Nancy Caroline's Emergency Care in the Streets by Caroline, Nancy L. -- Read -- Imperial Library of Trantor

Index

Cover Title Page Copyright Page: Volume 1 Copyright Page: Volume 2 Brief Contents Contents: Volume 1 Contents: Volume 2 Skill Drills: Volume 1 Skill Drills: Volume 2 Resources Acknowledgments: Volume 1 Acknowledgments: Volume 2 Section 1 Preparatory

Chapter 1 EMS Systems

Introduction EMS System Development

The History of EMS The 20th Century and Modern Technology

Licensure, Certification, and Registration

Reciprocity

The EMS System Levels of Education

The Dispatcher Emergency Medical Responder EMT Advanced EMT Paramedic

Paramedic Education

Initial Education Continuing Education

Additional Types of Transports

Transport to Specialty Centers Interfacility Transports

Working With Other Professionals

Working With Hospital Staff Working With Public Safety Agencies Continuity of Care

National EMS Group Involvement Professionalism Roles and Responsibilities Medical Direction Improving System Quality EMS Research

The Research Process Funding Types of Research Research Methods Ethical Considerations Evaluating Medical Research Evidence-Based Practice

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Chapter 2 Workforce Safety and Wellness

Introduction Components of Well-Being

Physical Well-Being Mental Well-Being Emotional Well-Being Spiritual Well-Being

Stress

What Triggers Stress The Physiology of Acute Stress How People React to Stressful Situations Coping With Your Own Stress Burnout

Coping With Death and Dying

Stages of the Grieving Process Dealing With the Dying Patient Dealing With a Grieving Family Dealing With a Grieving Child After the Call Is Over

Disease Transmission Protecting Yourself

Immunizations Personal Protective Equipment and Practices Management of an Exposure Hostile Situations Traffic Scenes

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Chapter 3 Public Health

Introduction Role of Public Health

Injuries as Public Health Threats Illness and Disease as Public Health Threats Public Health Efforts

Public Health Laws, Regulations, and Guidelines EMS Interface With Public Health Injury and Illness Prevention and EMS

Common Roots Why EMS Should Be Involved

Principles of Injury and Illness Prevention

The 4 Es of Prevention The Value of Automatic Protections Models for Injury and Illness Prevention The Haddon Matrix Injury and Illness Surveillance

Getting Started in Your Community

Recognizing Injury and Illness Patterns in Your Community Intentional Injuries Unintentional Injuries Risk Factors for Children Illness Prevention Community Organizing The Five Steps to Developing a Prevention Program Funding a Prevention Program

How Every Provider Can Be Involved

Responding to the Call Education for EMS Providers The “Teachable Moment” Collection/Analysis of Data and Research

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Chapter 4 Medical, Legal, and Ethical Issues

Introduction Medical Ethics

Ethics and EMS Research

The Legal System in the United States

Types of Law The Legal Process

Legal Accountability of the Paramedic

The Paramedic and the Medical Director EMS-Enabling Legislation Administrative Regulations Medical Practice Act Scope of Practice Health Insurance Portability and Accountability Act Emergency Medical Treatment and Active Labor Act Emergency Vehicle Laws Transportation Crime Scene and Emergency Scene Responsibilities Mandatory Reporting Coroner and Medical Examiner Cases

Paramedic—Patient Relationships

Consent and Refusal Decision-Making Capacity Minors Violent Patients and Restraints Triage and Allocation of Resources

Negligence and Protection Against Negligence Claims

Elements of Negligence Abandonment

Patient Autonomy

Advance Directives End-of-Life Decisions

Defenses to Litigation

Good Samaritan Legislation Governmental Immunity Qualified Immunity

Employment Law and the Paramedic

Americans With Disabilities Act Title VII of the Civil Rights Act Sexual Harassment Additional Federal Laws Dealing With Discrimination State Laws Family Medical Leave Act Occupational Safety and Health Administration Ryan White Act National Labor Relations Act

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Chapter 5 EMS Communications

Introduction EMS Communications System

Communications System Components Radio Communications Cellular Telephones Backup Communications Systems Biotelemetry Factors That May Affect Communications

Communicating by Radio

FCC Regulations Clarity of Transmission Content of Transmissions Codes Response to the Scene Relaying Information to Medical Control Format for Reporting Medical Information

Communication With Health Care Professionals

Phases of Communication Medical Terminology In-Person Report

Dispatching

Receipt of the Call for Help Information Gathering Dispatch Advice to the Caller Ongoing Communications With the Field

Therapeutic Communication

Developing Rapport Conducting the Interview Assessing Mental Status Strategies to Elicit Useful Reponses to Questions Common Interviewing Errors Nonverbal Skills Special Interview Situations

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Chapter 6 Documentation

Introduction Legal Issues of a Patient Care Report

Confidentiality and HIPAA Special HIPAA Circumstances

Purposes of Documentation

Continuity of Care Minimum Requirements and Billing EMS Research Incident Review and Quality Assurance

Types of Patient Care Reports Documentation for Every EMS Call

Transfer of Care Care Prior to Arrival

Situations Requiring Additional Documentation

Refusal of Care Reporting Workplace Injury and Illness Documentation Special Circumstances

Completing a Patient Care Report

The PCR Narrative Elements of a Properly Written Report The Effects of Poor Documentation

Errors and Falsification Documenting Incident Times Medical Terminology

Prefixes Suffixes Root Words Medical Abbreviations

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Section 2 The Human Body and Human Systems

Chapter 7 Anatomy and Physiology

Introduction Topographic Anatomy

The Planes of the Body Specific Areas of the Body Directional Terms Movement and Positional Terms Other Directional Terms Anatomic Positions

Atoms, Molecules, and Chemical Bonds

Atomic Structure Molecules Chemical Bonds Types of Chemical Reactions Enzymes Acids, Bases, and the pH Scale

Chemical Constituents of Cells

Inorganic Substances Organic Substances

Cell Physiology

Structure of the Cell

Cellular Transport Mechanisms

Cell Membrane Permeability Diffusion Osmosis Facilitated Diffusion Active Transport

The Cell Life Cycle

Interphase Cell Division and Cytoplasmic Division Differentiation Cell Division and Cancer Facilitating Cellular Metabolism

Types of Tissue

Epithelial Tissues Connective Tissues Muscle Tissues Nervous Tissues

Types of Membranes Organ Systems The Skeletal System: Anatomy

Overview of Bones Joints Growth and Development of Bones The Axial Skeleton The Neck The Spinal Column The Thorax The Appendicular Skeleton The Pelvic Girdle The Lower Extremity

The Skeletal System: Physiology The Musculoskeletal System: Anatomy

Skeletal Muscle Contraction of Skeletal Muscles

The Musculoskeletal System: Physiology The Respiratory System: Anatomy

The Upper Airway The Lower Airway Muscles of Breathing

The Respiratory System: Physiology

Respiration Ventilation Characteristics of Normal Breathing Inadequate Breathing Patterns in Adults

The Circulatory System: Anatomy

The Heart The Vascular System Blood Composition

The Circulatory System: Physiology

Normal Circulation in Adults Inadequate Circulation in Adults The Distribution of Blood

The Lymphatic System

Lymphatic Vessels The Thymus The Spleen Body Defenses and Fighting Infection Innate (Nonspecific) Defenses Immunity (Specific Defenses) The Effects of Aging on the Lymphatic System and Immunity

The Nervous System: Anatomy and Physiology

The Central Nervous System The Peripheral Nervous System Physiology of Sensation

The Integumentary System (Skin): Anatomy

Epidermis Dermis Accessory Structures

The Integumentary System (Skin): Physiology The Digestive System: Anatomy

The Abdomen Mouth Oropharynx Esophagus Stomach Pancreas Liver Small Intestine Large Intestine Appendix Rectum

The Digestive System: Physiology The Endocrine System: Anatomy and Physiology

The Pituitary Gland and the Hypothalamus The Thyroid Gland The Parathyroid Glands The Pancreas The Adrenal Glands The Reproductive Glands and Hormones

