Pre-hospital Emergency Medicine at a Glance by Seligman, William -- Read -- Imperial Library of Trantor

Index

Cover Title Page Copyright Preface Contributors Abbreviations Part 1 Principles of pre-hospital care

1 History of pre-hospital care

The beginning The catalyst of war Civilian advances in pre-hospital emergency medicine Pre-hospital emergency medicine in the UK

2 Pre-hospital care today

Changes in the ambulance service Hazardous area response teams Volunteer first responder schemes Helicopter emergency medical services Fire and rescue service Police Other providers

3 Major trauma pathways in the UK

The burden of trauma The need for trauma service reform Trauma networks: the new standard of care in major trauma Trauma networks explained The need for provision of enhanced pre-hospital emergency care

4 Emerging pre-hospital medical care pathways

The increasing demand for emergency and urgent care services The increasingly complex patient demographic The expanding role of physician response units Improving general practice unscheduled care services The shape of the future: integrated urgent and emergency care networks

5 Kinematics and mechanism of injury

Energy transfer in trauma Reading the scene Blunt trauma Penetrating injury Blast injuries

6 Hazardous materials

Scene management Approaching the scene Personal protective equipment Decontamination CBRN: specific treatments

7 Human factors

Making mistakes Team/crew resource management concepts

8 Pre-hospital transport

Land ambulance Helicopters Fixed wing aircraft

9 Scene safety

Importance of scene safety Initial approach and arrival at the scene Special considerations

Part 2 Initial assessment and management of immediately life-threatening injuries

10 The primary survey

Principles of rapid initial assessment Catastrophic haemorrhage Airway (+ cervical spine control + oxygen) Breathing Circulation Deficit (neurology) Exposure and environmental control

11 Control of major haemorrhage

The problem of major haemorrhage in trauma Acute coagulopathy in trauma The ladder approach to pre-hospital haemorrhage control Damage control resuscitation

12 Cervical spine injuries

Identifying cervical spine injury Securing the cervical spine

13 Basic airway management

Assessing the airway Manual airway opening manoeuvres Basic airway adjuncts Endotracheal intubation

14 The difficult airway

Assessing the airway Difficult airway management ‘Front of neck airway’

15 Life-threatening chest trauma

General principles of management Immediately life-threatening chest trauma Flail chest

16 Circulation I: haemodynamic instability

Shock Permissive hypotension Haemostatic resuscitation

17 Circulation II: medical cardiac arrest

Beyond advanced life support – enhanced cardiac arrest care Post-return of spontaneous circulation care

18 Circulation III: traumatic cardiac arrest

Traumatic cardiac arrest – a different disease process to medical cardiac arrest Recognition of cardiac arrest Key principles in the management of traumatic cardiac arrest Return of spontaneous circulation and on-going management and transfer

19 Pain relief and sedation

Importance of pain relief Non-pharmacological pain relief Pharmacological analgesia Procedural sedation

20 Head injury

Demographics and aetiology Primary vs secondary brain injury Assessment Management priorities Additional considerations

21 Spinal injuries

Anatomy of the spine and cord Pathophysiology of cord injury Management of spinal cord injury

22 Limb injuries

Primary survey Secondary survey Wound care Fractures and dislocations Analgesia Splintage and packaging Other scenarios

Part 3 Special considerations in trauma management

23 Paediatric trauma

Body size and weight Airway Respiratory system Cardiovascular system Neurological system Non-accidental injury Paediatric primary survey Burns Spinal injury Analgesia Consent and parents Box 23.1 Emergency drug doses

24 Trauma in the pregnant woman

Physiological and anatomical changes in pregnancy relevant to trauma

25 Trauma in the elderly

Physiological changes with advancing age Capacity Pharmacology in elderly patients Fractured neck of femur Cause and effect in trauma Burden on healthcare services

Part 4 Practical skills in pre-hospital emergency medicine

26 Anaesthesia in the pre-hospital environment

Safety Clinical complexity Operator-dependent Transfer Transport Indications for pre-hospital anaesthesia

27 The emergency surgical airway

The failed airway drill Indications Contraindications Technique Advantages Disadvantages

28 Peripheral vascular access

Importance of circulatory access Venous access Intraosseous devices

29 Chest techniques

Thoracostomy Needle thoracocentesis Chest seals for open chest wounds

30 Resuscitative thoracotomy

Indications Contraindications Technique Preparation Clam-shell thoracotomy Advantages Disadvantages

31 Pre-hospital ultrasound

Focused assessment with sonography in trauma (FAST scan) Ultrasound as a procedural aid

32 Packaging

What is packaging? Patient-oriented packaging Provider-oriented packaging

33 Handover

Preparing for handover and the pre-alert How to give an effective handover

Part 5 Management of complex problems

34 Major incidents

Declaring a major incident and initial management priorities Safety at major incidents Establishing the infrastructure Triage Conclusion

35 Expedition medicine

Types of expedition Preparing for the expedition Prevention on the expedition Specific environmental hazards

36 Event medicine

Planning Training Command and control Communication Business continuity

37 Military pre-hospital emergency care

Process and capability Methods of evacuation Environment Future

Part 6 Careers in pre-hospital emergency medicine

38 Careers in pre-hospital emergency medicine – NHS England

Medical careers in pre-hospital emergency medicine Paramedic careers in pre-hospital emergency medicine

References Index WILEY END USER LICENSE AGREEMENT

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