentially Violent Patient	1143	(3)
Prep Kit	1146	(4)
Gynecologic Emergencies	1150	(16)
Gynecologic Emergencies	1152	(1)
Anatomy of the Female Reproductive System	1152	(1)
Normal Physiology	1153	(1)
General Assessment	1154	(2)
Obstetric History	1154	(1)
History of Gynecologic Problems	1155	(1)
Physical Exam	1156	(1)
General Management	1156	(1)
Specific Gynecologic Emergencies	1157	(4)
Pelvic Inflammatory Disease	1157	(1)
Ruptured Ovarian Cyst	1158	(1)
Ectopic Pregnancy	1158	(1)
Vaginal Bleeding	1158	(1)
Traumatic Abdominal Pain	1159	(1)
Sexual Assault	1159	(2)
Prep Kit	1161	(5)
Section 7 Special Considerations
Obstetric Emergencies	1166	(34)
Introduction	1168	(1)
Obstetric Emergencies	1168	(1)
The Female Reproductive System	1168	(2)
The Ovaries	1168	(1)
The Fallopian Tubes	1168	(1)
The Uterus	1168	(1)
The Vagina	1169	(1)
The External Genitalia	1170	(1)
The Mammary Glands	1170	(1)
Gestation	1170	(3)
Normal Gestation	1170	(3)
Trimesters of Pregnancy	1173	(1)
Normal Maternal Changes of Pregnancy	1173	(2)
Emergencies Prior to Delivery	1175	(4)
Abortion	1175	(1)
Ectopic Pregnancy	1175	(1)
Hypertension	1176	(1)
Supine Hypotensive Syndrome	1177	(1)
Gestational Diabetes	1177	(1)
Late Pregnancy Complications	1177	(2)
Stages of Labor	1179	(10)
Preparing for Delivery	1180	(2)
Delivering the Infant	1182	(2)
Delivering the Head	1184	(2)
Delivering the Body	1186	(1)
Postdelivery Care	1186	(2)
Delivery of the Placenta	1188	(1)
Abnormal or Complicated Delivery Emergencies	1189	(5)
Breech Delivery	1189	(1)
Limb Presentations	1189	(1)
Prolapsed Cord Presentation	1190	(1)
Prolapsed Uterus	1191	(3)
Prep Kit	1194	(6)
Neonatal Emergencies	1200	(28)
Neonatal Emergencies	1204	(1)
Neonatal Pathophysiology	1204	(1)
Fetal Oxygenation In Utero	1204	(1)
Fetal Transition	1204	(1)
Fetal Distress	1205	(1)
Newborn Bradycardia	1206	(1)
Anticipating the Need for Resuscitation	1206	(1)
Resuscitation Equipment	1207	(1)
Basic Equipment	1207	(1)
Advanced Life Support Equipment	1207	(1)
Interventions Immediately Following Delivery	1208	(1)
Assessment of the Newborn	1208	(1)
Depressed Newborn Resuscitation	1208	(2)
The Initial Steps of Resuscitation	1209	(1)
Essential Parameters	1210	(4)
Assess Respiratory Effort	1211	(1)
Assess Heart Rate	1212	(1)
Assess Color	1213	(1)
Advanced Life Support Interventions	1214	(5)
Orogastric Tube Insertion	1214	(2)
Endotracheal Intubation	1216	(1)
Venous Access	1217	(1)
Medication Therapy	1217	(2)
Special Considerations	1219	(5)
Meconium Staining and Aspiration	1219	(1)
Hypothermia	1220	(1)
Diaphragmatic Hernia	1220	(1)
Twins	1220	(1)
Delivering a Newborn of an Addicted Mother	1221	(1)
Premature Newborn	1221	(1)
Fetal Death	1222	(2)
Prep Kit	1224	(4)
Pediatric Emergencies	1228	(108)
Unique Needs of Children	1234	(1)
Epidemiology	1234	(1)
Pediatric Trauma	1234	(1)
Pediatric Illness	1234	(1)
Injury and Illness Prevention	1234	(1)
Continuing Education	1235	(1)
Growth and Development	1235	(3)
The Infant	1236	(1)
The Toddler	1236	(1)
The Preschool-Age Child	1237	(1)
The School-Age Child	1237	(1)
The Adolescent	1237	(1)
Anatomy and Physiology	1238	(4)
The Head	1238	(1)
The Airway	1238	(1)
Chest and Lungs	1239	(1)
The Abdomen	1240	(1)
The Extremities	1240	(1)
Skin and Body Surface Area	1240	(1)
The Respiratory System	1240	(1)
Cardiovascular System	1241	(1)
The Nervous System	1241	(1)