The Urinary System: Anatomy and Physiology

The Nephrons Formation of Urine

Body Fluid Balance The Genital System: Anatomy and Physiology

The Male Reproductive System and Organs The Female Reproductive System and Organs

Nutrition, Metabolism, and Body Temperature

Digestion and Absorption of Nutrients Cellular Metabolism Control of Metabolic Reactions Chemical Energy Cellular Respiration Body Temperature

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Chapter 8 Pathophysiology

Introduction Review of the Basic Cellular Systems

Cells Tissues Homeostasis Ligands

Adaptations in Cells and Tissues The Cellular Environment

Distribution of Body Fluids Fluid and Water Balance Fluid and Electrolyte Balance

Acid-Base Balance

Disturbance of Acid-Base Balance Buffer Systems Types of Acid-Base Disorders

Cellular Injury

Hypoxic Injury Chemical Injury Infectious Injury Immunologic and Inflammatory Injury Injurious Genetic Factors Injurious Nutritional Imbalances Injurious Physical Agents or Conditions Apoptosis Abnormal Cell Death

Factors That Cause Disease

Controllable Versus Uncontrollable Risk Factors Analysis of Disease Risk Common Familial Diseases and Associated Risk Factors

Hypoperfusion Types of Shock

Central Shock Peripheral Shock Management of Shock

Multiple Organ Dysfunction Syndrome The Body’s Self-Defense Mechanisms

Anatomic Barriers Immune Response Inflammatory Response Chronic Inflammatory Responses

Variances in Immunity and Inflammation

Hypersensitivity Immune Deficiencies

Stress and Disease

General Adaptation Syndrome Effects of Chronic Stress

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Chapter 9 Life Span Development

Introduction Infants

Physical Changes Psychosocial Changes

Toddlers and Preschoolers

Physical Changes Psychosocial Changes

School-Age Children

Physical Changes Psychosocial Changes

Adolescents (Teenagers)

Physical Changes Psychosocial Changes

Early Adults

Physical Changes Psychosocial Changes

Middle Adults

Physical Changes Psychosocial Changes

Late Adults

Physical Changes Psychosocial Changes

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Section 3 Pharmacology

Chapter 10 Principles of Pharmacology

Introduction Historical Perspective on Medication Administration Medication and Drug Regulation

Sources of Medication Forms of Medication

Medication Management for Paramedics

Medication Names Medication Reference Sources Medication Storage Medication Security

The Physiology of Pharmacology

Principles of Pharmacodynamics Types of Medication Responses Principles of Pharmacokinetics Routes of Medication Administration Distribution of Medication Volume of Distribution Medication Metabolism Medication Elimination

Reducing Medication Errors Important Medications in the Prehospital Setting

Medications Used in Airway Management Medications Used in Respiratory Management Medications Affecting the Cardiovascular System Additional Cardiovascular Medications Blood Products and Medications Affecting the Blood Medications Used for Neurologic Conditions Medications Affecting the Gastrointestinal System Miscellaneous Medications Used in the Prehospital Setting

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Chapter 11 Medication Administration

Introduction Medical Direction

Paramedic’s Responsibility Associated with Drug Orders

Local Drug Distribution System Medical Asepsis

Clean Technique Versus Sterile Technique Antiseptics and Disinfectants

Standard Precautions and Contaminated Equipment Disposal

Standard Precautions Disposal of Contaminated Equipment

Basic Cell Physiology

Body Fluid Composition Fluid and Electrolyte Movement

IV Fluid Composition

Types of IV Solutions

IV Techniques and Administration

Assembling Your Equipment Choosing an IV Solution Choosing an Administration Set Choosing an IV Site Choosing an IV Catheter Inserting the IV Catheter Securing the Line Changing an IV Bag Discontinuing the IV Line Alternative IV Sites and Techniques Pediatric IV Therapy Considerations Geriatric IV Therapy Considerations

Factors Affecting IV Flow Rates Potential Complications of IV Therapy

Local IV Site Reactions and Local Complications Systemic Complications

Obtaining Blood Samples Blood Transfusions Intraosseous Infusion

Equipment for IO Infusion Performing IO Infusion Potential Complications of IO Infusion Contraindications to IO Infusion

Medication Administration

Mathematical Principles Used in Pharmacology Calculating Medication Doses Weight-Based Drug Doses

Calculating Fluid Infusion Rates Calculating the Dose and Rate for a Medication Infusion

Non–Weight-Based Medication Infusions Weight-Based Medication Infusions

Pediatric Drug Doses Enteral Medication Administration

Oral Medication Administration Orogastric and Nasogastric Tube Medication Administration Rectal Medication Administration

Parenteral Medication Administration

Syringes and Needles Packaging of Parenteral Medications Intradermal Medication Administration Subcutaneous Medication Administration Intramuscular Medication Administration IV Bolus Medication Administration IO Medication Administration Percutaneous Medication Administration

Medications Administered by the Inhalation Route

Nebulizer and Metered-Dose Inhaler Endotracheal Medication Administration

Rates of Medication Absorption Prep Kit

Chapter 12 Emergency Medications

Introduction Medication References

AHA Classification of Recommendations and Level of Evidence Pregnancy Category Ratings for Drugs Federal “Controlled Substance Act of 1970” Schedule Summary

Medical Terminology Related to Pharmacology

Drug Dosage Calculations

Medication Listings Drug Profiles

Activated Charcoal (EZ-Char, Actidose, Liqui-Char) Adenosine (Adenocard) Albuterol (Proventil, Ventolin) Alteplase, Recombinant (tissue plasminogen activator or rTPA, Activase) Amiodarone (Cordarone, Pacerone) Amyl Nitrite Aspirin (ASA, Bayer, Ecotrin, St. Joseph, and others) Atenolol (Tenormin) Atropine Sulfate Benzocaine Spray (Hurricane) Bumetanide (Bumex) Calcium Chloride Calcium Gluconate Clopidogrel (Plavix) Dexamethasone Sodium Phosphate (Decadron) Dextrose Diazepam (Valium and others) Digoxin (Lanoxin) Diltiazem (Cardizem) Diphenhydramine (Benadryl) Dobutamine Hydrochloride (Dobutrex) Dolasetron (Anzemet) Dopamine Hydrochloride (Intropin) Epinephrine (Adrenalin) Epinephrine Racemic (Micronefrin) Eptifibatide (Integrilin) Etomidate (Amidate) Fentanyl Citrate (Sublimaze) Flumazenil (Romazicon) Fosphenytoin (Cerebyx) Furosemide (Lasix) Glucagon (GlucaGen) Haloperidol Lactate (Haldol) Heparin Sodium Hydrocortisone Sodium Succinate (Solu-Cortef) Hydroxocobalamin (Cyanokit) Hydroxyzine (Atarax, Vistaril) Insulin Ipratropium (Atrovent) Isoetharine (Bronchosol, Bronkometer) Ketorolac Tromethamine (Toradol) Labetalol (Normodyne, Trandate) Levalbuterol (Xopenex) Lidocaine Hydrochloride (Xylocaine) Lorazepam (Ativan) Magnesium Sulfate Mannitol (Osmitrol) Meperidine Hydrochloride (Demerol) Metaproterenol Sulfate (Alupent) Methylprednisolone Sodium Succinate (Solu-Medrol) Metoprolol Tartrate (Lopressor) Midazolam Hydrochloride (Versed) Morphine Sulfate (Roxanol, MS Contin) Nalbuphine Hydrochloride (Nubain) Naloxone Hydrochloride (Narcan) Nifedipine (Procardia, Adalat) Nitroglycerin (Nitrostat, Nitro-Bid, Tridil) Nitropaste (Nitro-Bid Ointment) Nitrous Oxide 50:50 (Nitronox) Norepinephrine Bitartrate (Levophed) Ondansetron Hydrochloride (Zofran) Oral Glucose (Insta-Glucose) Oxygen Oxytocin (Pitocin) Pancuronium Bromide (Pavulon) Phenobarbital (Luminal) Phenytoin (Dilantin) Pralidoxime (2-PAM, Protopam) Procainamide Hydrochloride (Pronestyl) Promethazine Hydrochloride (Phenergan) Propofol (Diprivan) Propranolol Hydrochloride (Inderal) Rocuronium Bromide (Zemuron) Sodium Bicarbonate Sodium Nitrate Sodium Thiosulfate Streptokinase (Streptase) Succinylcholine Chloride (Anectine) Terbutaline Sulfate (Brethine) Thiamine (Betaxin) Tirofiban Hydrochloride (Aggrastat) Vasopressin (Pitressin) Vecuronium Bromide (Norcuron) Verapamil Hydrochloride (Isoptin, Calan)

