Advanced EMT: A Clinical Reasoning Approach

Cover
Title Page
Copyright Page
Dedication
Brief Contents
Detailed Contents
Photo Scans
Letter to Students
Preface
Acknowledgments
About the Authors
A Guide to Key Features
Section 1 Preparing for Advanced Emergency Medical Technician Practice
	1 Introduction to Advanced Emergency Medical Technician Practice
		Introduction
		EMS and EMS Providers
			The Contemporary EMS Profession
			EMS Provider Levels
		Advanced EMT Roles and Responsibilities
			Emergency Vehicle Readiness and Operations
			Safety
			Scene Leadership, Management, and Teamwork
			Patient Assessment and Management
			Maintaining Certification or Licensure
			Interprofessional Teamwork
		Advanced EMT Professional Characteristics
	2 Emergency Medical Services, Health Care, and Public Health Systems
		Introduction
		Evolution of the EMS System
			Transportation of the Sick and Injured
			Emergency Prehospital Care
			Military Influence
			Key Events in EMS
			Key Documents in EMS
			Key People in EMS
		Components of an EMS System
			Legislation and Regulation
			EMS Provider Education
			National EMS Certification
			EMS System Configuration and Workforce
			Communication and System Access
			Medical Direction
			Evaluation
		Health Care and Public Health
			The Health Care System
			The Public Health System
		Getting to the Future
	3 Workforce Wellness and Personal Safety
		Introduction
		Health of the Nation
		Wellness and Emergency Medical Services
			Wellness and Maslow’s Hierarchy of Needs
			Stress
			Physical Wellness
			Infectious Disease Prevention
			Sleep
			Nutrition
			Physical Fitness
			Other Physical Health Considerations
			Other Aspects of Wellness
	4 Ethical and Medical/Legal Considerations in Advanced EMT Practice
		Introduction
		Ethics
		Branches of Government and General Areas of Law
		Authorization to Practice
			Scope of Practice
			Medical Direction
		Consent and Refusal of Emergency Medical Care
			Decision-Making Capacity
			Informed Consent
			Refusal of Consent
			Implied Consent
			Minor’s Consent
			Legal Issues Related to Consent
		Resuscitation Decisions and Recognizing Death
			Advance Directives
			Present Directives
			Presumptive Signs of Death
			Withholding or Terminating Resuscitation
		Matters of Civil Law
			Establishing the Elements of Negligence
			Other Civil Claims
			High-Risk Situations
		Criminal Law Issues
		Legal Protections
		Crime Scenes
		Other Legal Situations
	5 Ambulance Operations and Responding to EMS Calls
		Introduction
		Phases of EMS Calls
			Preparation
			Receiving and Responding
			On-Scene Care and Preparation for Transport
			Transporting the Patient
			Transferring Patient Care
			Terminating the Call
		Prehospital Environment and Types of Calls
			Nonemergency Calls
			Emergency Calls
			Medical Calls
			Trauma Calls
			Responding to a Residence
			Responding to Roadway Scenes
			Rescue Situations
			Hazardous Materials Situations
			Multiple-Casualty Incidents
		Ambulance Design
		Vehicle Readiness
			Exterior Vehicle and Mechanical Readiness
			Patient Care Equipment and Supplies
		Emergency Vehicle Operations
			Defensive Driving
			Speed
			Due Regard
			Emergency Driving
			Safe Backing
			Night Driving
			Highway Driving
			Emergency Response and Use of Warning Devices
			Always Pass on the Left
			Emergency Patient Transportation
			Intersections
			Following Other Emergency Vehicles
			Parking on a Scene
			Occupant Safety and Vehicle Security
			Carbon Monoxide in Ambulances
			Operational Security
		Scene Size-Up
			Nature of the Situation
			Scene Safety
			Number of Patients
			Additional Resources
			Patient Assessment Aspects of Scene Size-Up
		Lifting and Moving Patients
