Paramedic Care: Principles and Practice, Volume 1: Introduction to Advanced Prehospital Care

by Bledsoe, Bryan E.; Porter, Robert S.; Cherry, Richard A.

• ISBN13: 9780131178199
• ISBN10: 0131178199
• Edition: 2nd
• Format: Hardcover
• Copyright: 2006-01-01
• Publisher: Pearson

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 first of 5 titles in the Brady Paramedic Care Principles and Practice series, this book provides an overview of a Paramedic's role and Paramedic systems. Also covered are illness and injury prevention, medical/legal aspects, ethics, pathophysiology, pharmacology, medication administration, therapeutic communications, life span development, and airway management.Paramedic Level Emergency Responders or Intermediate level responders training to enter into Paramedic.

Table of Contents

Series Preface	xxvii
Acknowledgments	xxxiii
Preface	xxxi
About the Authors	xxxix
Introduction to Advanced Prehospital Care	2	(12)
Introduction	5	(3)
Description of the Profession	5	(1)
Paramedic Characteristics	6	(1)
The Paramedic: A True Health Professional	7	(1)
Expanded Scope of Practice	8	(6)
Critical Care Transport	10	(1)
Primary Care	10	(1)
Industrial Medicine	10	(1)
Sports Medicine	11	(3)
The Well-Being of the Paramedic	14	(30)
Introduction	16	(1)
Basic Physical Fitness	17	(6)
Core Elements	17	(1)
Nutrition	18	(3)
Habits and Addictions	21	(1)
Back Safety	21	(2)
Personal Protection from Disease	23	(6)
Infectious Diseases	23	(1)
Infection Control Practices	24	(5)
Death and Dying	29	(4)
Loss, Grief, and Mourning	30	(1)
What to Say	31	(1)
When It Is Someone You Know	32	(1)
Stress and Stress Management	33	(5)
Shift Work	35	(1)
Signs of Stress	35	(1)
Common Techniques for Managing Stress	35	(2)
Specific EMS Stresses	37	(1)
Mental Health Services	38	(1)
Disaster Mental Health Services	38	(1)
General Safety Considerations	38	(6)
Interpersonal Relations	39	(1)
Roadway Safety	39	(5)
EMS Systems	44	(32)
Introduction	46	(1)
History of EMS	47	(5)
Ancient Times	47	(2)
Eighteenth and Nineteenth Centuries	49	(1)
Twentieth Century	49	(3)
The EMS Agenda for the Future	52	(1)
Today's EMS Systems	53	(23)
Local and State-Level Agencies	53	(1)
Medical Direction	54	(2)
Public Information and Education	56	(1)
Communications	56	(2)
Education and Certification	58	(5)
Patient Transportation	63	(3)
Receiving Facilities	66	(1)
Mutual Aid and Mass-Casualty Preparation	66	(1)
Quality Assurance and Improvement	67	(3)
Research	70	(1)
System Financing	71	(5)
Roles and Responsibilities of the Paramedic	76	(20)
Introduction	78	(1)
Primary Responsibilities	78	(6)
Preparation	79	(1)
Response	79	(1)
Scene Size-up	79	(1)
Patient Assessment	80	(1)
Recognition of Illness or Injury	81	(1)
Patient Management	81	(1)
Appropriate Disposition	81	(2)
Patient Transfer	83	(1)
Documentation	84	(1)
Returning to Service	84	(1)
Additional Responsibilities	84	(2)
Community Involvement	85	(1)
Support for Primary Care	85	(1)
Citizen Involvement in EMS	85	(1)
Personal and Professional Development	86	(1)
Professionalism	86	(10)
Professional Ethics	86	(1)
Professional Attitudes	87	(1)
Professional Attributes	87	(5)
Continuing Education	92	(4)
Illness and Injury Prevention	96	(14)
Introduction	97	(1)
Epidemiology	98	(1)
Prevention within EMS	99	(4)
Organizational Commitment	99	(2)
EMS Provider Commitment	101	(2)
Prevention in the Community	103	(7)
Areas of Need	103	(2)
Implementation of Prevention Strategies	105	(5)
Medical/Legal Aspects of Advanced Prehospital Care	110	(32)
Introduction	113	(1)