IV Solutions (Colloids and Crystalloids)

Plasma Protein Fraction (Plasmanate) Dextran Hetastarch (Hespan) Lactated Ringer’s (Hartmann’s Solution) 5% Dextrose in Water (D5W) 10% Dextrose in Water (D10W) 0.9% Sodium Chloride (normal saline) 0.45% Sodium Chloride (½ normal saline) 5% Dextrose in 0.45% Sodium Chloride (D5½NS) 5% Dextrose in 0.9% Sodium Chloride (D5NS) 5% Dextrose in Lactated Ringer’s (D5LR)

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Section 4 Patient Assessment

Chapter 13 Patient Assessment

Introduction

Sick Versus Not Sick Establishing the Field Impression Medical Versus Trauma

Scene Size-up

Scene Safety Mechanism of Injury or Nature of Illness Standard Precautions

Primary Assessment

Form a General Impression Assess the Airway Assess Breathing Assess Circulation Assess the Patient for Disability Perform a Rapid Exam Make a Transport Decision

History Taking

Purpose Patient Information Techniques for History Taking Responsive Medical Patients Unresponsive Patients Trauma Patients Patients With Minor Injuries or No Significant Mechanism of Injury Review of Body Systems Clinical Reasoning Communication Techniques Getting a History on Sensitive Topics Cultural Competence Special Challenges in History Taking Age-Related Considerations

Secondary Assessment

Assessment Techniques Vital Signs Equipment Used in the Secondary Assessment The Physical Examination The Full-Body Exam The Focused Assessment Secondary Assessment of Unresponsive Patients Secondary Assessment of Trauma Patients Secondary Assessment of Infants and Children Recording Secondary Assessment Findings Limits of the Secondary Assessment Monitoring Devices

Reassessment

Reassessment of Mental Status and the ABCs Reassessment of Patient Care and Transport Priorities

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Chapter 14 Critical Thinking and Clinical Decision Making

Introduction The Cornerstones of Effective Paramedic Practice

Gathering, Evaluating, and Synthesizing Developing and Implementing a Patient Care Plan Using Judgment and Independent Decision Making Thinking and Working Under Pressure

The Range of Patient Conditions Critical Thinking and Clinical Decision Making

Concept Formation Data Interpretation Application of Principle Reflection in Action Reflection on Action

From Theory to Practical Application Taking It to the Streets

1. Read the Scene 2. Read the Patient 3. React 4. Reevaluate 5. Revise the Plan 6. Review Your Performance

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Section 5 Airway Management

Chapter 15 Airway Management and Ventilation

Introduction Anatomy of the Respiratory System

Anatomy of the Upper Airway Anatomy of the Lower Airway

Physiology of Breathing Ventilation

Inhalation Exhalation Regulation of Ventilation Oxygenation Respiration

Pathophysiology of Respiration

Hypoxia Ventilation-Perfusion Ratio and Mismatch Factors Affecting Ventilation Factors Affecting Oxygenation and Respiration Acid-Base Balance

Patient Assessment: Airway Evaluation

Recognizing Adequate Breathing Recognizing Inadequate Breathing Assessment of Breath Sounds Quantifying Ventilation and Oxygenation

Airway Management

Positioning the Patient Manual Airway Maneuvers

Suctioning

Suctioning Equipment Suctioning Techniques

Airway Adjuncts

Oropharyngeal Airway Nasopharyngeal Airway

Airway Obstructions

Causes of Airway Obstruction Recognition of an Airway Obstruction Emergency Medical Care for Foreign Body Airway Obstruction

Supplemental Oxygen Therapy

Oxygen Sources Safety Reminders Oxygen Regulators and Flowmeters Preparing an Oxygen Cylinder for Use

Supplemental Oxygen-Delivery Devices

Nonrebreathing Mask Nasal Cannula Partial Rebreathing Mask Venturi Mask Tracheostomy Masks Oxygen Humidifier

Ventilatory Support

Normal Ventilation Versus Positive-Pressure Ventilation Assisted Ventilation Artificial Ventilation The Bag-Mask Device Manually Triggered Ventilation Devices Automatic Transport Ventilators

Continuous Positive Airway Pressure

Indications for CPAP Contraindications to CPAP Application of CPAP Complications of CPAP

Gastric Distention

Invasive Gastric Decompression

Special Patient Considerations

Laryngectomy, Tracheostomy, Stoma, and Tracheostomy Tubes Dental Appliances Facial Trauma

Advanced Airway Management

Predicting the Difficult Airway Endotracheal Intubation Orotracheal Intubation by Direct Laryngoscopy Nasotracheal Intubation Technique for Nasotracheal Intubation Digital Intubation Transillumination Techniques for Intubation Retrograde Intubation Face-to-Face Intubation Failed Intubation Tracheobronchial Suctioning Field Extubation Pediatric Endotracheal Intubation

Pharmacologic Adjuncts to Airway Management and Ventilation

Sedation in Emergency Intubation Neuromuscular Blockade in Emergency Intubation Pharmacology of Neuromuscular Blocking Agents Rapid-Sequence Intubation

Alternative Advanced Airway Devices

Multilumen Airways Supraglottic Airway Devices

Surgical and Nonsurgical Cricothyrotomy

Open Cricothyrotomy Needle Cricothyrotomy

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Section 6 Medical

Chapter 16 Respiratory Emergencies

Introduction

Epidemiology Hypoventilation Hyperventilation

Anatomy and Physiology

Structures of the Upper Airway Structures of the Lower Airway Functions of the Respiratory System Mechanisms of Respiratory Control

Assessment of a Patient With Dyspnea Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decisions

History Taking

Investigate the Chief Complaint

Secondary Assessment

Physical Examination Vital Signs

Reassessment

Interventions Communication and Documentation

Emergency Medical Care

Ensure an Adequate Airway Decrease the Work of Breathing Provide Supplemental Oxygen Administer a Bronchodilator Administer a Vasodilator Restore Fluid Balance Administer a Diuretic Support or Assist Ventilation Intubate the Patient Inject a Beta-Adrenergic Receptor Agonist Subcutaneously Instill Medication Directly Through an Endotracheal Tube

Pathophysiology, Assessment, and Management of Obstructive Upper Airway Diseases

Anatomic Obstruction Inflammation Caused by Infection Aspiration

Pathophysiology, Assessment, and Management of Obstructive Lower Airway Diseases

Asthma Chronic Obstructive Pulmonary Disease: Emphysema and Chronic Bronchitis

Pathophysiology, Assessment, and Management of Common Respiratory Problems

Pulmonary Infections Atelectasis Cancer Toxic Inhalations Pulmonary Edema Acute Respiratory Distress Syndrome

Pathophysiology, Assessment, and Management of Problems Outside the Lung Parenchyma

Pneumothorax Pleural Effusion Pulmonary Embolism

Age-Related Variations

Anatomy Pathophysiology

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Chapter 17 Cardiovascular Emergencies

Introduction Epidemiology Anatomy and Physiology

Structure and Function The Heart The Blood Vessels The Pump at Work The Electrical Conduction System of the Heart The Autonomic Nervous System and the Heart The Sympathetic Nervous System and Blood Pressure Regulation