			Back Safety
			Equipment and Techniques Used to Lift and Move Patients
		Air Medical Transport
			Advantages and Capabilities of Air Medical Transport
			Limitations of Air Medical Transport
			Requesting Air Medical Transport
			Setting Up a Landing Zone
			Air and Ground Crew Safety
	6 Communication and Teamwork
		Introduction
		Communication
			Sender Characteristics
			Receiver Characteristics
			Message Characteristics
			Communication Channels, Interference, and Feedback
		Team Dynamics and Communication
		EMS System Communication
			Oversight, Maintenance, and Coordination
			Radio Frequencies and Traffic
			Communicating and Documenting Times
			Communication Equipment
			Guidelines for Radio Communication
		Therapeutic Communication and Interviewing Patients
			Intercultural and Language Considerations
			Trust and Rapport
			Control the Environment
			Nonverbal Communication
			Verbal Communication
			Pitfalls in Communication
			Special Patient Communication Situations
		Documentation
			Standardized Data Collection
			Sections of the Patient Care Report
			Legal Considerations in Documentation
			Special Documentation Circumstances
Section 2 Human Development, Health, and Disease
	7 Medical Terminology
		Introduction
		Medical Terminology Basics
		Anatomical Terms
		Terms by Body System
	8 Human Body Systems
		Introduction
		General Concepts in Anatomy and Physiology
			Chemical Basis of Life
			Cellular Basis of Life
			The Cell Membrane
			The Organelles
			Tissues
			Anatomical Terminology and Topographic Anatomy
			Body Cavities
			Organs and Body Systems
		Support, Movement, and Protection
			Skeletal System
			Muscular System
			Integumentary System
		Respiration and Circulation
			Respiratory System
			Cardiovascular System
		Control, Communication, and Integration
			The Nervous System
			Endocrine System
		Nutrition and Excretion
			Gastrointestinal System
			Urinary System
		Reproduction
			Reproductive System
	9 Life Span Development and Cultural Considerations
		Introduction
		Psychosocial Development
			Piaget’s Theory of Cognitive Development
			Erikson’s Theory of Psychosocial Development
			Kohlberg’s Theory of Moral Development
		Physical Development
			Neonates and Infants
			Toddlers and Preschoolers
			School-Age Children
			Adolescents
			Young Adulthood
			Middle Adulthood
			Late Adulthood
		Cultural Differences
			Health Disparities
			Health Care Beliefs and Social Interactions
		Grief, Dying, and Death
			Elisabeth Ku¨bler-Ross’s Stages of Dying
			Children and Grief
			Cross-Cultural Perspectives on Death and Dying
			Death in the Field
			Hospice and Palliative Care
	10 Pathophysiology: Selected Impairments of Homeostasis
		Introduction
		Mechanisms of Disease and Injury
		Compensation and Adaptation
		Hypoxic Cellular Injury
			Aerobic Metabolism
			Anaerobic Metabolism
			Causes of Hypoxia
		Cellular Glucose Use
		Acid–Base and Electrolyte Disturbances
		Shock
			Hypovolemic Shock
			Cardiogenic Shock
			Distributive Shock
			Obstructive Shock
			Pathophysiology of Shock
		Heat and Cold Emergencies
Section 3 Pharmacology
	11 Principles of Pharmacology
		Introduction
		Medication Sources
		Medication Reference Material
		Medication Profile
		Medication Oversight and Regulation
			Legislation
			Medication Safety and Regulation
			Special Considerations
		Medication Names
		Medication Forms
			Solid Medications
			Liquid Medications
			Semisolid Medications
			Gases
		Classifications of Medications
			Medications That Affect the Nervous System
		Medication Packaging
		Pharmacokinetics
			Absorption
			Distribution
			Biotransformation
			Elimination
			Pharmacodynamics
			Receptor Sites
			Affinity
			Mechanism of Action
