Mosby's Paramedic Textbook by Sanders, Mick J. -- Read -- Imperial Library of Trantor

Index

About the Author and Contributors Title Page Copyright Dedication Preface Author Acknowledgments Publisher Acknowledgments Contents Part One: Preparatory

1 EMS Systems: Roles, Responsibilities, and Professionalism

Emergency Medical Services System Development Current Medical Services Systems EMS Education Emergency Medical Services Personnel Levels National Emergency Medical Services Group Involvement Licensure, Certification, and Registration Professionalism Roles and Responsibilities of the Paramedic Medical Direction for Emergency Medical Services Improving System Quality Patient Safety

2 Well-Being of the Paramedic

Wellness Components Stress Dealing with Death, Dying, Grief, and Loss Prevention of Disease Transmission

3 Injury Prevention and Public Health

Injury Epidemiology Overview of Injury Prevention Basic Principles of Public Health Feasibility of Emergency Medical Services Involvement in Public Health Participation in Prevention Programs

4 Documentation

Importance of Documentation General Considerations The Narrative Elements of a Properly Written EMS Document Systems of Narrative Writing Special Considerations in Documentation Document Revision and Correction Consequences of Inappropriate Documentation

5 EMS Communications

Phases of Communications during a Typical EMS Event Role of Communications in Emergency Medical Services Communications Systems Components and Functions of Dispatch Communications Systems Regulation Procedures for EMS Communications

6 Medical and Legal Issues

Legal Duties and Ethical Responsibilities The Legal System Legal Accountability of the Paramedic Paramedic-Patient Relationships Resuscitation Issues Crime Scene Responsibilities Documentation

7 Ethics

Ethics Overview Rapid Approach to Ethical Problems in an Emergency Ethical Tests in Health Care Resolving Ethical Dilemmas Ethical Issues in Paramedic Practice Consent Other Ethical Principles for Patient Care Situations

8 Research Principles and Evidence-Based Practice

EMS Research Basic Principles of Research Evidence-Based Practice

Part Two: Anatomy and Physiology

9 Medical Terminology

The Language of Medicine Word Parts of Medical Terminology Plural Forms of Medical Terms Medical Abbreviations, Acronyms, and Symbols Pronunciation of Medical Terms

10 Review of Human Systems

Terminology Cell Structure Body Tissues Organ Systems Special Senses

11 General Principles of Pathophysiology

Section One: Cellular Physiology Basic Cellular Review Cellular Environment Section Two: Cellular Injury and Disease Alterations in Cells and Tissues Hypoperfusion Self-Defense Mechanisms Variances in Immunity and Inflammation Stress and Disease Genetics and Familial Diseases

12 Life Span Development

Newborn Toddler and Preschool Years School-Age Years Adolescence Early Adulthood Middle Adulthood Late Adulthood

Part Three: Pharmacology

13 Principles of Pharmacology and Emergency Medications

Section One: Drug Information Historical Trends in Pharmacology Section Two: Mechanisms of Drug Action General Properties of Drugs Drug Interactions Drug Forms, Preparations, and Storage Drug Profiles and Special Considerations in Drug Therapy Section Three: Drugs That Affect the Nervous System Review of Anatomy and Physiology Section Four: Drugs That Affect the Cardiovascular System Review of Anatomy and Physiology Section Five: Drugs That Affect the Blood Anticoagulants, Fibrinolytics, and Blood Components Section Six: Drugs That Affect the Respiratory System Review of Anatomy and Physiology Section Seven: Drugs That Affect the Gastrointestinal System Review of Anatomy and Physiology Section Eight: Drugs That Affect the Eye and Ear Treatment of Eye Disorders Section Nine: Drugs That Affect the Endocrine System Review of Anatomy and Physiology Section Ten: Drugs That Affect the Reproductive System Treatment of Disorders of the Reproductive System Section Eleven: Drugs Used in Neoplastic Diseases Antineoplastic Agents Section Twelve: Drugs Used in Infectious Disease and Inflammation Treatment of Infectious Disease and Inflammation Section Thirteen: Drugs That Affect the Immunological System Review of Anatomy and Physiology

14 Venous Access and Medication Administration

Mathematical Equivalents Used in Pharmacology Drug Calculations Drug Administration Medical Asepsis Universal Precautions in Medication Administration Enteral Administration of Medications Parenteral Administration of Medications Administration of Percutaneous Medications Special Considerations for Pediatric Patients Obtaining a Blood Sample Disposal of Contaminated Items and Sharps