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking

Symptoms Medications Commonly Prescribed to Patients with Cardiovascular Diseases

Secondary Assessment

Physical Exam Vital Signs

Reassessment Electrophysiology

Cardiac Monitoring and ECG Use Approach to Dysrhythmia Interpretation Specific Cardiac Dysrhythmias

12-Lead ECGs

Precordial Leads Placement of 12-Lead ECG Electrodes Acquisition Modes Lead Placement 12-Lead ECG Concepts Approach to Interpretation of the 12-Lead ECG

Emergency Medical Care

Treating Dysrhythmias Management of Symptomatic Bradycardia Management of Tachycardia Management of Cardiac Arrest

Pathophysiology, Assessment, and Management of Specific Cardiovascular Problems

Coronary Artery Disease and Angina Acute Myocardial Infarction Congestive Heart Failure Cardiac Tamponade Cardiogenic Shock Aortic Aneurysm Hypertensive Emergencies Infectious Diseases of the Heart

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Chapter 18 Neurologic Emergencies

Introduction Anatomy and Physiology

Structure of the Nervous System

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment

Level of Consciousness Cranial Nerve Functioning Speech Body Movement Sensation Blood Glucose Level Vital Signs

Reassessment

Interventions Communication and Documentation

Pathophysiology, Assessment, and Management of Common Neurologic Emergencies

Stroke Transient Ischemic Attacks Coma Seizures Status Epilepticus Syncope Headache Dementia Neoplasms

Pathophysiology, Assessment, and Management of Demyelinating and Motor Neuron Disorders

Multiple Sclerosis Guillain-Barré Syndrome Amyotrophic Lateral Sclerosis (ALS) Parkinson Disease Cranial Nerve Disorders Dystonia Central Nervous System Infections/Inflammation Abscesses Poliomyelitis and Postpolio Syndrome Peripheral Neuropathy

Pathophysiology, Assessment, and Management of Pediatric Neurologic Conditions

Hydrocephalus Spina Bifida Cerebral Palsy

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Chapter 19 Diseases of the Eyes, Ears, Nose, and Throat

Introduction The Eye

Anatomy and Physiology of the Eye Patient Assessment Pathophysiology, Assessment, and Management of Specific Conditions

The Ear

Anatomy and Physiology of the Ear Patient Assessment Pathophysiology, Assessment, and Management of Ear Injuries

The Nose

Anatomy and Physiology of the Nose Patient Assessment Pathophysiology, Assessment, and Management of Specific Conditions

The Throat

Anatomy and Physiology of the Throat Patient Assessment Pathophysiology, Assessment, and Management of Specific Conditions

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Chapter 20 Abdominal and Gastrointestinal Emergencies

Introduction Anatomy and Physiology Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care

Airway Management Breathing Circulation

Pathophysiology, Assessment, and Management of Specific Abdominal and Gastrointestinal Emergencies Pathophysiology, Assessment, and Management of Gastrointestinal Bleeding

Upper Gastrointestinal Bleeding: Esophagogastric Varices Upper Gastrointestinal Bleeding: Mallory-Weiss Syndrome Upper Gastrointestinal Bleeding: Peptic Ulcer Disease Upper Gastrointestinal Bleeding: Gastroesophageal Reflux Disease (GERD) Lower Gastrointestinal Bleeding: Hemorrhoids Lower Gastrointestinal Bleeding: Anal Fissures

Pathophysiology, Assessment, and Management of Acute Inflammatory Conditions

Cholecystitis and Biliary Tract Disorders Appendicitis Diverticulitis Pancreatitis

Pathophysiology, Assessment, and Management of Chronic Inflammatory Conditions

Ulcerative Colitis Irritable Bowel Syndrome Crohn Disease

Pathophysiology, Assessment, and Management of Acute Infectious Conditions

Acute Gastroenteritis Rectal Abscess Liver Disease: Cirrhosis Liver Disease: Hepatic Encephalopathy

Pathophysiology, Assessment, and Management of Obstructive Conditions

Small-Bowel Obstruction Large-Bowel Obstruction Hernia Rectal Foreign Body Obstruction Mesenteric Ischemia

Gastrointestinal Conditions in Pediatric Patients Gastrointestinal Conditions in Older Adults Prevention Strategies Prep Kit

Chapter 21 Genitourinary and Renal Emergencies

Introduction Anatomy and Physiology

Kidneys Ureters Urinary Bladder Urethra

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Pathophysiology, Assessment, and Management of Specific Emergencies

Pain Urinary Tract Infections Urinary Catheters Urinary Incontinence Renal Calculi (Kidney Stones) Acute Renal Failure Chronic Renal Failure End-Stage Renal Disease Renal Dialysis Male Genital Tract Conditions

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Chapter 22 Gynecologic Emergencies

Introduction Female Reproductive System

Anatomy Menstruation

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care

Management of Gynecologic Trauma

Pathophysiology, Assessment, and Management of Specific Emergencies

Vaginal Bleeding Ectopic Pregnancy Endometritis Endometriosis Pelvic Inflammatory Disease Vaginitis Bartholin Abscess Gardnerella Vaginitis Ruptured Ovarian Cyst, Ovarian Torsion, and Tubo-ovarian Abscess Prolapsed Uterus Toxic Shock Syndrome Sexually Transmitted Diseases Sexual Assault Sexual Practices and Vaginal Foreign Bodies

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Chapter 23 Endocrine Emergencies

Introduction Anatomy and Physiology

Mechanisms of Hormonal Regulation Components of the Endocrine System

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care Pathophysiology, Assessment, and Management of Glucose Metabolic Derangements

Diabetes Mellitus Gestational Diabetes Hypoglycemia Hyperglycemia and Diabetic Ketoacidosis Hyperosmolar Nonketotic Coma

Pathophysiology, Assessment, and Management of Other Disorders of the Pancreas

Pancreatitis

Pathophysiology, Assessment, and Management of Adrenal Insufficiency

Primary Adrenal Insufficiency Secondary Adrenal Insufficiency

Pathophysiology, Assessment, and Management of Other Adrenal Emergencies

Cushing Syndrome Adrenal Gland Tumor Congenital Adrenal Hyperplasia

Pathophysiology, Assessment, and Management of Thyroid, Parathyroid, and Pituitary Gland Disorders

Hypothyroidism and Hyperthyroidism Graves Disease Hashimoto Disease Myxedema Coma Thyrotoxicosis Hyperparathyroidism Panhypopituitarism Diabetes Insipidus Inborn Errors of Metabolism

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Chapter 24 Hematologic Emergencies

Introduction Anatomy and Physiology

Blood and Plasma Blood-Forming Organs and RBC Production The Inflammatory Process The Immune System Blood Classifications Hemostasis

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care Pathophysiology, Assessment, and Management of Specific Emergencies

Sickle Cell Crisis Anemia Leukemia Lymphomas Polycythemia Disseminated Intravascular Coagulation Hemophilia Multiple Myeloma Transfusion Reactions

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Chapter 25 Immunologic Emergencies

Introduction Anatomy and Physiology

The Normal Immune Response Routes of Entry for Allergens Physiology

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Breathing and Airway Circulation Transport Decision

History Taking Secondary Assessment

Physical Examinations Vital Signs

Reassessment

Interventions

Pathophysiology, Assessment, and Management of Specific Emergencies

Anaphylactic Reactions Collagen Vascular Diseases Organ Transplant Disorders

Patient Education

Anaphylaxis Collagen Vascular Diseases and Organ Transplants

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Chapter 26 Infectious Diseases

Introduction Protecting Public Health

Responsibilities of Public Health Agencies Responsibilities of Paramedics

Protecting Health Care Providers

Communicable Disease Transmission Personal Protective Equipment and Practices Postexposure Medical Follow-up

Patient Assessment Pathophysiology, Assessment, and Management of Common Infectious Diseases