			Dose–Response Relationship
		Factors Influencing Medication Effects
		Medication Storage
	12 Medication Administration
		Introduction
		Principles of Safe Medication Administration
			Six Rights of Medication Administration
			Additional Medication Safety Considerations
		Routes of Drug Administration
		Drug Orders
		Interpreting Drug Orders
		Drug Dosage Calculation
			Review of the Metric System
			Translating the Order to Units to Administer
		Techniques of Medication Administration
			Aseptic Technique
			EMS Provider Safety
			Oral Medication Administration
			Sublingual Medication Administration
			Nebulized Medication Administration
			Medication Administration by Metered-Dose Inhaler
			Nitrous Oxide Administration
			Equipment Used for Injections
			Drawing Medication from Ampules and Vials
			Subcutaneous Injection
			Intramuscular Injection
			Auto-Injectors
			Intravenous Injection
		Establishing a Peripheral Intravenous Line
			Equipment for Establishing IV Access
			Selecting a Suitable Vein
			Performing the Venipuncture
			Unsuccessful IV Attempts and Discontinuing IV Therapy
			Changing an IV Bag
			Complications of IV Therapy
		Pediatric Intraosseous Access
	13 Medications
		Introduction
		Medications in Patient Care
		IV Solutions
		IV Fluids
			Normal Saline (0.9 Percent Sodium Chloride Solution) for Intravenous Infusion
			5 Percent Dextrose in Water for Intravenous Infusion
			Lactated Ringer’s Solution
		Medications
			Albuterol Sulfate
			Aspirin
			50 Percent Dextrose
			Epinephrine 1:1,000
			Glucagon
			Glucose
			Naloxone
			Nitroglycerin—Sublingual Tablets and Spray
			Nitrous Oxide
			Oxygen
			Activated Charcoal
			Acetaminophen
			Ibuprofen
			Nerve Agent Antidote Kits
Section 4 Assessment and Initial Management
	14 General Approach to Patient Assessment and Clinical Reasoning
		Introduction
		Purpose and Goals of Patient Assessment
		General Approach to Patient Assessment
		Components of the Patient Assessment Process
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Reassessment
		Clinical Reasoning and Problem Solving
			Readiness for Problem Solving
			The Hypothetico–Deductive Approach to Problem Solving
			Pattern Recognition
			Heuristics: Rules of Thumb
			Pitfalls in Clinical Reasoning
	15 Scene Size-Up and Primary Assessment
		Introduction
		Scene Size-Up
		Primary Assessment
			Assessing the General Appearance
			Assessing Level of Responsiveness
			Assessing the Airway
			Assessing Breathing
			Assessing Circulation
			Patient Care Decisions
			Primary Assessments Compared
		Reassessment and Documentation
	16 Airway Management, Ventilation, and Oxygenation
		Introduction
		Anatomy and Physiology Review
			Physiology of Air Movement
			Upper Airway
			Lower Airway
			Gas Exchange
			Ventilation
		Pathophysiology of the Airway, Ventilation, and Oxygenation
			Upper Airway Problems
			Lower Airway Problems
			Ventilation Problems
		Assessment of the Airway, Ventilation, and Oxygenation
			Scene Size-Up
			Primary Assessment
			Secondary Assessment and Reassessment
		Airway Management
			Positioning and Manual Maneuvers
			Removing Foreign Bodies and Fluids from the Airway
			Airway Adjuncts
		Ventilation
			Positive Pressure Ventilation
			Bag-Valve-Mask Ventilations
			Manually Triggered Ventilation Device and the Automatic Transport Ventilator
			Continuous Positive Airway Pressure
		Oxygenation
			Oxygen as a Medication
			Oxygen Equipment
			Oxygen Safety
			Oxygen Delivery Devices
	17 Resuscitation: Managing Shock and Cardiac Arrest
		Introduction
		Pathophysiology of Shock
			Hypoperfusion
			Mechanisms of Shock
		Assessing for Shock
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical Reasoning
			Reassessment
