DICKINSON ALS SCENARIOS _p1

by Dickinson, Edward T., ,Medical Editor; Stern, Andrew, NREMT-P, MPA, MA

• ISBN13: 9780130943170
• ISBN10: 0130943177
• Edition: 1st
• Format: Paperback
• Copyright: 2003-12-01
• Publisher: Pearson

Summary

Written by leading practitioners in the medical field, these case studies offer in-depth explanations of scenarios encountered in the prehospital environment. A consistent format helps readers understand the discussions, questions, and the resolution for each case; allowing them to gain exposure to the many different situations that will arise on the job.51 cases are organized into 3 topic areas: Medical Emergencies, Trauma and Surgical Emergencies, and Special Situations.An excellent reference and interesting reading for emergency medical technicians and paramedics.

Author Biography

Edward T. Dickinson, MD, NREMT-P, FACEP: Hospital of the University of Pennsylvania Andrew W. Stern, NREMT-P, MPA, MA: Town of Colonie Emergency Medical Services

Table of Contents

Preface	p. IX
Acknowledgments	p. XI
Medical Emergencies	p. 1
Acute Chest Pain	p. 3
Acute Myocardial Infarction	p. 7
Acute Myocardial Infarction with Bradycardia	p. 12
Acute Severe Asthma Exacerbation	p. 18
Acute Stroke	p. 23
Anaphylaxis	p. 28
Cardiac Arrest	p. 34
Catheters/PICC Lines	p. 41
Cocaine-Related Chest Pain	p. 45
Congestive Heart Failure	p. 50
Dehydration	p. 56
Diabetic AMS	p. 61
Chronic Renal Failure	p. 66
Difficult Intubation	p. 71
Facilitated Intubation	p. 78
Hypertensive Crisis	p. 83
Hypothermia with Altered Mental Status	p. 87
Meningitis	p. 91
Overdose	p. 95
Pain Management	p. 100
Poisoning	p. 106
Post-CABG Surgery	p. 112
Seizure	p. 117
Sudden-Onset Tachycardia	p. 123
Syncope	p. 129
Trauma and Surgical Emergencies	p. 135
Amputation	p. 137
Blunt Chest Trauma	p. 142
Burns	p. 147
Cervical Spine Injury	p. 151
Head Injury	p. 155
Blunt Multiple Trauma	p. 161
Ruptured Abdominal Aortic Aneurysm	p. 166
Shock in Penetrating Injury to the Chest	p. 170
Stab Wound	p. 176
Trauma Arrest	p. 180
Special Situations	p. 187
Advance Directives	p. 189
Attempted Suicide	p. 195
Care under Fire	p. 200
Child Abuse	p. 206
Domestic Violence	p. 212
EMS and Air Medical Service Interaction	p. 217
Exposure to Hazardous Material	p. 225
Extrication	p. 231
Near-Drowning	p. 236
Needle-Stick Injuries	p. 241
Preeclampsia/Eclampsia	p. 247
Refusal of Care	p. 252
Sexual Assault	p. 257
Vaginal Bleeding	p. 261
Violent Psychiatric Patient	p. 265
Weapons of Mass Destruction	p. 271
List of Abbreviations	p. 275
Index	p. 279
Table of Contents provided by Rittenhouse. All Rights Reserved.

Excerpts

ALS Case Studies in Emergency Careis intended to be a paramedic-level, mufti-purpose learning tool. There is a uniqueness to prehospital emergency care that requires providers to perform difficult tasks in uncontrolled environments, often with limited personnel, and often under specific time constraints.The intent of this book is to challenge those who use case studies as a learning technique to expand their ability to be more thorough in assessments, flexible when interpreting clinical findings, and ultimately be prepared to provide the best clinical care possible. To optimize learning for both new and current providers, each case is presented in the same easy-to-follow format. TheCase Presentationdescribes the history, physical findings, and basic interventions that may be applied in a real-life situation. This is followed byQuestionsregarding intervention and pathophysiology/mechanisms of action. TheDiscussionincludes a presentation of pathology, key prehospital interventions to optimize care, and controversial issues regarding management. TheReturn to the Casereturns to the scenario to describe the use of the intervention and patient's response.Case studies provide a methodology for looking at an entire EMS call from initial dispatch until transition of care to the emergency department. Integrating this information is important to both the provider and the patient. The process of planning and preparing to give care starts with dispatch information. As a call progresses, additional data is provided from first responders, family members, and the patient. All this information needs to be processed in order to develop a full clinical picture of the patient's presenting problems and to determine what treatment options should be considered. Case studies make students and active field providers sort information and frequently reevaluate decisions.Please note that the case studies contained in this book reflect generally acceptable clinical treatment approaches and modalities. There is usually more than one clinically acceptable way to treat patients. There are variances that field providers must always take into account such as local or regional protocol as well as different approaches to care based on training and local resources. EMS is evolving. As more and more research is being conducted, some current practices may change. Finally, be open to change and realize that the evolution of new standards and interventions is an essential part of the dynamics of pre-hospital care. Edward T. Dickinson Andrew W. Stem