Metabolic Differences	1242	(1)
Pediatric Assessment	1242	(6)
General Considerations	1242	(1)
Scene Size-up	1242	(2)
Initial Assessment	1244	(1)
Pediatric Assessment Triangle	1244	(2)
Vital Functions	1246	(2)
Pediatric Vital Signs	1248	(2)
Transport Decision	1250	(1)
Transition Phase	1250	(1)
Focused History and Physical Exam	1251	(1)
Focused History	1251	(1)
Physical Exam	1251	(1)
Ongoing Assessment	1252	(1)
Pediatric Airway Management	1252	(1)
Manual Airway Positioning	1252	(1)
Foreign Body Upper Airway Obstruction	1252	(6)
Partial Upper Airway Obstruction	1254	(1)
Complete Upper Airway Obstruction	1254	(3)
Removal of an Airway Obstruction With Magill Forceps	1257	(1)
Suctioning	1258	(1)
Airway Adjuncts	1259	(4)
Oropharyngeal Airway	1259	(1)
Nasopharyngeal Airway	1260	(3)
Oxygenation	1263	(1)
Oxygen Delivery Devices	1263	(1)
Ventilation	1264	(2)
BVM Device	1264	(1)
Cricoid Pressure	1265	(1)
Endotracheal Intubation	1266	(6)
Equipment for Endotracheal Intubation	1267	(1)
Preparation for Endotracheal Intubation	1268	(4)
Gastric Decompression	1272	(1)
Preparation of Equipment	1272	(1)
NG Tube Insertion	1273	(1)
OG Tube Insertion	1273	(1)
Complications of NG or OG Tube Insertion	1273	(1)
Circulation	1273	(11)
Cardiopulmonary Resuscitation	1274	(2)
Intravenous Access	1276	(2)
IO Infusion	1278	(1)
Fluid Resuscitation	1279	(1)
Medication Therapy	1280	(1)
Manual Defibrillation	1280	(4)
Transport Considerations	1284	(1)
Pediatric Medical Emergencies	1284	(1)
Respiratory Compromise	1285	(1)
Phases of Respiratory Compromise	1285	(1)
Emergency Medical Care	1286	(1)
Upper Airway Diseases	1286	(2)
Croup	1286	(1)
Epiglottitis	1287	(1)
Lower Airway Diseases	1288	(3)
Asthma	1288	(2)
Bronchiolitis	1290	(1)
Pneumonia	1290	(1)
Foreign Body Lower Airway Obstruction	1291	(1)
Shock	1291	(3)
Classifications of Shock	1292	(1)
General Shock Management	1292	(2)
Etiologies of Shock	1294	(2)
Hypovolemic Shock	1294	(1)
Distributive Shock	1294	(2)
Cardiogenic Shock	1296	(1)
Cardiac Dysrhythmias	1296	(3)
Tachydysrhythmias	1296	(1)
Bradydysrhythmias	1297	(1)
Absent Rhythms	1297	(2)
Other Medical Emergencies	1299	(8)
Seizures	1299	(2)
Altered Level of Consciousness	1301	(1)
Poisoning	1302	(1)
Fever	1303	(1)
Meningitis	1303	(1)
Dehydration	1304	(1)
Hypoglycemia	1305	(1)
Hyperglycemia	1306	(1)
Sudden Infant Death Syndrome	1307	(2)
Assessment and Management	1307	(1)
Communication and Support of the Family	1308	(1)
Scene Assessment	1308	(1)
Apparent Life-Threatening Event	1308	(1)
Death of a Child	1309	(1)
Pediatric Trauma Emergencies	1310	(1)
Anatomic Differences	1310	(1)
Injury Patterns	1311	(2)
Physical Differences	1311	(1)
Psychological Differences	1312	(1)
Child Safety Seats	1312	(1)
Automobile Collisions	1312	(1)
Sports Activities	1313	(1)
Special Considerations	1313	(2)
Airway Control	1313	(1)
Immobilization	1314	(1)
Fluid Management	1314	(1)
Traumatic Brain Injury	1314	(1)
Injuries to Specific Body Systems	1315	(3)
Head Injuries	1315	(1)
Chest Injuries	1316	(1)
Abdominal Injuries	1316	(1)
Injuries of the Extremities	1316	(1)
Burns	1316	(2)
Submersion Injury	1318	(1)
Emergency Medical Care	1318	(3)
Airway	1319	(1)
Breathing	1319	(1)
Immobilization	1320	(1)
Child Abuse	1321	(4)
Signs of Abuse	1321	(3)
Symptoms and Other Indicators of Abuse	1324	(1)
Emergency Medical Care	1324	(1)
Sexual Abuse	1324	(1)
EMS Response to Pediatric Emergencies	1325	(2)