		Managing Bleeding and Shock
			Bleeding Control
			Intravenous Access and Fluid Administration
			Fluid Resuscitation in Nonhemorrhagic Shock
			Pneumatic Anti-Shock Garments
		Cardiac Arrest
			The Chain of Survival
			Cardiopulmonary Resuscitation
			Health Care Provider CPR
			Scene Size-Up and Primary Assessment
			Chest Compressions
			Airway and Ventilations
			Integrating Advanced Airway Devices
			Defibrillation
			Intravenous Access and Medications
			Resuscitation Outcomes and Postresuscitation Care
			CPR in Infants and Children
			Secondary Assessment and History Taking in Resuscitation
			Ethical and Legal Considerations
			Return of Spontaneous Circulation
			Management of Body Temperature
	18 Vital Signs and Monitoring Devices
		Introduction
		Prioritizing Information Collection
		Vital Signs
			Assessing the Pulse
			Assessing Blood Pressure
			Orthostatic Vital Signs
			Assessing Respirations
			Assessing Body Temperature
		Assessing the Skin
		Assessing the Pupils
		Monitoring Devices
			Pulse Oximetry
			End-Tidal Carbon Dioxide Monitoring
			Blood Glucose Level
			Cardiac Monitoring
	19 History Taking, Secondary Assessment, and Reassessment
		Introduction
		General Approaches to the Secondary Assessment and History Taking
			Medical Patients
			Trauma Patients
			Field Impression
			Reassessment
			Documentation
		Taking a Medical History
			The SAMPLE History
			Working from the Presenting Problem or Chief Complaint
		Overview of the Physical Examination
			Anatomical Approach to Secondary Assessment
			Body Systems Approach to Secondary Assessment
Section 5 Medical Emergencies
	20 Respiratory Disorders
		Introduction
		Anatomy and Physiology Review
			The Need for Oxygen
			Structure and Function of the Lungs
			Ventilation
		General Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical-Reasoning Process
			Treatment
			Reassessment
		Specific Respiratory Disorders
			Chronic Obstructive Pulmonary Disease
			Asthma
			Pulmonary Embolism
			Pulmonary Edema
			Spontaneous Pneumothorax
			Hyperventilation Syndrome
			Infectious Respiratory Diseases
			Lung Cancer
			Cystic Fibrosis
	21 Cardiovascular Disorders
		Introduction
		Anatomy and Physiology Review
			Coronary Circulation
			The Vascular System and Blood
			Perfusion, Cardiac Output, and Blood Pressure
			Cardiac Electrophysiology
		General Assessment of Cardiovascular Complaints
		Specific Cardiovascular Conditions
			Acute Coronary Syndrome
			Signs and Symptoms
			Heart Failure
			Cardiogenic Shock
			Hypertension
			Aortic Aneurysm and Dissection
			Heart Rate Disturbances
	22 Neurologic Disorders
		Introduction
		Anatomy and Physiology Review
		Assessment
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical Reasoning and Decision Making
			Reassessment
		Specific Neurologic Disorders
			Altered Mental Status
			Syncope
			Stroke
			Seizures
			Headache
			Dementia and Delirium
			Vertigo
			Nontraumatic Back and Neck Pain
			Central Nervous System Infections
			Other Neurologic Disorders
	23 Endocrine Disorders
		Introduction
		Anatomy and Physiology Review
			The Pancreas and Blood Glucose Level
			The Thyroid Gland and Metabolism
			The Adrenal Glands
		Assessment
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Reassessment
		Common Endocrine Disorders
			Diabetes and Diabetic Emergencies
			Thyroid Disorders
			Adrenal Disorders
	24 Abdominal Pain and Gastrointestinal Disorders
		Introduction
		Anatomy and Physiology Review
			Stomach and Intestines
			Accessory Organs of Digestion
		Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical-Reasoning Process
			Treatment
			Reassessment
		General Abdominal Complaints
			Abdominal Pain
			Nausea and Vomiting
		Specific Abdominal Problems
