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Paramedic Care: Principles and Practice, Volume 5: Special Considerations Operations,9780131178410
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Paramedic Care: Principles and Practice, Volume 5: Special Considerations Operations

by ; ;
Edition:
2nd
ISBN13:

9780131178410

ISBN10:
0131178415
Format:
Hardcover
Pub. Date:
1/1/2006
Publisher(s):
Pearson

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Summary

Written by the best-selling author team of Bryan E. Bledsoe D.O., F.A.C.E.P., EMT-P, Robert S. Porter M.A., NREMT-P, and Richard A. Cherry, M.S., NREMT-P, this student-friendly easy to understand series covers the DOT National Standard Curriculum.The fifth of 5 titles in the Brady Paramedic Care Principles and Practice series, Volume 5 - Special Considerations/Operations - contains neonatology, pediatrics, geriatrics, abuse and assault, the challenged patient, chronic-care patient, assessment-based management, operations, incident command, rescue awareness and operations, hazmat, crime scene awareness, rural EMS, and a new chapter on EMS response to WMD.Paramedic Level Emergency Responders or Intermediate level responders training to enter into Paramedic.

Table of Contents

Series Preface xxv
Preface xxix
Acknowledgments xxxiii
About the Authors xxxix
Neonatology
2(36)
Introduction
4(1)
General Pathophysiology, Assessment, and Management
4(9)
Epidemiology
5(1)
Pathophysiology
6(3)
Assessment
9(1)
Treatment
10(3)
The Distressed Newborn
13(12)
Resuscitation
14(1)
Inverted Pyramid for Resuscitation
14(9)
Maternal Narcotic Use
23(1)
Neonatal Transport
23(2)
Specific Neonatal Situations
25(13)
Meconium-Stained Amniotic Fluid
26(1)
Apnea
27(1)
Diaphragmatic Hernia
27(1)
Bradycardia
28(1)
Prematurity
28(1)
Respiratory Distress/Cyanosis
29(1)
Hypovolemia
30(1)
Seizures
30(1)
Fever
31(1)
Hypothermia
31(1)
Hypoglycemia
32(1)
Vomiting
33(1)
Diarrhea
33(1)
Common Birth Injuries
34(1)
Cardiac Resuscitation, Postresuscitation, and Stabilization
35(3)
Pediatrics
38(100)
Introduction
41(1)
Role of Paramedics in Pediatric Care
41(2)
Continuing Education and Training
42(1)
Improved Health Care and Injury Prevention
42(1)
General Approach to Pediatric Emergencies
43(11)
Communication and Psychological Support
44(1)
Growth and Development
45(4)
Anatomy and Physiology
49(5)
General Approach to Pediatric Assessment
54(13)
Basic Considerations
54(1)
Scene Size-Up
55(1)
Initial Assessment
55(7)
Focused History and Physical Exam
62(5)
Ongoing Assessment
67(1)
General Management of Pediatric Patients
67(22)
Basic Airway Management
67(7)
Advanced Airway and Ventilatory Management
74(7)
Circulation
81(5)
C-Spine Immobilization
86(1)
Transport Guidelines
86(3)
Specific Medical Emergencies
89(27)
Infections
89(1)
Respiratory Emergencies
90(2)
Specific Respiratory Emergencies
92(7)
Shock (Hypoperfusion)
99(9)
Neurologic Emergencies
108(2)
Gastrointestinal Emergencies
110(1)
Metabolic Emergencies
111(3)
Poisoning and Toxic Exposure
114(2)
Trauma Emergencies
116(9)
Mechanisms of Injury
116(3)
Special Considerations
119(3)
Specific Injuries
122(3)
Sudden Infant Death Syndrome (SIDS)
125(1)
Child Abuse and Neglect
126(4)
Perpetrators of Abuse or Neglect
126(1)
Types of Abuse
127(1)
Assessment of the Potentially Abused or Neglected Child
128(1)
Management of the Potentially Abused or Neglected Child
129(1)
Resources for Abuse and Neglect