Legal Duties and Ethical Responsibilities	113	(5)
The Legal System	114	(1)
Anatomy of a Civil Lawsuit	115	(1)
Laws Affecting EMS and the Paramedic	116	(2)
Legal Accountability of the Paramedic	118	(4)
Negligence and Medical Liability	118	(4)
Special Liability Concerns	122	(1)
Paramedic-Patient Relationships	122	(9)
Confidentiality	123	(2)
Consent	125	(3)
Legal Complications Related to Consent	128	(2)
Reasonable Force	130	(1)
Patient Transportation	131	(1)
Resuscitation Issues	131	(4)
Advance Directives	132	(3)
Death in the Field	135	(1)
Crime and Accident Scenes	135	(1)
Documentation	136	(6)
Ethics in Advanced Prehospital Care	142	(20)
Introduction	144	(1)
Overview of Ethics	144	(7)
Relationship of Ethics to Law and Religion	144	(1)
Making Ethical Decisions	145	(1)
Codes of Ethics	146	(1)
Impact of Ethics on Individual Practice	146	(1)
The Fundamental Questions	146	(1)
Fundamental Principles	147	(1)
Resolving Ethical Conflicts	148	(3)
Ethical Issues in Contemporary Paramedic Practice	151	(11)
Resuscitation Attempts	151	(2)
Confidentiality	153	(2)
Consent	155	(1)
Allocation of Resources	155	(1)
Obligation to Provide Care	156	(1)
Teaching	157	(1)
Professional Relations	157	(2)
Research	159	(3)
General Principles of Pathophysiology	162	(112)
Introduction	166	(1)
Part 1: The Cell and the Cellular Environment	166	(1)
The Normal Cell	166	(8)
Cell Structure	167	(1)
Cell Function	168	(1)
Tissues	169	(1)
Organs, Organ Systems, and the Organism	170	(1)
System Integration	171	(3)
How Cells Respond to Change and Injury	174	(6)
Cellular Adaptation	175	(1)
Cellular Injury	176	(4)
Cellular Death: Apoptosis and Necrosis	180	(1)
The Cellular Environment: Fluids and Electrolytes	180	(15)
Water	180	(4)
Electrolytes	184	(2)
Osmosis and Diffusion	186	(4)
Intravenous Therapy	190	(5)
Acid-Base Balance	195	(5)
The pH Scale	195	(1)
Bodily Regulation of Acid-Base Balance	196	(2)
Acid-Base Derangements	198	(2)
Part 2: Disease---Causes and Pathophysiology	200	(1)
Genetic and Other Causes of Disease	200	(5)
Genetics, Environment, Life Style, Age, and Gender	200	(1)
Family History and Associated Risk Factors	201	(4)
Hypoperfusion	205	(16)
The Physiology of Perfusion	206	(4)
The Pathophysiology of Hypoperfusion	210	(4)
Types of Shock	214	(5)
Multiple Organ Dysfunction Syndrome	219	(2)
Part 3: The Body's Defenses Against Disease and Injury	221	(1)
Self-Defense Mechanisms	221	(4)
Infectious Agents	221	(2)
Three Lines of Defense	223	(2)
The Immune Response	225	(15)
How the Immune Response Works: An Overview	225	(1)
Characteristics of the Immune Response and Immunity	225	(1)
Induction of the Immune Response	226	(4)
Humoral Immune Response	230	(5)
Cell-Mediated Immune Response	235	(2)
Cellular Interactions in Immune Response	237	(1)
Fetal and Neonatal Immune Function	238	(1)
Aging and the Immune Response	239	(1)
Inflammation	240	(13)
Inflammation Contrasted to the Immune Response	240	(1)
How Inflammation Works: An Overview	240	(1)
Acute Inflammatory Response	241	(1)
Mast Cells	242	(2)
Plasma Protein Systems	244	(3)
Cellular Components of Inflammation	247	(2)
Cellular Products	249	(1)
Systemic Responses of Acute Inflammation	249	(1)
Chronic Inflammatory Responses	249	(1)
Local Inflammatory Responses	250	(1)
Resolution and Repair	251	(1)
Age and the Mechanisms of Self-Defense	252	(1)
Variances in Immunity and Inflammation	253	(8)
Hypersensitivity: Allergy, Autoimmunity, and Isoimmunity	253	(5)
Deficiencies in Immunity and Inflammation	258	(3)
Stress and Disease	261	(13)