Chain of Infection Exposure and the Risk of Infection General Management Principles Meningitis Tuberculosis Pneumonia Respiratory Syncytial Virus Other Respiratory Conditions Mononucleosis Seasonal Influenza

Pathophysiology, Assessment, and Management of Sexually Transmitted Diseases

Gonorrhea Syphilis Genital Herpes Chlamydia Scabies Lice

Pathophysiology, Assessment, and Management of Common Bloodborne Diseases

Types of Viral Hepatitis Hepatitis B Virus Infection Hepatitis C Virus Infection Hepatitis D Virus Infection Human Immunodeficiency Virus Infection Acquired Immunodeficiency Syndrome

Pathophysiology, Assessment, and Management of Enteric (Intestinal) Diseases

Norovirus Infection Hepatitis A Virus Infection Hepatitis D Virus Infection Hepatitis E Virus Infection

Pathophysiology, Assessment, and Management of Vector-borne and Zoonotic (Animal-borne) Diseases

Introduction West Nile Virus Lyme Disease Rocky Mountain Spotted Fever Hantavirus Infection Rabies Tetanus

Pathophysiology, Assessment, and Management of Infection With Antibiotic-Resistant Organisms

Methicillin-Resistant Staphylococcus aureus Vancomycin-Resistant Staphylococcus aureus Vancomycin-Resistant Enterococci Clostridium difficile

Pathophysiology, Assessment, and Management of Common Communicable Diseases of Childhood

Bronchiolitis Croup Measles Rubella Mumps Chickenpox Pertussis

Pathophysiology, Assessment, and Management of New and Emerging Diseases

Severe Acute Respiratory Syndrome Avian Flu

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Chapter 27 Toxicology

Introduction Types of Toxicologic Emergencies Poison Centers Anatomy and Physiology

Routes of Absorption Understanding and Using Toxidromes Overview of Substance Abuse

Patient Assessment Scene Size-up Primary Assessment History Taking Secondary Assessment Reassessment Emergency Medical Care Pathophysiology, Assessment, and Management of Abuse of and Overdose With Specific Substances

Alcohol Stimulants Marijuana and Cannabis Compounds Hallucinogens Sedatives and Hypnotics Narcotics, Opiates, and Opioids Cardiac Medications Organophosphates Carbon Monoxide Chlorine Gas Cyanide Caustics Common Household Items Drugs Abused for Sexual Purposes Poisonous Alcohols Hydrocarbons Hydrofluoric Acid/Hydrogen Fluoride Hydrogen Sulfide Oxides of Nitrogen Psychiatric Medications Nonprescription Pain Medications Theophylline Metals and Metalloids Poisonous Plants Poisonous Mushrooms Food Poisoning

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Chapter 28 Psychiatric Emergencies

Introduction Definition of Behavioral Emergency Prevalence Medicolegal Considerations Pathophysiology

Causes of Abnormal Behavior Psychiatric Signs and Symptoms

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care

Communication Techniques Crisis Intervention Skills Use of Force and Types of Restraint

Pathophysiology, Assessment, and Management of Specific Emergencies

Acute Psychosis Agitated Delirium Suicidal Ideation Patterns of Violence, Abuse, and Neglect Specific Psychiatric Disorders

Medications for Psychiatric Disorders and Behavioral Emergencies

Psychiatric Medication Types Problems Associated With Medication Noncompliance Emergency Use of Medications

Special Populations

Pediatric Behavioral Problems Geriatric Behavioral Problems

Prep Kit

Section 7 Trauma

Chapter 29 Trauma Systems and Mechanism of Injury

Introduction Trauma, Energy, and Kinetics

Factors Affecting Types of Injury Kinetics

Blunt Trauma

Motor Vehicle Crashes Motorcycle Crashes Pedestrian Injuries Falls From Heights

Penetrating Trauma

Stab Wounds Gunshot Wounds

Blast Injuries

Primary Blast Injuries Secondary Blast Injuries Tertiary Blast Injuries Quaternary (Miscellaneous) Blast Injuries Quinary Blast Injuries The Physics of an Explosion Tissues at Risk

Multisystem Trauma Trauma Score Revised Trauma Score General Assessment of Trauma Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment

Vital Signs Physical Examinations

Reassessment Management of Trauma

Criteria for Referral to a Trauma Center Mode of Transport

Prep Kit

Chapter 30 Bleeding

Introduction Anatomy and Physiology

Structures of the Heart Blood Flow Within the Heart and Lungs The Cardiac Cycle Blood and Its Components Blood Circulation and Perfusion

Pathophysiology of Hemorrhage

External Hemorrhage Internal Hemorrhage The Significance of Hemorrhage Physiologic Response to Hemorrhage

Shock

Hemorrhagic Shock

Patient Assessment Scene Size-up Primary Assessment History Taking Secondary Assessment Reassessment Emergency Medical Care of Bleeding and Hemorrhagic Shock

Managing External Hemorrhage Special Management Techniques for External Hemorrhage Managing Internal Hemorrhage Management of Hemorrhagic Shock

Prep Kit

Chapter 31 Soft-Tissue Trauma

Introduction Incidence, Mortality, and Morbidity Structure and Function of the Skin

Epidermis Dermis Subcutaneous Tissue Deep Fascia Skin Tension Lines

General Pathophysiology: Closed-Versus Open Wounds

Closed Wounds Open Wounds Crush Injuries Blast Injury

Wound Healing

The Process of Wound Healing Alterations of Wound Healing Pathophysiology of Wound Healing

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care

Treatment of Closed Wounds Treatment of Open Wounds: General Principles Bandaging and Dressing Wounds Complications of Improperly Applied Dressings Control of External Bleeding Pain Control Managing Wound Healing and Infection Dressing Specific Anatomic Sites

Pathophysiology, Assessment, and Management of Specific Injuries

Abrasions Lacerations Puncture Wounds Avulsions Amputations Bite Wounds Crush Syndrome Compartment Syndrome High-Pressure Injection Injuries

Pathophysiology, Assessment, and Management of Soft-Tissue Injuries to Specific Anatomic Sites

Facial and Neck Injuries Thoracic Injuries Abdominal Injuries

Prep Kit

Chapter 32 Burns

Introduction Anatomy and Physiology of the Skin

Layers of the Skin The Eye

Pathophysiology

Burn Shock Thermal Burns Burn Depth Inhalation Burns and Intoxication

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Assess Burn Severity Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care

General Management Fluid Resuscitation Pain Management Burn Shock Thermal Burns Thermal Inhalation Burns

Pathophysiology, Assessment, and Management of Specific Burns

Chemical Burns of the Skin Inhalation Burns From Other Toxic Chemicals Chemical Burns of the Eye Electrical Burns and Associated Injuries Lightning-Related Injuries Radiation Burns

Management of Burns in Pediatric Patients Management of Burns in Geriatric Patients Long-Term Consequences of Burns

The Patient The Provider

Prep Kit

Chapter 33 Face and Neck Trauma

Introduction Anatomy and Physiology

The Facial Bones The Eyes, Ears, Teeth, and Mouth The Anterior Region of the Neck

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care Pathophysiology, Assessment, and Management of Face Injuries

Pathophysiology Assessment Management

Pathophysiology, Assessment, and Management of Eye Injuries

Pathophysiology Assessment Management

Pathophysiology, Assessment, and Management of Ear Injuries

Pathophysiology Assessment and Management

Pathophysiology, Assessment, and Management of Oral and Dental Injuries

Pathophysiology Assessment and Management

Pathophysiology, Assessment, and Management of Injuries to the Anterior Part of the Neck

Pathophysiology Assessment Management

Pathophysiology, Assessment, and Management of Spine Trauma

Pathophysiology Assessment Management

Injury Prevention Prep Kit

Chapter 34 Head and Spine Trauma

Introduction Anatomy and Physiology

The Scalp The Skull The Brain The Meninges The Spine

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment

Placement on the Backboard Level of Consciousness Pupillary Assessment Assessing ICP Neurologic Exam