129(1)
Infants and Children with Special Needs
130(8)
Common Home-Care Devices
130(3)
General Assessment and Management Practices
133(5)
Geriatric Emergencies
138(66)
Introduction
142(1)
Epidemiology and Demographics
142(8)
Population Characteristics
142(1)
Societal Issues
143(4)
Financing and Resources For Health Care
147(3)
General Pathophysiology, Assessment, and Management
150(11)
Pathophysiology of the Elderly Patient
150(5)
Assessment Considerations
155(5)
Management Considerations
160(1)
System Pathophysiology in the Elderly
161(7)
Respiratory System
162(1)
Cardiovascular System
163(1)
Nervous System
164(1)
Endocrine System
165(1)
Gastrointestinal System
165(1)
Thermoregulatory System
166(1)
Integumentary System
166(1)
Musculoskeletal System
166(1)
Renal System
167(1)
Genitourinary System
167(1)
Immune System
167(1)
Hematology System
168(1)
Common Medical Problems in the Elderly
168(28)
Pulmonary/Respiratory Disorders
168(4)
Cardiovascular Disorders
172(3)
Neurologic Disorders
175(5)
Metabolic and Endocrine Disorders
180(1)
Gastrointestinal Disorders
181(2)
Skin Disorders
183(1)
Musculoskeletal Disorders
184(1)
Renal Disorders
185(1)
Urinary Disorders
186(1)
Environmental Emergencies
186(2)
Toxicological Emergencies
188(4)
Substance Abuse
192(2)
Behavioral/Psychological Disorders
194(2)
Trauma in the Elderly Patient
196(8)
Contributing Factors
196(1)
General Assessment
196(2)
General Management
198(1)
Specific Injuries
198(6)
Abuse and Assault
204(20)
Introduction
206(1)
Partner Abuse
206(3)
Reasons for Not Reporting Abuse
206(1)
Identification of Partner Abuse
207(1)
Characteristics of Partner Abusers
207(1)
Characteristics of Abused Partners
208(1)
Approaching the Battered Patient
209(1)
Elder Abuse
209(2)
Identification of Elder Abuse
209(1)
Theories about Domestic Elder Abuse
210(1)
Characteristics of Abused Elders
210(1)
Characteristics of Elder Abusers
211(1)
Child Abuse
211(5)
Characteristics of Child Abusers
211(1)
Characteristics of Abused Children
212(1)
Identification of the Abused Child
213(3)
Recording and Reporting Child Abuse
216(1)
Sexual Assault
216(8)
Characteristics of Victims of Sexual Assault/Rape
217(1)
Characteristics of Sexual Assailants
218(1)
Date Rape Drugs
218(1)
EMS Responsibilities
219(1)
Legal Considerations
219(5)
The Challenged Patient
224(24)
Introduction
226(1)
Physical Challenges
226(9)
Hearing Impairment
226(3)
Visual Impairments
229(2)
Speech Impairments
231(1)
Obesity
232(2)
Paralysis
234(1)
Mental Challenges and Emotional Impairments
235(1)
Developmental Disabilities
235(2)
Accommodations for Developmental Disabilities
235(1)
Down Syndrome
236(1)
Fetal Alcohol Syndrome
237(1)
Pathological Challenges
237(6)
Arthritis
237(1)
Cancer
238(1)
Cerebral Palsy
239(1)
Cystic Fibrosis (Mucoviscidosis)
240(1)
Multiple Sclerosis
240(1)
Muscular Dystrophy
241(1)
Poliomyelitis
241(1)
Previous Head Injuries
242(1)
Spina Bifida
242(1)
Myasthenia Gravis
242(1)
Other Challenges
243(5)
Culturally Diverse Patients
243(1)
Terminally Ill Patients
244(1)
Patients with Communicable Diseases
244(1)
Patients with Financial Challenges
244(4)
Acute Interventions for the Chronic Care Patient
248(44)
Introduction
251(1)
Epidemiology of Home Care
251(10)
Patients Receiving Home Care
252(1)
ALS Response to Home Care Patients
252(9)
General System Pathophysiology, Assessment, and Management
261(4)
Assessment
261(4)
Transport and Management Treatment Plan