Prep Kit	1327	(9)
Geriatric Emergencies	1336	(36)
Geriatric Assessment	1338	(4)
The GEMS Diamond	1338	(2)
The Economic Impact of Aging	1340	(1)
Independent and Dependent Living	1341	(1)
Leading Causes of Death	1342	(1)
Physiologic Changes That Accompany Age	1342	(4)
Skin	1343	(1)
Senses	1343	(1)
Respiratory System	1344	(1)
Cardiovascular System	1344	(1)
Renal System	1345	(1)
Nervous System	1345	(1)
Musculoskeletal System	1346	(1)
Gastrointestinal System	1346	(1)
Immune System	1346	(1)
Advance Directives	1346	(2)
Patient Assessment	1348	(8)
Scene Size-up	1348	(1)
Initial Assessment	1348	(1)
Most Common Geriatric Complaints	1349	(3)
Focused History and Physical Exam	1352	(4)
Response to Nursing and Skilled Care Facilities	1356	(1)
Trauma	1356	(2)
Mechanism of Injury	1356	(1)
Systemic Impact of Aging and Trauma	1357	(1)
Falls and Trauma	1357	(1)
Cardiovascular Emergencies	1358	(1)
Syncope	1358	(1)
Myocardial Infarction	1358	(1)
The Acute Abdomen	1358	(2)
Altered Mental Status	1360	(1)
Elder Abuse	1360	(5)
Assessment of Elder Abuse	1361	(1)
Signs of Physical Abuse	1362	(3)
Prep Kit	1365	(7)
Section 8 Operations
Ambulance Operations	1372	(30)
Ambulance Operations	1374	(1)
Emergency Vehicle Design	1374	(1)
Phases of an Ambulance Call	1375	(20)
The Preparation Phase	1376	(8)
The Dispatch Phase	1384	(1)
En Route to the Scene	1384	(7)
Arrival at the Scene	1391	(1)
The Transfer Phase	1392	(1)
The Transport Phase	1393	(1)
The Delivery Phase	1393	(1)
En Route to the Station	1394	(1)
The Postrun Phase	1394	(1)
Air Medical Operations	1395	(4)
Safety Precautions Around Helicopters	1396	(1)
Landing Sites	1396	(3)
Prep Kit	1399	(3)
Lifting and Moving	1402	(42)
Lifting and Moving Patients	1404	(1)
Body Mechanics	1404	(4)
Anatomy Review	1404	(4)
Weight and Distribution	1408	(6)
Directions and Commands	1414	(3)
Additional Lifting and Carrying Guidelines	1415	(2)
Principles of Safe Reaching and Pulling	1417	(2)
General Considerations	1419	(1)
Emergency Moves	1419	(2)
Urgent Moves	1421	(5)
Rapid Extrication Technique	1421	(5)
Nonurgent Moves	1426	(4)
Direct Ground Lift	1426	(1)
Extremity Lift	1427	(1)
Transfer Moves	1427	(3)
Patient-Moving Equipment	1430	(8)
The Wheeled Ambulance Stretcher	1430	(5)
Portable/Folding Stretchers	1435	(1)
Flexible Stretchers	1435	(1)
Backboards	1436	(1)
Basket Stretchers	1437	(1)
Scoop Stretcher	1437	(1)
Stair Chairs	1437	(1)
Moving and Positioning the Patient	1438	(3)
Prep Kit	1441	(3)
Gaining Access	1444	(16)
Gaining Access	1446	(1)
Fundamentals of Extrication	1446	(10)
Scene Size-Up	1447	(1)
Patient and Bystander Safety	1448	(1)
Gaining Access to the Patient	1449	(1)
Patient Care During Entrapment and Extrication	1450	(1)
Preparation for Removal	1450	(1)
Removal	1451	(1)
Specialized Rescue Situations	1451	(5)
Prep Kit	1456	(4)
Special Operations	1460	(30)
Special Operations	1462	(1)
Incident Command Systems	1462	(3)
Components and Structure of an Incident Command System	1462	(3)
Introduction to Hazardous Materials	1465	(8)
Identifying Hazardous Materials	1467	(2)
Caring for Patients at a Hazardous Materials Incident	1469	(2)
Resources	1471	(2)
Mass-Casualty Incidents	1473	(4)
Triage	1473	(4)
Disaster Management	1477	(1)
Clandestine Drug Laboratories	1478	(8)
Location of Illegal Drug Laboratories	1479	(1)
Recognizing Illegal Drug Laboratories	1479	(2)