Reassessment Pathophysiology, Assessment, and Management of Head Injuries

Skull Fracture Traumatic Brain Injury Assessment and Management

Pathophysiology, Assessment, and Management of Scalp Lacerations

Assessment and Management

Pathophysiology, Assessment, and Management of Spine Injuries

Mechanism of Injury Categories of Spinal Cord Injuries Assessment and Management Pharmacotherapy of Spinal Cord Injury Complications of Spinal Cord Injury

Nontraumatic Spinal Conditions Injury Prevention Prep Kit

Chapter 35 Chest Trauma

Introduction Anatomy Physiology Pathophysiology Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care Pathophysiology, Assessment, and Management of Chest Wall Injuries

Flail Chest Rib Fractures Sternal Fractures Clavicle Fractures

Pathophysiology, Assessment, and Management of Lung Injuries

Simple Pneumothorax Open Pneumothorax Tension Pneumothorax Hemothorax Pulmonary Contusion

Pathophysiology, Assessment, and Management of Myocardial Injuries

Cardiac Tamponade Myocardial Contusion Myocardial Rupture Commotio Cordis

Pathophysiology, Assessment, and Management of Vascular Injuries

Traumatic Aortic Disruption Great Vessel Injury

Pathophysiology, Assessment, and Management of Other Thoracic Injuries

Diaphragmatic Injuries Esophageal Injuries Tracheobronchial Injuries Traumatic Asphyxia

Prep Kit

Chapter 36 Abdominal and Genitourinary Trauma

Introduction Anatomy and Physiology

Anatomic Regions Abdominal Organs and Vital Vessels Organs of the Genitourinary System The Diaphragm Physiology

Mechanism of Injury

Blunt Trauma Penetrating Trauma Motor Vehicle Crashes Motorcycle Falls or Crashes Falls From Heights Blast Injuries

General Pathophysiology Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Emergency Medical Care

Evisceration Impaled Objects

Pathophysiology, Assessment, and Management of Specific Injuries

Pathophysiology Assessment Management

Pathophysiology, Assessment, and Management of Injuries to the Male Genitalia

Pathophysiology Assessment Management

Pathophysiology, Assessment, and Management of Injuries to the Female Genitalia

Pathophysiology Assessment Management

Prep Kit

Chapter 37 Orthopaedic Trauma

Introduction Anatomy and Physiology of the Musculoskeletal System

Functions of the Musculoskeletal System The Body’s Scaffolding: The Skeleton Characteristics and Composition of Bone Joints Skeletal Connecting and Supporting Structures The Moving Forces: Muscles Muscle Innervation Musculoskeletal Blood Supply

Patterns and Mechanisms of Musculoskeletal Injury

Injury Forces and Motions

Pathophysiology

Fractures Ligament Injuries and Dislocations Muscle and Tendon Injuries Injuries That May Signify Fractures

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment

Pain Inspection Palpation Motor Function and Sensory Exam

Reassessment Emergency Medical Care

Volume Deficit Due to Musculoskeletal Injuries Pain Control Cold and Heat Application Splinting

Pathophysiology, Assessment, and Management of Pediatric Fractures

Assessment and Management

Pathophysiology, Assessment, and Management of Complications of Musculoskeletal Injuries

Vascular and Neurovascular Injuries Compartment Syndrome Crush Syndrome Thromboembolic Disease

Pathophysiology, Assessment, and Management of Specific Fractures

Shoulder Girdle Midshaft Humerus Fractures Elbow Forearm Wrist and Hand Pelvis Hip Femoral Shaft Knee Tibia and Fibula Ankle Calcaneus

Pathophysiology, Assessment, and Management of Ligament Injuries and Dislocations

Shoulder Girdle Injuries and Dislocations Elbow Dislocation Wrist and Hand Dislocation Finger Dislocation Hip Dislocation Knee Dislocation Tendon Lacerations, Transections, and Ruptures Achilles Tendon Rupture

Pathophysiology, Assessment, and Management of Nontraumatic Musculoskeletal Disorders

Bony Abnormalities Disorders of the Spine Cauda Equina Syndrome Spinal Stenosis Joint Abnormalities Muscle Disorders Overuse Syndromes Soft-Tissue Infections

Prep Kit

Chapter 38 Environmental Emergencies

Introduction Anatomy and Physiology

Homeostasis and Body Temperature Thermoregulatory Mechanisms Physiologic Responses to Heat and Cold

Pathophysiology, Assessment, and Management of Heat Illness

Risk Factors for Heat Illness Heat Cramps Heat Syncope Heat Exhaustion Heatstroke

Pathophysiology, Assessment, and Management of Cold Injuries

Local Cold Injury/Frostbite Trench Foot and Chilblains Hypothermia

Pathophysiology, Assessment, and Management of Drowning

Pathophysiology Assessment Management

Pathophysiology, Assessment, and Management of Diving Injuries

General Pathophysiology: Physical Principles of Pressure Effects General Assessment: Diving History Injuries at Depth Injuries During Descent and Ascent Other Gas-Related Problems Shallow Water Blackout Getting Help for Diving Injuries

Pathophysiology, Assessment, and Management of Altitude Illness

Pathophysiology Assessment Management

Pathophysiology, Assessment, and Management of Lightning Strike

Pathophysiology Assessment and Management

Pathophysiology, Assessment, and Management of Envenomation: Bites and Stings

Hymenoptera Snake Bites Spider Bites Scorpion Stings Tick Bites

Prep Kit

Section 8 Shock and Resuscitation

Chapter 39 Responding to the Field Code

Introduction Improving the Response to Cardiac Arrest

The Chain of Survival Developing Prehospital Program Objectives: The SMART Way Simulation Training, or “Mock Code” Training Development of New CPR Guidelines

Adult CPR

Two or More Rescuer CPR

CPR for Infants and Children

Technique for Children Technique for Infants

Defibrillation

Manual Defibrillation Automated External Defibrillation Shockable ECG Rhythms Shock First or Compressions First? Effective Shocks and Special Circumstances

The Advanced Cardiac Life Support Algorithm

Managing Patients in Ventricular Fibrillation or Ventricular Tachycardia Managing Patients in Pulseless Electrical Activity or Asystole

Mechanical Adjuncts to Circulation

Impedance Threshold Device Load-Distributing Band CPR or Vest CPR Device Thumper CPR Device Mechanical Piston Device

Postresuscitative Care When to Start and When to Stop CPR

Terminating Resuscitative Efforts Termination Rules

Scene Choreography and Teamwork

Code Team Member and Code Team Leader Roles

Plan for a Code Prep Kit

Chapter 40 Management and Resuscitation of the Critical Patient

Introduction Developing Critical Thinking and Decision-Making Abilities

Critical Patients The EMS Approach to Diagnosis The Role of Intuition in Critical Decision Making Bias to Decision Making

A Snapshot of Critical Decision Making Shock: The Critical Patient Evolving In Front of You Anatomy and Physiology of Perfusion

Respiration and Oxygenation Regulation of Blood Flow

Pathophysiology of Shock

Compensation for Decreased Perfusion Shock-Related Events at the Capillary and Microcirculatory Levels Multiple-Organ Dysfunction Syndrome

Causes of Shock The Progression of Shock

Compensated Shock Decompensated Shock Irreversible (Terminal) Shock

Patient Assessment of Shock Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment

Special Considerations for Assessing Shock Pediatric Considerations Geriatric Considerations

Emergency Medical Care of a Patient With Suspected Shock

IV Therapy

Pathophysiology, Assessment, and Management of Specific Types of Shock

Cardiogenic Shock Obstructive Shock Distributive Shock Hypovolemic Shock Respiratory Insufficiency

Transportation of Shock Patients Prevention Strategies Prep Kit

Section 9 Special Patient Populations

Chapter 41 Obstetrics

Introduction Anatomy and Physiology of the Female Reproductive System Conception and Fetal Development Physiologic Maternal Changes During Pregnancy Cultural Value Considerations