265(1)
Specific Acute Home Health Situations
265(27)
Respiratory Disorders
266(10)
Vascular Access Devices
276(2)
Cardiac Conditions
278(1)
GI/GU Crisis
279(3)
Acute Infections
282(1)
Maternal and Newborn Care
283(2)
Hospice and Comfort Care
285(7)
Assessment-Based Management
292(28)
Introduction
295(1)
Effective Assessment
296(5)
Importance of Accurate Information
296(2)
Factors Affecting Assessment and Decision Making
298(2)
Assessment/Management Choreography
300(1)
The Right Equipment
301(1)
General Approach to the Patient
302(3)
Scene Size-Up
302(1)
Initial Assessment
303(1)
Focused History and Physical Exam
303(1)
The Ongoing Assessment and the Detailed Physical Exam
304(1)
Identification of Life-Threatening Problems
305(1)
Presenting the Patient
305(3)
Establishing Trust and Credibility
306(1)
Developing Effective Presentation Skills
307(1)
Review of Common Complaints
308(12)
Practice Sessions
308(1)
Laboratory-Based Simulations
308(1)
Self-Motivation
308(12)
Ambulance Operations
320(24)
Introduction
321(1)
Ambulance Standards
322(2)
Ambulance Design
322(1)
Medical Equipment Standards
323(1)
Additional Guidelines
324(1)
Checking Ambulances
324(2)
Ambulance Deployment and Staffing
326(1)
Traffic Congestion
326(1)
Operational Staffing
327(1)
Safe Ambulance Operations
327(8)
Educating Providers
328(1)
Reducing Ambulance Collisions
328(1)
Standard Operating Procedures
329(1)
The Due Regard Standard
330(1)
Lights and Siren: a False Sense of Security
331(1)
Escorts and Multiple-Vehicle Responses
332(1)
Parking and Loading the Ambulance
332(2)
The Deadly Intersection
334(1)
Utilizing Air Medical Transport
335(9)
Fixed-Wing Aircraft
335(1)
Rotorcraft
335(1)
Advantages and Disadvantages of Air Transport
336(1)
Activation
337(1)
Indications for Patient Use
337(1)
Patient Preparation and Transfer
337(2)
Scene Safety and the Landing Zone
339(5)
Medical Incident Management
344(34)
Introduction
348(1)
Origins of Emergency Incident Management
349(3)
Regulations and Standards
349(2)
A Uniform, Flexible System
351(1)
Command
352(5)
Establishing Command
352(1)
Incident Size-Up
353(1)
Singular vs. Unified Command
354(1)
Identifying a Staging Area
355(1)
Incident Communications
355(1)
Resource Utilization
356(1)
Command Procedures
356(1)
Termination of Command
357(1)
Support of Incident Command
357(4)
Command Staff
358(2)
Finance/Administration
360(1)
Logistics
360(1)
Operations
360(1)
Planning
361(1)
Division of Operations Functions
361(1)
Branches
361(1)
Groups and Divisions
361(1)
Units
361(1)
Sectors
361(1)
Functional Groups With an EMS Branch
362(9)
Triage
362(4)
Morgue
366(1)
Treatment
366(2)
On-Scene Physicians
368(1)
Staging
368(1)
Transport Unit
368(1)
Extrication/Rescue Unit
369(1)
Rehabilitation Unit
369(1)
Communications
370(1)
Disaster Management
371(1)
Mitigation
371(1)
Planning
371(1)
Response
371(1)
Recovery
371(1)
Meeting the Challenge of Multiple-Casualty Incidents
372(6)
Common Problems
372(1)
Preplanning, Drills, and Critiques
372(1)
Disaster Mental Health Services
373(5)
Rescue Awareness and Operations
378(46)
Introduction
381(1)
Role of the Paramedic
381(1)
Protective Equipment
382(4)
Rescuer Protection
383(2)
Patient Protection
385(1)
Safety Procedures
386(2)
Rescue SOPs
386(1)
Crew Assignments
387(1)
Preplanning
387(1)
Rescue Operations
388(8)
Phase 1: Arrival and Size-Up
388(1)
Phase 2: Hazard Control
389(1)
Phase 3: Patient Access
390(1)
Phase 4: Medical Treatment