Part Four: Airway

15 Airway Management, Respiration, and Artificial Ventilation

Section One: The Airway Airway Anatomy Section Two: Respiratory Physiology Mechanics of Respiration Measurement of Gases Pulmonary Circulation Regulation of Respiration Section Three: Respiratory Pathophysiology Upper Airway Obstruction Aspiration by Inhalation Section Four: Ventilation Essential Parameters of Airway Evaluation Supplemental Oxygen Therapy Augmenting Patient Ventilations Rescue Breathing and Mechanical Ventilation Airway Management Suction Mechanical Adjuncts in Airway Management Advanced Airway Procedures Pharmacological Adjuncts to Airway Management and Ventilation Translaryngeal Cannula Ventilation Cricothyrotomy

Part Five: Patient Assessment

16 Scene Size-Up

Scene Size-Up Scene Safety Evaluation of the Scene Scene Management

17 Therapeutic Communications

Communication Internal Factors in Effective Communication External Factors in Effective Communication Patient Interview Strategies for Obtaining Information Methods of Assessing Mental Status During the Interview Special Interview Situations

18 History Taking

Components of the Patient History Content of the Patient History Techniques of History Taking Current Health Status Getting More Information Clinical Reasoning Special Challenges

19 Primary Assessment

Scene Size-Up and Personal Safety Patient Assessment Priorities Identifying Patients Who Need Priority Care and Transport

20 Secondary Assessment

Secondary Assessment: Approach and Overview Mental Status General Survey Anatomical Regions Physical Examination of Infants and Children Physical Examination of Older Adults

21 Clinical Decision Making

The Spectrum of Prehospital Care Critical Thinking Process for Paramedics Fundamental Elements of Critical Thinking for Paramedics Field Application of Assessment-Based Patient Management Putting It All Together: The Six R’s

Part Six: Cardiovascular

22 Cardiology

Risk Factors and Prevention Strategies for Cardiovascular Disease Section One: Anatomy and Physiology of the Heart Anatomy Review Physiology Section Two: Electrophysiology of the Heart Electrical Activity of Cardiac Cells and Membrane Potentials Cell Excitability Electrical Conduction System of the Heart Section Three: Electrocardiogram Monitoring Basic Concepts of Electrocardiogram Monitoring Relationship of the Electrocardiogram to Electrical Activity Section Four: Electrocardiogram Interpretation Steps in Rhythm Analysis Section Five: Introduction to Dysrhythmias Classification of Dysrhythmias Dysrhythmias Originating in the Sinoatrial Node Dysrhythmias Originating in the Atria Dysrhythmias Sustained or Originating in the Atrioventricular Junction Dysrhythmias Originating in the Ventricles Dysrhythmias That Are Disorders of Conduction Section Six: The 12-Lead Electrocardiogram 12-Lead Monitoring 12-Lead ECG and Bundle Branch Blocks Determination of the Axis Axis and Hemiblocks 12-Lead Strategies for Wide-Complex Tachycardias ST-Segment and T-Wave Changes Use of a 12-Lead ECG to Assess Infarcts 15- and 18-Lead Diagnostics Section Seven: Assessment of the Patient with Cardiac Disease Assessment Section Eight: Specific Cardiovascular Diseases Pathophysiology and Management of Cardiovascular Disease Acute Coronary Syndromes Specific Heart Diseases Cardiomyopathy Section Nine: Techniques for Managing Cardiac Emergencies Basic Cardiac Life Support Defibrillation Implantable Cardioverter-Defibrillators Left Ventricular Assist Device Synchronized Cardioversion Transcutaneous Cardiac Pacing Cardiac Arrest and Sudden Death Termination of Resuscitation

Part Seven: Medical

23 Diseases of the Eyes, Ears, Nose, and Throat

Conditions of the Eye Conditions of the Ear Conditions of the Nose Conditions of the Oropharynx and Throat

24 Respiratory

Anatomy and Physiology Review Pathophysiology Assessment Findings Diagnostic Testing Obstructive Airway Disease Pneumonia Acute Respiratory Distress Syndrome Pulmonary Embolism Upper Respiratory Infection Spontaneous Pneumothorax Hyperventilation Syndrome Lung Cancer

25 Neurology

Anatomy and Physiology of the Nervous System Neurological Pathophysiology Neurological Evaluation Pathophysiology and Management of Specific Central Nervous System Disorders Differential Diagnosis of Neurological Disorders

26 Endocrinology

Anatomy and Physiology of the Endocrine System Hormone Receptors Specific Disorders of the Endocrine System Disorders of the Pancreas: Diabetes Mellitus Disorders of the Thyroid Gland Disorders of the Adrenal Glands Other Endocrine Disorders