			Disorders of the Esophagus
			Disorders of the Stomach and Intestines
			Pancreatitis
			Liver Disease
			Cholecystitis
		Other Causes of Abdominal Pain
	25 Renal, Genitourinary, and Gynecologic Disorders
		Introduction
		Anatomy and Physiology Review
			The Urinary System
			Kidneys
			Male Reproductive System
			Female Reproductive System
		Urinary System Disorders
			Assessment and Management
			Renal Disorders
			Urinary Tract Disorders
		Reproductive System Emergencies
			Male Genitalia
			Gynecologic Disorders
		Sexually Transmitted Infections
	26 Hematologic Disorders
		Introduction
		Anatomy and Physiology Review
			Plasma
			Red Blood Cells
			White Blood Cells
			Platelets
			Hemostasis
			Blood Groups
		Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical-Reasoning Process
			Treatment
			Reassessment
		Hematologic Conditions
			Blood Transfusion Reactions
			Red Blood Cell Disorders
			White Blood Cell Disorders
			Clotting Disorders
	27 Immunologic Disorders
		Introduction
		Anatomy and Physiology Review
		Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical-Reasoning Process
			Treatment
			Reassessment
		Immunologic Disorders
			Allergies and Anaphylaxis
			Immunocompromise
			Autoimmune Diseases
	28 Infectious Illnesses
		Introduction
		Anatomy and Physiology Review
		Infection and Disease Transmission
			Pathogens
			Infection Control
		General Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical-Reasoning Process
			Treatment
			Reassessment
		Infectious Illnesses
			Bloodborne Infections
			Respiratory Infections
			Infections of Regional Concern
			Childhood Illnesses
			Meningitis and Encephalitis
			Other Vectorborne Illnesses
			Gastrointestinal Infections and Botulism
			Mononucleosis and Herpes
			External Parasites and Skin Infections
			Sexually Transmitted Infections
	29 Nontraumatic Musculoskeletal and Soft-Tissue Disorders
		Introduction
		Anatomy and Physiology Review
			The Skin
			Skeletal Muscle
			Skeletal System
		General Assessment and Management
		Soft-Tissue and Musculoskeletal Disorders
			Skin and Soft-Tissue Disorders
			Joint Disorders
			Bone Disorders
			Muscular Disorders
			Neck and Back Disorders
	30 Disorders of the Eye, Ear, Nose, Throat, and Oral Cavity
		Introduction
		Anatomy and Physiology Review
			The Eyes
			The Ears
			The Nose
			The Oral Cavity
			The Throat
		Assessment and Management
		Specific Disorders
			Disorders of the Eye
			Disorders of the Ear
			Disorders of the Nose
			Disorders of the Oral Cavity and Throat
	31 Mental Illness and Behavioral Emergencies
		Introduction
		An Overview
		Assessment and Management
			Scene Size-Up and Primary Assessment
			History and Secondary Assessment
			Clinical Reasoning
			Treatment and Reassessment
		Common Disorders
			Anxiety Disorders
			Cognitive Disorders
			Eating Disorders
			Factitious Disorders and Somatoform Disorders
			Impulse Control Disorders
			Mood Disorders
			Personality Disorders
			Schizophrenia
			Substance Abuse, Addiction, and Withdrawal
			Alcohol
			Suicide
			Violent Patients
	32 Toxicologic Emergencies
		Introduction
		Toxicology
		Poison Control Centers
		Assessment and Management
			Scene Size-Up
			Primary Assessment
			History and Secondary Assessment
			Clinical Reasoning
			Treatment
			Reassessment
		Specific Toxicologic Emergencies
			Carbon Monoxide
			Cyanide
			Caustic Substances
			Hydrocarbons
			Organophosphates
			Ethanol and Toxic Alcohols
			Food and Plant Toxins
			Venom
			Over-the-Counter Medications
			Prescription Medications
			Street Drugs
Section 6 Trauma
	33 Trauma Systems and Incident Command
		Introduction
		Injury Prevention
		Trauma Systems
		Managing Multiple-Casualty Incidents