Adolescent Pregnancy

Patient Assessment Scene Size-up Primary Assessment

Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Pathophysiology, Assessment, and Management of Complications Related to Pregnancy

Substance Abuse Supine Hypotensive Syndrome Cardiac Conditions Hypertensive Disorders Seizures Diabetes Respiratory Disorders Hyperemesis Gravidarum Renal Disorders Rh Sensitization Infections

Pathophysiology, Assessment, and Management of Bleeding Related to Pregnancy

Pathophysiology Assessment and Management

Normal Childbirth

Stages of Labor Maternal and Fetal Response to Labor Preparing for Delivery Assisting Delivery Postpartum Care

Emergency Pharmacology in Pregnancy

Magnesium Sulfate Calcium Chloride Terbutaline Valium Diphenhydramine Oxytocin

Pathophysiology, Assessment, and Management of Complications of Labor

Premature Rupture of Membranes Preterm Labor Fetal Distress Uterine Rupture

Pathophysiology, Assessment, and Management of High-Risk Pregnancy Considerations

Precipitous Labor and Birth Post-Term Pregnancy Meconium Staining Fetal Macrosomia Multiple Gestation Intrauterine Fetal Death Amniotic Fluid Embolism Hydramnios Cephalopelvic Disproportion

Pathophysiology, Assessment, and Management of Complications of Delivery

Cephalic Presentation Breech Presentations Shoulder Dystocia Nuchal Cord Prolapsed Umbilical Cord

Pathophysiology, Assessment, and Management of Postpartum Complications

Uterine Inversion Postpartum Hemorrhage Pulmonary Embolism Postpartum Depression

Trauma and Pregnancy

Pathophysiology and Assessment Considerations Considerations for the Fetus and Trauma Management of the Pregnant Trauma Patient

Prep Kit

Chapter 42 Neonatal Care

Introduction General Pathophysiology and Assessment

Transition from Fetus to Newborn Arrival of the Newborn The Apgar Score Algorithm for Neonatal Resuscitation

Specific Intervention and Resuscitation Steps

Drying and Stimulation Airway Management Circulation

Pharmacologic Interventions

Bradycardia Low Blood Volume Acidosis Respiratory Depression Secondary to Narcotics Hypoglycemia

Family and Transport Considerations Pathophysiology, Assessment, and Management of Specific Conditions

Apnea Bradycardia Pneumothorax Evacuation Meconium-Stained Amniotic Fluid Diaphragmatic Hernia Respiratory Distress and Cyanosis Premature and Low Birth Weight Infants Seizures in the Newborn Hypoglycemia Vomiting Diarrhea Neonatal Jaundice

Pathophysiology, Assessment, and Management of Conditions Related to Thermoregulation

Fever Hypothermia

Pathophysiology, Assessment, and Management of Common Birth Injuries in the Newborn Pathophysiology, Assessment, and Management of Cardiac Conditions in Newborns

Pathophysiology Assessment and Management

Prep Kit

Chapter 43 Pediatric Emergencies

Introduction Developmental Stages

Neonate and Infant Toddler Preschool-Age Child School-Age Child (Middle Childhood) Adolescence

Pediatric Anatomy, Physiology, and Pathophysiology

The Head The Neck and Airway The Respiratory System The Cardiovascular System The Nervous System The Abdomen and Pelvis The Musculoskeletal System The Chest and Lungs The Integumentary System Metabolic Differences

Parents of Ill or Injured Children Pediatric Patient Assessment Scene Size-up Primary Assessment

Using the Pediatric Assessment Triangle to Form a General Impression Hands-on ABCs Transport Decision

History Taking Secondary Assessment Reassessment Pathophysiology, Assessment, and Management of Respiratory Emergencies

Respiratory Arrest, Distress, and Failure Upper Airway Emergencies Lower Airway Emergencies Other Respiratory Conditions General Assessment and Management of Respiratory Emergencies Cardiopulmonary Arrest

Pathophysiology, Assessment, and Management of Shock

Hypovolemic Shock Distributive Shock Cardiogenic Shock

Pathophysiology, Assessment, and Management of Cardiovascular Emergencies

Dysrhythmias Congenital Heart Disease Congestive Heart Failure General Assessment and Management of Cardiovascular Emergencies

Pathophysiology, Assessment, and Management of Neurologic Emergencies

Altered LOC and Mental Status Seizures Meningitis Hydrocephalus Closed Head Injuries

Pathophysiology, Assessment, and Management of Gastrointestinal Emergencies

Neonatal Jaundice Biliary Atresia Viral Gastroenteritis Appendicitis Ingestion of Foreign Bodies Gastrointestinal Bleeding Intussusception Meckel Diverticulum Pyloric Stenosis and Malrotation With Volvulus General Assessment and Management of Gastrointestinal Emergencies

Pathophysiology, Assessment, and Management of Endocrine Emergencies

Hyperglycemia Hypoglycemia Congenital Adrenal Hyperplasia Panhypopituitarism Inborn Errors of Metabolism

Pathophysiology, Assessment, and Management of Hematologic, Oncologic, and Immunologic Emergencies

Sickle Cell Disease Bleeding Disorders Leukemia/Lymphoma

Pathophysiology, Assessment, and Management of Toxicologic Emergencies

Assessment of Toxicologic Emergencies Management of Toxicologic Emergencies

Pathophysiology, Assessment, and Management of Psychiatric and Behavioral Emergencies

Safety Assessment and Management of Psychiatric and Behavioral Emergencies

Pathophysiology, Assessment, and Management of Fever Emergencies Child Abuse and Neglect

Risk Factors for Abuse Suspecting Abuse or Neglect Assessment and Management of Abuse and Neglect

Sudden Infant Death Syndrome

Assessment and Management of SIDS

Apparent Life-Threatening Event Pathophysiology, Assessment, and Management of Pediatric Trauma Emergencies

Pathophysiology of Traumatic Injuries Assessment and Management of Traumatic Injuries Transport Considerations History Taking and Secondary Assessment Fluid Management Pain Management

Pathophysiology, Assessment, and Management of Burns

Assessment and Management of Burns

Children With Special Health Care Needs

Technology-Assisted Children Assessment and Management of Children With Special Health Care Needs Transport of Children With Special Health Care Needs

An Ounce of Prevention

Emergency Medical Services for Children Prevention of Injuries

Prep Kit

Chapter 44 Geriatric Emergencies

Introduction Geriatric Anatomy and Physiology

Changes in the Respiratory System Changes in the Cardiovascular System Changes in the Nervous System Changes in the Digestive System Changes in the Renal System Changes in the Endocrine System Changes in the Immunologic System Changes in the Integumentary System Homeostatic and Other Changes Changes in the Musculoskeletal System

Geriatric Patient Assessment Scene Size-up Primary Assessment

Using the GEMS Diamond to Form a General Impression Airway and Breathing Circulation Transport Decision

History Taking Secondary Assessment Reassessment Pathophysiology, Assessment, and Management of Respiratory Conditions

Pneumonia Chronic Obstructive Pulmonary Disease Asthma Pulmonary Embolism

Pathophysiology, Assessment, and Management of Cardiovascular Conditions

Myocardial Infarction Congestive Heart Failure Dysrhythmias Hypertension Aneurysms Traumatic Aortic Disruption Stroke Transient Ischemic Attack

Pathophysiology, Assessment, and Management of Neurologic Conditions

Delirium Dementia Alzheimer Disease Parkinson Disease Seizures

Pathophysiology, Assessment, and Management of Gastrointestinal Conditions

Bowel Obstruction Biliary Diseases Peptic Ulcer Disease Gastrointestinal Bleeding