27 Immune System Disorders

Section One: Immune System and Allergic Reaction Overview of the Immune System Immune Response Allergic Reactions Anaphylaxis Section Two: Collagen Vascular Disease Systemic Lupus Scleroderma Section Three: Transplant Complications Infection Rejection

28 Infectious and Communicable Diseases

Public Health Principles Related to Infectious Diseases Pathophysiology of Infectious Disease Physiology of the Human Response to Infection Stages of Infectious Disease Human Immunodeficiency Virus Hepatitis Tuberculosis Meningococcal Meningitis Pneumonia Tetanus Rabies Hantavirus Viral Diseases of Childhood Other Viral Diseases Sexually Transmitted Diseases Lice and Scabies Reporting an Exposure to an Infectious or a Communicable Disease Paramedic’s Role in Preventing Disease Transmission

29 Abdominal and Gastrointestinal Disorders

Review of Gastrointestinal Anatomy Assessment of the Patient with Acute Abdominal Pain Management of the Patient with an Abdominal Emergency Specific Abdominal Emergencies Age-Related Variations in Abdominal Pain

30 Genitourinary and Renal Disorders

Anatomy and Physiology Review Renal Diseases Urinary System Conditions Male Genital Tract Conditions Physical Examination of Patients with Genitourinary or Renal Disorders

31 Gynecology

Organs of the Female Reproductive System Menstruation and Ovulation Gynecological Emergencies Assessment and Management of Gynecologic Emergencies Sexual Assault

32 Hematology

Blood and Blood Components Hemostasis Specific Hematological Disorders General Assessment and Management of Patients with Hematological Disorders

33 Nontraumatic Musculoskeletal Disorders

Anatomy and Physiology Review General Assessment Strategies General Management Strategies Osteomyelitis Bone Tumors Low Back Pain Joint Disorders Muscle Disorders Overuse Syndromes Peripheral Nerve Syndromes Soft Tissue Infections

34 Toxicology

Section One: Poisonings Poison Control Centers General Guidelines for Managing a Poisoned Patient Poisoning by Ingestion Poisoning by Inhalation Poisoning by Injection Poisoning by Absorption Section Two: Drug Abuse Toxic Effects of Drugs Section Three: Alcoholism Alcohol Dependence Medical Consequences of Chronic Alcohol Ingestion Alcohol Emergencies Section Four: Management of Toxic Syndromes General Management Principles for Toxic Syndromes

35 Behavioral and Psychiatric Disorders

Understanding Behavioral Emergencies Assessment and Management of Behavioral Emergencies Specific Behavioral and Psychiatric Disorders Special Considerations for Patients with Behavioral Problems

Part Eight: Shock and Resuscitation

36 Shock

Shock Tissue Oxygenation The Body as a Container Capillary-Cellular Relationship in Shock Classifications of Shock Stages of Shock Management and Treatment Plan for the Patient in Shock Resuscitation Management of Specific Forms of Shock Integration of Patient Assessment and the Treatment Plan

Part Nine: Trauma

37 Trauma Overview and Mechanism of Injury

Epidemiology of Trauma Section One: Kinematics Energy Section Two: Blunt Trauma Blunt Trauma Restraints Organ Collision Injuries Other Motorized Vehicular Collisions Pedestrian Injuries Other Causes of Blunt Trauma Section Three: Penetrating Trauma Penetrating Trauma Trauma Assessment Role of Documentation in Trauma

38 Bleeding and Soft Tissue Trauma

Hemorrhage Anatomy and Physiology of the Skin Pathophysiology Pathophysiology and Assessment of Soft Tissue Injuries Management Principles for Soft Tissue Injuries Hemorrhage and Control of Bleeding Dressing Materials Used with Soft Tissue Trauma Management of Specific Soft Tissue Injuries Not Requiring Closure Special Considerations for Soft Tissue Injuries

39 Burns

Incidence and Patterns of Burn Injury Classifications of Burn Injury Pathophysiology of Burn Shock Assessment of the Burn Patient General Principles in Burn Management Inhalation Burn Injuries Chemical Burn Injuries Electrical Burn Injuries Radiation Exposure

40 Head, Face, and Neck Trauma

Maxillofacial Injuries Ear, Eye, and Dental Trauma Anterior Neck Trauma Head Trauma Traumatic Brain Injury Injury Rating Systems