Hazards Associated with Clandestine Drug Labs	1481	(1)
Emergency Scene Operations	1481	(1)
EMS Operations	1482	(1)
Fire Suppression Operations	1482	(1)
Positive-Pressure Ventilation	1483	(1)
Monitoring Personnel Working in the Hot Zone	1483	(1)
Interacting with a Methamphetamine User	1484	(2)
Prep Kit	1486	(4)
Response to Terrorism and Weapons of Mass Destruction	1490	(34)
Introduction	1492	(1)
What Is Terrorism?	1492	(1)
Weapons of Mass Destruction (WMD)	1493	(1)
What Are WMDs?	1493	(1)
Chemical Warfare/Terrorism	1493	(1)
Biological Terrorism/Warfare	1494	(1)
Nuclear/Radiological Terrorism	1494	(1)
EMT-I Response to Terrorism	1494	(4)
Recognizing a Terrorist Event (Indicators)	1494	(1)
Response Actions	1495	(3)
Chemical Agents	1498	(7)
Vesicants (Blister Agents)	1498	(1)
Pulmonary Agents (Choking Agents)	1499	(1)
Nerve Agents	1500	(3)
Industrial Chemicals/Insecticides	1503	(2)
Biological Agents	1505	(6)
Viruses	1505	(1)
Bacteria	1506	(2)
Neurotoxins	1508	(1)
Other EMT-I Roles During a Biological Event	1509	(2)
Radiological/Nuclear Devices	1511	(6)
What Is Radiation?	1511	(1)
Sources of Radiological Material	1511	(2)
Radiological Dispersal Devices (RDD)	1513	(1)
Nuclear Energy	1513	(1)
Nuclear Weapons	1513	(1)
Symptomology	1513	(1)
Medical Management	1513	(1)
Protective Measures	1514	(3)
Prep Kit	1517	(7)
Section 9 Enrichment
Assessment-Based Management	1524	(20)
Assessment-Based Management	1528	(1)
Effective Patient Assessment	1528	(2)
Gathering Information	1528	(1)
The Importance of History	1528	(1)
Physical Assessment	1529	(1)
Recognizing Patterns and Obtaining a Field Impression	1529	(1)
BLS/ALS Treatment	1529	(1)
Choreographing Assessment and Management	1530	(1)
Team Leader	1530	(1)
Patient Care Person(s)	1530	(1)
The Right Stuff	1531	(1)
Optional ``Take In'' Equipment	1531	(1)
Aspects of Assessment and Decision Making	1532	(1)
Uncooperative Patients	1532	(1)
Distracting Injuries	1532	(1)
The Environment, Patient Compliance, and Manpower Considerations	1533	(1)
General Approach	1533	(1)
The Initial Assessment	1533	(1)
The Role of Experience	1534	(1)
Transferring the Patient	1534	(1)
Drills for Common Prehospital Complaints	1535	(5)
Prep Kit	1540	(4)
BLS Review	1544	(36)
BLS Review	1546	(1)
Elements of BLS	1546	(2)
Automated External Defibrillation	1548	(1)
Assessing the Need for BLS	1549	(1)
When to Start and Stop BLS	1549	(2)
Positioning the Patient	1551	(1)
Opening the Airway in Adults	1551	(3)
Head Tilt--Chin Lift Maneuver	1551	(2)
Jaw-Thrust Maneuver	1553	(1)
Foreign Body Airway Obstruction in Adults	1554	(4)
Recognizing Foreign Body Obstruction	1554	(1)
Removing a Foreign Body Obstruction	1555	(2)
Manual Removal of Foreign Objects	1557	(1)
Partial Airway Obstruction	1557	(1)
Foreign Body Obstruction in Infants and Children	1558	(2)
Removing a Foreign Body Airway Obstruction	1558	(2)
Rescue Breathing in Adults	1560	(3)
Ventilation	1560	(1)
Ventilation Through a Stoma	1561	(1)
Gastric Distention	1562	(1)
Recovery Position	1563	(1)
Adult CPR	1563	(4)
External Chest Compression	1564	(3)
One-Rescuer Adult CPR	1567	(1)
Two-Rescuer Adult CPR	1567	(3)
Switching Positions	1569	(1)
Infant and Child CPR	1570	(3)
External Chest Compression	1571	(1)
Proper Hand Position and Compression Technique	1572	(1)
Interrupting CPR	1573	(3)
Prep Kit	1576	(4)
Index	1580	(18)
Photo Credits	1598