Concepts of Stress	261	(1)
Stress Responses	262	(4)
Stress, Coping, and Illness Interrelationships	266	(8)
General Principles of Pharmacology	274	(94)
Introduction	278	(1)
Part 1: Basic Pharmacology	278	(1)
General Aspects	278	(2)
Names	278	(1)
Sources	279	(1)
Reference Materials	279	(1)
Components of a Drug Profile	280	(1)
Legal Aspects	280	(2)
Federal	280	(2)
State	282	(1)
Local	282	(1)
Standards	282	(1)
Drug Research and Bringing a Drug to Market	282	(3)
Phases of Human Studies	283	(1)
FDA Classification of Newly Approved Drugs	284	(1)
Patient Care Using Medications	285	(4)
Six Rights of Medication Administration	285	(1)
Special Considerations	286	(3)
Pharmacology	289	(11)
Pharmacokinetics	289	(6)
Pharmacodynamics	295	(5)
Part 2: Drug Classifications	300	(1)
Classifying Drugs	300	(1)
Drugs Used to Affect the Nervous System	301	(24)
Central Nervous System Medications	302	(8)
Autonomic Nervous System Medications	310	(15)
Drugs Used to Affect the Cardiovascular System	325	(16)
Cardiovascular Physiology Review	325	(4)
Classes of Cardiovascular Drugs	329	(12)
Drugs Used to Affect the Respiratory System	341	(5)
Antiasthmatic Medications	341	(3)
Drugs Used for Rhinitis and Cough	344	(2)
Drugs Used to Affect the Gastrointestinal System	346	(3)
Drugs Used to Treat Peptic Ulcer Disease	346	(1)
Drugs Used to Treat Constipation	347	(1)
Drugs Used to Treat Diarrhea	348	(1)
Drugs Used to Treat Emesis	348	(1)
Drugs Used to Aid Digestion	349	(1)
Drugs Used to Affect the Eyes	349	(1)
Drugs Used to Affect the Ears	349	(1)
Drugs Used to Affect the Endocrine System	350	(8)
Drugs Affecting the Pituitary Gland	350	(1)
Drugs Affecting the Parathyroid and Thyroid Glands	351	(1)
Drugs Affecting the Adrenal Cortex	352	(1)
Drugs Affecting the Pancreas	352	(3)
Drugs Affecting the Female Reproductive System	355	(2)
Drugs Affecting the Male Reproductive System	357	(1)
Drugs Affecting Sexual Behavior	357	(1)
Drugs Used to Treat Cancer	358	(1)
Drugs Used to Treat Infectious Diseases and Inflammation	358	(4)
Drugs Used to Affect the Skin	362	(1)
Drugs Used to Supplement the Diet	362	(1)
Vitamins and Minerals	362	(1)
Fluids and Electrolytes	363	(1)
Drugs Used to Treat Poisoning and Overdoses	363	(5)
Intravenous Access and Medication Administration	368	(96)
Introduction	372	(1)
Part 1: Principles and Routes Of Medication Administration	372	(1)
General Principles	372	(4)
Medical Direction	373	(1)
Body Substance Isolation	373	(1)
Medical Asepsis	374	(1)
Disposal of Contaminated Equipment and Sharps	375	(1)
Medication Administration and Documentation	375	(1)
Percutaneous Drug Administration	376	(4)
Transdermal Administration	376	(1)
Mucous Membranes	376	(4)
Pulmonary Drug Administration	380	(4)
Nebulizer	380	(1)
Metered Dose Inhaler	381	(3)
Endotracheal Tube	384	(1)
Enteral Drug Administration	384	(6)
Oral Administration	384	(2)
Gastric Tube Administration	386	(1)
Rectal Administration	387	(3)
Parenteral Drug Administration	390	(17)
Syringes and Needles	390	(2)
Medication Packaging	392	(6)
Parenteral Routes	398	(9)
Part 2: Intravenous Access, Blood Sampling, and Intraosseous Infusion	407	(1)
Intravenous Access	407	(34)
Types of Intravenous Access	407	(1)
Equipment and Supplies for Venous Access	408	(9)
Intravenous Access in the Hand, Arm, and Leg	417	(3)
Intravenous Access in the External Jugular Vein	420	(2)
Intravenous Access with a Measured Volume Administration Set	422	(1)
Intravenous Access with Blood Tubing	422	(3)
Factors Affecting Intravenous Flow Rates	425	(1)