			Communications
			National Incident Management System
			Incident Command System
		On the Scene
			Triage
			Treatment
			Transport
	34 Mechanisms of Injury, Trauma Assessment, and Trauma Triage Criteria
		Introduction
		Kinematics of Trauma
			Kinetics
			Classifying Trauma
		Assessment of the Trauma Patient
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Reassessment
	35 Soft-Tissue Injuries and Burns
		Introduction
		Anatomy and Physiology Review
		Soft-Tissue Injuries
			General Guidelines for Emergency Care
			Closed Soft-Tissue Injuries
			Open Soft-Tissue Injuries
			Bleeding
		Burns
			Effects of Burns on the Body
			Sources of Burns
			Classification of Burn Severity
			Burn Injury Assessment
			Emergency Management of Burn Injuries
			Specific Burn Injuries
	36 Musculoskeletal Injuries
		Introduction
		Anatomy and Physiology Review
			Skeletal Muscles
			Ligaments and Tendons
			Cartilage
			Bones
			Joints
		Emergency Care of Musculoskeletal Injuries
			Focused Assessment of Musculoskeletal Injuries
			Splinting and Care of Musculoskeletal Injuries
		Fractures
			Types of Fractures
			Complications of Fractures
			Managing Long-Bone Fractures
			Critical Fractures
		Joint Injuries
		Muscle Injuries
	37 Head, Brain, Face, and Neck Trauma
		Introduction
		Anatomy and Physiology Review
			The Skull
			The Brain
			The Neck
			The Face
			The Eye
		General Assessment and Management
		Injuries to the Head
			Scalp Injuries
			Skull Injuries
		Traumatic Brain Injuries
			Cerebral Edema and Increased Intracranial Pressure
			Assessment and Management of Traumatic Brain Injury
			Specific Brain Injuries
			Injuries to the Face
			Eye Injuries
			Ear Injuries
			Avulsed Teeth
		Injuries to the Neck
			Injuries to the Cervical Spine
			Injuries to Blood Vessels
			Injuries to the Airway
	38 Thoracic Trauma
		Introduction
		Anatomy and Physiology Review
			The Lungs and Ventilation
			The Heart
		General Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Communication and Documentation
			Reassessment
		General Categories
			Open Chest Injury
			Closed Chest Injury
		Specific Thoracic Injuries
			Rib Fracture
			Flail Chest
			Pneumothorax
			Hemothorax
			Traumatic Asphyxia
		Blunt Cardiac Injury
			Myocardial Contusion
			Commotio Cordis
			Pericardial Tamponade
	39 Abdominal Trauma
		Introduction
		Anatomy and Physiology Review
		General Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Management of Abdominal Trauma
			Reassessment
		Specific Abdominal Injuries
			Penetrating Trauma
			Blunt Trauma
	40 Spine Injuries
		Introduction
		Anatomy and Physiology Review
			The Spinal Column
			The Spinal Cord
		Mechanisms of Spine Injury
			Spinal-Column Injury Versus Spinal-Cord Injury
			Complete and Incomplete Spinal-Cord Injury
			Spinal Shock
		Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Reassessment
			Spinal Motion Restriction
		Spinal Trauma Management
			Current Trends
			Spinal Motion Restriction for Supine and Prone Patients
			Spinal Motion Restriction for Seated Patient
			Spinal Motion Restriction and Rapid Extrication
			Special Considerations
			Spinal Motion Restriction for Infants and Children
	41 Environmental Emergencies
		Introduction
		Heat- and Cold-Related Emergencies
			Anatomy and Physiology
			Risk Factors
			General Assessment
			Specific Heat-Related Emergencies
			Specific Cold-Related Emergencies
		Drowning
			Pathophysiology of Drowning
			Assessment and Management
		Diving Emergencies
			Effects of Pressure
			Assessment and Management
			Specific Diving Injuries
		High-Altitude Illness
			Acute Mountain Sickness
			High-Altitude Pulmonary Edema
			High-Altitude Cerebral Edema
		Lightning Injuries