41 Spine and Nervous System Trauma

Spinal Trauma: Incidence, Morbidity, and Mortality Review of Spinal Anatomy Traditional Spinal Assessment Criteria General Assessment of Spinal Injury Classifications of Spinal Injury Evaluation and Assessment of Spinal Cord Injury General Management of Spinal Injuries Cord Injury Presentations Nontraumatic Spinal Conditions Assessment and Management of Nontraumatic Spinal Conditions

42 Chest Trauma

Skeletal Injuries Pulmonary Injuries Heart and Great Vessel Injuries Other Thoracic Injuries

43 Abdominal Trauma

Review of Abdominal Anatomy Mechanisms of Abdominal Injury Specific Abdominal Injuries Vascular Structure Injuries Assessment of Abdominal Trauma Management of Abdominal Trauma

44 Orthopedic Trauma

Review of the Musculoskeletal System Classifications of Musculoskeletal Injuries Signs and Symptoms of Extremity Trauma Assessment of Musculoskeletal Injuries Upper Extremity Injuries Lower Extremity Injuries Open Fractures Straightening Angular Fractures and Reducing Dislocations Referral of Patients with Minor Musculoskeletal Injury

45 Environmental Conditions

Thermoregulation Hyperthermia Hypothermia Frostbite Submersion Diving Emergencies High-Altitude Illness

Part Ten: Special Patient Populations

46 Obstetrics

Review of Female Reproductive Anatomy Normal Events of Pregnancy Specialized Structures of Pregnancy Fetal Growth and Development Pregnancy Terminology (GTPAL) Patient Assessment Trauma During Pregnancy Medical Conditions and Disease Processes That Can Complicate Pregnancy Bleeding Complications Related to Pregnancy Labor and Delivery Delivery Complications

47 Neonatal Care

Risk Factors Associated with the Need for Resuscitation Congenital Anomalies Physiological Adaptations at Birth Assessment and Management of the Neonate Resuscitation of the Distressed Neonate Routes of Drug Administration Postresuscitation Care Neonatal Transport Specific Situations Psychological and Emotional Support

48 Pediatrics

The Paramedic’s Role in Caring for Pediatric Patients Emergency Medical Services for Children Growth and Development Review Anatomy and Physiology Review General Principles of Pediatric Assessment General Principles of Patient Management Specific Pathophysiology, Assessment, and Management Infants and Children with Special Needs

49 Geriatrics

Demographics, Epidemiology, and Societal Issues Living Environments and Referral Sources Physiological Changes of Aging General Principles in Assessment of the Geriatric Patient System Pathophysiology, Assessment, and Management

50 Abuse and Neglect

Battering Elder Abuse Child Abuse Sexual Assault

51 Patients with Special Challenges

Physical Challenges Mental Challenges Pathological Challenges Culturally Diverse Patients Terminally Ill Patients Patients with Communicable Diseases Financial Challenges

52 Acute Interventions for Home Care

Overview of Home Health Care General Principles and Management Specific Acute Home Health Care Interventions

Part Eleven: EMS Operations

53 Ground and Air Ambulance Operations

Ambulance Standards Checking Ambulances Ambulance Stationing Safe Ambulance Operation Aeromedical Transportation

54 Medical Incident Command

Incident Command System Mass Casualty Incidents Principles and Technology of Triage Critical Incident Stress Management

55 Rescue Awareness and Operations

Appropriate Training for Rescue Operations Rescuer Personal Protective Equipment Surface Water Rescue Hazardous Atmospheres Highway Operations Hazardous Terrain Assessment Procedures during Rescue

56 Crime Scene Awareness

Approaching the Scene Dangerous Residence Dangerous Highway Encounters Violent Street Incidents Violent Groups and Situations Safety Tactics Tactical Patient Care EMS at Crime Scenes

57 Hazardous Materials Awareness

Scope of Hazardous Materials Laws and Regulations Identification of Hazardous Materials Personal Protective Clothing and Equipment Health Hazards Response to Hazardous Materials Emergencies Rehabilitation and Medical Monitoring Emergency Management of Contaminated Patients Decontamination of Rescue Personnel and Equipment

58 Bioterrorism and Weapons of Mass Destruction

History of Biological Weapons Critical Biological Agents and Responder Databases Methods of Dissemination Specific Biological Threats Nuclear and Radiological Threats Incendiary Threats Specific Chemical Threats Explosive Threats Department of Homeland Security General Guidelines for Emergency Response

59 Putting It All Together: Assessment-Based Management

Effective Assessment The “Right Stuff” Optional “Take-In” Equipment General Approach to the Patient Presenting the Patient

Emergency Drug Index (EDI) Glossary CCT Appendix: Advanced Practice Procedures for the Critical Care Paramedic Index

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