Complications of Peripheral Intravenous Access	426	(1)
Changing an IV Bag or Bottle	427	(1)
Intravenous Drug Administration	428	(9)
Venous Blood Sampling	437	(4)
Removing a Peripheral IV	441	(1)
Intraosseous Infusion	441	(8)
Access Site	441	(2)
Equipment for Intraosseous Access	443	(1)
Placing an Intraosseous Infusion	444	(4)
Intraosseous Access Complications and Precautions	448	(1)
Contraindications to Intraosseous Placement	449	(1)
Part 3: Medical Mathematics	449	(1)
Metric System	449	(3)
Conversion between Prefixes	450	(1)
Household and Apothecary Systems of Measure	451	(1)
Weight Conversion	451	(1)
Temperature	451	(1)
Units	452	(1)
Medical Calculations	452	(12)
Calculating Dosages for Oral Medications	453	(1)
Converting Prefixes	454	(1)
Calculating Dosages for Parenteral Medications	455	(1)
Calculating Weight-Dependent Dosages	455	(1)
Calculating Infusion Rates	456	(8)
Therapeutic Communications	464	(18)
Introduction	466	(1)
Basic Elements of Communication	466	(3)
Trust and Rapport	467	(1)
Professional Behaviors	467	(2)
Communication Techniques	469	(13)
General Guidelines	469	(2)
Interview Techniques	471	(3)
Patients with Special Needs	474	(5)
Transferring Patient Care	479	(3)
Life-Span Development	482	(22)
Introduction	484	(1)
Infancy	484	(5)
Physiological Development	484	(4)
Psychosocial Development	488	(1)
Toddler and Preschool Age	489	(4)
Physiological Development	489	(2)
Psychosocial Development	491	(2)
School Age	493	(1)
Physiological Development	493	(1)
Psychosocial Development	493	(1)
Adolescence	494	(1)
Physiological Development	494	(1)
Psychosocial Development	494	(1)
Early Adulthood	495	(1)
Middle Adulthood	495	(1)
Late Adulthood	496	(8)
Physiological Development	496	(3)
Psychosocial Development	499	(5)
Airway Management and Ventilation	504	(108)
Introduction	508	(1)
Anatomy of the Respiratory System	509	(6)
Upper Airway Anatomy	509	(3)
Lower Airway Anatomy	512	(2)
The Pediatric Airway	514	(1)
Physiology of the Respiratory System	515	(8)
Respiration and Ventilation	516	(1)
Measuring Oxygen and Carbon Dioxide Levels	517	(4)
Regulation of Respiration	521	(2)
Respiratory Problems	523	(2)
Airway Obstruction	523	(2)
Inadequate Ventilation	525	(1)
Respiratory System Assessment	525	(13)
Initial Assessment	525	(2)
Focused History and Physical Examination	527	(4)
Noninvasive Respiratory Monitoring	531	(7)
Basic Airway Management	538	(8)
Manual Airway Maneuvers	538	(4)
Basic Mechanical Airways	542	(4)
Advanced Airway Management	546	(50)
Endotracheal Intubation	546	(30)
Nasotracheal Intubation	576	(3)
Field Extubation	579	(1)
Esophageal Tracheal Combitube	580	(2)
Pharyngo-Trachcal Lumen Airway	582	(2)
Laryngeal Mask Airway	584	(3)
Esophageal Gastric Tube Airway and Esophageal Obturator Airway	587	(1)
Foreign Body Removal under Direct Laryngoscopy	587	(1)
Surgical Airways	587	(9)
Managing Patients with Stoma Sites	596	(1)
Suctioning	597	(3)
Suctioning Equipment	597	(2)
Suctioning Techniques	599	(1)
Gastric Distention and Decompression	600	(1)
Oxygenation	601	(1)
Oxygen Supply and Regulations	601	(1)
Oxygen Delivery Devices	601	(1)
Ventilation	602	(10)
Mouth-to-Mouth/Mouth-to-Nose Ventilation	603	(1)
Mouth-to-Mask Ventilation	603	(1)
Bag-Valve Devices	603	(2)
Demand Valve Device	605	(1)
Automatic Transport Ventilator	606	(6)
Appendix: Research in EMS	612	(19)
Precautions on Bloodborne Pathogens and Infectious Disease	631	(2)
Suggested Responses to ``You Make the Call''	633	(8)
Answers to ``Review Questions''	641	(2)
Glossary	643	(16)
Index	659