Pathophysiology, Assessment, and Management of Renal Conditions

Urinary Tract Infections Renal Failure Incontinence

Pathophysiology, Assessment, and Management of Endocrine Conditions

Diabetic Disorders Thyroid Disorders

Pathophysiology, Assessment, and Management of Immunologic Conditions Pathophysiology, Assessment, and Management of Toxicologic Conditions

Polypharmacy and Medication Noncompliance Pharmacokinetics Drug and Alcohol Abuse

Pathophysiology, Assessment, and Management of Psychological Conditions Pathophysiology, Assessment, and Management of Integumentary Conditions

Herpes Zoster Cellulitis Pressure Ulcers

Pathophysiology, Assessment, and Management of Musculoskeletal Conditions

Osteoporosis Arthritis

Management of Medical Emergencies in Elderly People Pathophysiology, Assessment, and Management of Geriatric Trauma Emergencies

Pathophysiology Assessment and Management of Trauma

Elder Abuse End-of-Life Care Prep Kit

Chapter 45 Patients With Special Challenges

Introduction

General Strategies for Patients With Special Challenges

EMS, Health Care, and Poverty Care of Patients With Suspected Abuse and Neglect

Epidemiology Definitions Recognizing Abuse or Neglect Benign Physical Findings Management of Suspected Abuse or Neglect

Care of Patients With Terminal Illness

Advance Directives

Care of Bariatric Patients

Clinical Concerns for the Bariatric Patient Operational Concerns for the Bariatric Patient

Care of Patients With Communicable Diseases Medical Technology in the Prehospital Setting

Tracheostomy Tubes Long-Term Ventilators Ventricular Assist Devices Apnea Monitors Long-Term Vascular Access Devices Medication Infusion Pumps Insulin Pumps Tube Feeding Colostomy Urostomy/Urinary Diversion Urinary Catheterization Dialysis Surgical Drains and Devices Cerebrospinal Fluid Shunts

Medical Technology Used During Interfacility Transport

Hemodynamic Monitoring Intra-Aortic Balloon Pumps Intracranial Pressure Monitor

Care of Patients With Cognitive, Sensory, or Communication Impairment

Developmental Disability Developmental Delay Down Syndrome Mental Retardation Autism Mental/Emotional Impairment Hearing Impairment Visual Impairment Speech Impairment Paralysis, Paraplegia, and Quadriplegia Trauma in Cognitively Impaired Patients

Other Notable Chronic Medical Conditions

Arthritis Cancer Cerebral Palsy Cystic Fibrosis Multiple Sclerosis Muscular Dystrophy Myasthenia Gravis Myelomeningocele (Spina Bifida) Poliomyelitis/Postpolio Syndrome Systemic Lupus Erythematosus Traumatic Brain Injury

Conclusion Prep Kit

Section 10 Operations

Chapter 46 Transport Operations

Introduction Emergency Vehicle Design Ambulance Equipment Checking the Ambulance Ambulance Staffing and Development

Ambulance and EMS Systems System Status Management Ambulance Stationing

Mitigating Hazards Throughout the Call

En Route to the Scene Arrival at the Scene Traffic Control Securing Equipment Safe Patient Transfer Postrun Activities: Restocking, Cleaning, and Disinfection

Defensive Ambulance Driving Techniques

Driver Characteristics Safe Driving Practices Emergency Vehicle Control Braking Controlled Braking Laws and Regulations

Air Medical Transports

Rotor-Wing Versus Fixed-Wing Air Ambulances Advantages of Using Air Ambulances Disadvantages of Using Air Ambulances Helicopter Medical Evacuation Operations Establishing a Landing Zone Landing Zone Safety and Patient Transfer Communicating With Other Agencies Special Considerations

Prep Kit

Chapter 47 Incident Management and Multiple-Casualty Incidents

Introduction The NIMS The Incident Command System

Incident Command System Roles and Responsibilities Communications and Information Management Mobilization and Deployment

EMS Response Within the Incident Command System

Preparedness Scene Size-up Establishing Command Communications

Medical Incident Command

Triage Supervisor Treatment Supervisor Transportation Supervisor Staging Supervisor Physicians on Scene Rehabilitation Supervisor Extrication and Special Rescue Morgue Supervisor

Multiple-Casualty Incidents Triage

Triage Categories Triage Tags START Triage JumpSTART Triage for Pediatric Patients Triage Special Considerations Destination Decisions

Critical Incident Stress Management

After-Action Reviews

Prep Kit

Chapter 48 Vehicle Extrication and Special Rescue

Introduction Awareness Guidelines for Rescue Operations Steps of Special Rescue

Preparation Response Arrival and Scene Size-up Stabilization of the Scene Access Disentanglement Removal Transport

Vehicle Extrication

Vehicle Anatomy and Structural Components Alternative Powered Vehicles Hazardous Materials Hand Tools Vehicle Stabilization Gaining Access to the Patient Disentangling the Patient

Additional Specialized Rescue Situations

Confined Spaces Trenches Water Spinal Injuries in Submersion Incidents Rope Rescue Wilderness Search and Rescue Lost Person Search and Rescue Structure Fires Agricultural and Industrial Rescue Tactical Emergency Medical Support

Patient Care

Pain Management Medical Supplies Patient Packaging

Prep Kit

Chapter 49 Hazardous Materials

Introduction Regulations and Standards Paramedics and Hazardous Materials Incidents Scene Size-up

Identification of Hazardous Materials Containers Roadway Transportation of Hazardous Materials Establishing Safety Zones Personal Protective Equipment

Contamination and Toxicology

Primary and Secondary Contamination Routes of Exposure Chemical Terms Toxicology Terms

Decontamination and Treatment

Decontamination Mass Decontamination Technical Decontamination Treatment of Patients Exposed to Hazardous Materials Transportation Considerations

Medical Monitoring and Rehabilitation Prep Kit

Chapter 50 Terrorism

Introduction Terrorism

International Terrorism Domestic Terrorism Types of Terrorist Organizations

Paramedic Response to Terrorism

Recognizing a Terrorist Event (Indicators) Response Actions

Weapons of Mass Destruction Explosives/Incendiary Weapons

Ammonium Nitrate or “Fertilizer” Bombs Suicide Bombers (Human Bombs)

Chemical Agents

Vesicants (Blister Agents) Pulmonary Agents (Choking Agents) Nerve Agents Industrial Chemicals/Insecticides

Biologic Agents

Viruses Bacteria Neurotoxins Other Paramedic Roles During a Biologic Event

Radiologic/Nuclear Devices

Radiation Sources of Radiologic Material Radiologic Dispersal Devices

Prep Kit

Chapter 51 Disaster Response

Introduction Disaster Response Planning

Phases of a Disaster Response Plan

Natural Disasters

Forest and Brush Fires Snow and Ice Storms Tornadoes Hurricanes Tsunamis Earthquakes Landslides, Avalanches, and Mudslides Cave-ins Volcanic Eruptions Flooding Sandstorms and Dust Storms Prolonged Cold Weather Drought Heat Wave Meteors and Space Debris Pandemics

Man-Made Disasters

Structural Fires Construction Failures and Building Collapse Power Failures or Disruptions Riots, Civil Disturbances, and Stampedes Strikes and Labor Disputes Sniper, Shooter, and Hostage Situations Explosions IT (Cyber) Disruptions

Prep Kit

Chapter 52 Crime Scene Awareness

Introduction Awareness

Paramedics Mistaken for Law Enforcement Personnel Body Armor Indicators of Violence Standard Operating Procedures

Highway and Rural Road Incidents

Approach and Vehicle Positioning Approaching the Motor Vehicle Retreating From Danger

Residential Incidents

Warning Signs Approaching a Residence Entering a Residence Domestic Violence

Violence on the Streets

Clandestine Drug Laboratories Gangs Mass Shootings, Active Shooters, and Snipers Hostage Situations

Contact and Cover

Using Walls as Cover Evasive Tactics Concealment Techniques

Self-Defense

Self-Defense in Armed Encounters

Crime Scenes

Preserving Evidence

Prep Kit

Glossary Index Credits

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