390(3)
Phase 5: Disentanglement
393(1)
Phase 6: Patient Packaging
394(1)
Phase 7: Removal/Transport
395(1)
Surface Water Rescues
396(8)
General Background
396(1)
Moving Water
397(3)
Flat Water
400(4)
Hazardous Atmosphere Rescues
404(4)
Confined-Space Hazards
405(2)
Confined-Space Protections in the Workplace
407(1)
Cave-Ins and Structural Collapses
407(1)
Highway Operations And Vehicle Rescues
408(6)
Hazards in Highway Operations
408(3)
Auto Anatomy
411(1)
Rescue Strategies
412(1)
Rescue Skills Practice
413(1)
Hazardous Terrain Rescues
414(10)
Types of Hazardous Terrain
414(1)
Patient Access in Hazardous Terrain
414(2)
Patient Packaging for Rough Terrain
416(1)
Patient Removal from Hazardous Terrain
417(2)
Extended Care Assessment and Environmental Issues
419(5)
Hazardous Materials Incidents
424(32)
Introduction
427(1)
Role of the Paramedic
428(1)
Requirements and Standards
429(1)
Levels of Training
429(1)
Incident Size-Up
429(9)
IMS and Hazmat Emergencies
429(1)
Incident Awareness
430(2)
Recognition of Hazards
432(3)
Identification of Substances
435(3)
Hazardous Materials Zones
438(1)
Specialized Terminology
438(3)
Terms for Medical Hazmat Operations
439(1)
Toxicological Terms
440(1)
Contamination and Toxicology Review
441(4)
Types of Contamination
442(1)
Routes of Exposure
442(1)
Cycles and Actions of Poisons
442(1)
Treatment of Common Exposures
443(2)
Approaches to Decontamination
445(4)
Methods of Decontamination
445(1)
Decontamination Decision Making
446(1)
Field Decontamination
447(2)
Hazmat Protection Equipment
449(2)
Medical Monitoring and Rehabilitation
451(1)
Entry Readiness
451(1)
Post-Exit ``Rehab''
451(1)
Heat Stress Factors
451(1)
Importance of Practice
452(4)
Crime Scene Awareness
456(22)
Introduction
458(1)
Approach to the Scene
459(2)
Possible Scenarios
459(2)
Specific Dangerous Scenes
461(5)
Highway Encounters
461(1)
Violent Street Incidents
462(2)
Drug-Related Crimes
464(1)
Clandestine Drug Laboratories
465(1)
Domestic Violence
466(1)
Tactical Considerations
466(5)
Safety Tactics
466(3)
Tactical Patient Care
469(2)
EMS at Crime Scenes
471(7)
EMS and Police Operations
472(1)
Preserving Evidence
472(6)
Rural EMS
478(24)
Introduction
480(1)
Practicing Rural EMS
480(6)
Special Problems
481(2)
Creative Problem-Solving
483(3)
Typical Rural EMS Situations and Decisions
486(16)
The Distance Factor
486(3)
Agricultural Emergencies
489(7)
Recreational Emergencies
496(6)
Responding to Terrorist Acts
502(21)
Introduction
504(1)
Explosive Agents
505(1)
Nuclear Detonation
506(2)
A Nuclear Incident Response
507(1)
Radioactive Contamination
508(1)
Chemical Agents
508(5)
Nerve Agents
509(1)
Vesicants (Blistering Agents)
510(1)
Pulmonary Agents
511(1)
Biotoxins
511(1)
Incapacitating Agents
512(1)
Other Hazardous Chemicals
512(1)
Recognition of a Chemical Agent Release
512(1)
Management of a Chemical Agent Release
513(1)
Biological Agents
513(4)
Pneumonia-like Agents
515(1)
Encephalitis-like Agents
516(1)
Other Agents
516(1)
Protection against Biological Agent Transmission
516(1)
General Considerations Regarding Terrorist Attacks
517(6)
Scene Safety
517(1)
Recognizing a Terrorist Attack
518(1)
Responding to a Terrorist Attack
518(5)
Precautions on Bloodborne Pathogens and Infectious Disease 523(2)
Suggested Responses to ``You Make the Call'' 525(8)
Answers to ``Review Questions'' 533(2)
Glossary 535(8)
Index 543


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