	42 Multisystem Trauma and Trauma Resuscitation
		Introduction
		Assessment and Management
			Scene Size-Up
			Primary Assessment
			Transport Decision
			Secondary Assessment
			Multisystem Trauma Patient Packaging
			Reassessment
		Principles of Trauma Resuscitation
Section 7 Special Patient Populations
	43 Obstetrics and Care of the Newborn
		Introduction
		Anatomy and Physiology
			Female Reproductive System
			Pregnancy
			The Fetus
			The Neonate
		The Pregnant Patient
			Assessment and Management
			Obstetrical Complications and Emergencies
		Labor and Delivery
			Signs and Symptoms
			Transport Decision
			Preparing for Delivery
			Assisting Delivery
			Complications
		Neonate Assessment and Management
			Neonatal Resuscitation
			APGAR Score
			Vital Signs
			Considerations in Neonatal Resuscitation
			Complications and Defects
	44 Pediatric Emergencies
		Introduction
		Pediatric Development
			Infants
			Toddlers and Preschool Children
			School-Age Children
			Adolescents
		Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical-Reasoning Process
			Treatment
			Reassessment
		Pediatric Medical Emergencies
			Respiratory Emergencies
			Cardiovascular Disorders
			Sudden Infant Death Syndrome
			Infectious Diseases
			Neurologic Disorders
			Diabetes
			Gastrointestinal Disorders
			Eye, Ear, Nose, and Throat Disorders
			Behavioral Emergencies
			Toxicologic Emergencies
		Shock and Trauma in Pediatric Patients
			Mechanisms of Injury
			Assessment and Management
			Considerations in Spinal Motion Restriction
			Burns
			Drowning
			Child Abuse and Neglect
	45 Geriatrics
		Introduction
		Anatomy and Physiology
		Psychosocial Aspects of Aging
		Assessment and Management
			Scene Size-Up
			Primary Assessment
			Secondary Assessment
			Clinical-Reasoning Process
			Treatment
			Reassessment
			Additional Considerations
		Common Medical Disorders
			Respiratory Disorders
			Cardiovascular Disorders
			Neurologic Disorders
			Renal and Genitourinary Disorders
			Gastrointestinal Disorders
			Endocrine Disorders
			Infectious Disease
			Musculoskeletal Disorders
			Hematologic Disorders
			Behavioral Emergencies
			Toxicologic Emergencies
		Trauma in the Geriatric Population
			Mechanisms of Injury
			Shock
			Fractures
			Burns
			Environmental Emergencies
	46 Patients with Special Challenges
		Introduction
		Sensory and Speech Impairments
			Hearing Impaired
			Vision Impaired
			Speech Impairment
		Cognitive Impairment
			Developmental Impairments
			Brain-Injured Patients
		Paralyzed Patients
		Bariatric Patients
		Homeless and Impoverished Patients
		Abused Patients
			Child Abuse
			Elder Abuse
		Technology-Dependent Patients
			Medical Oxygen
			Apnea Monitors
			Tracheostomy Tubes
			CPAP and BiPAP
			Mechanical Ventilators
			Vascular Access Devices
			Dialysis Shunts
			Gastrointestinal and Genitourinary Devices
			Ventriculostomy Shunts
		Hospice Care
Section 8 Rescue and Special Operations
	47 Rescue Operations and Vehicle Extrication
		Introduction
		Personal and Patient Safety
			Personal Protective Equipment
			Patient Safety
		Phases of Rescue Operations
			Phase One: Arrival and Size-Up
			Phase Two: Hazard Control
			Phase Three: Patient Access
			Phase Four: Medical Treatment
			Phase Five: Disentanglement
			Phase Six: Patient Packaging
			Phase Seven: Removal/Transport
			Types of Rescue Operations
			Hazardous Atmosphere
			Disentanglement and Extrication
		Vehicle Extrication
			Scene Size-Up
			Hazards
			Vehicle Stabilization
			Impact Damage and Extrication
			Interior of the Vehicle
			Gaining Access
			Extrication Tools
	48 Hazardous Materials
		Introduction
		Initial Recognition and Response
			Recognize the Hazardous Material
			Avoid the Hazardous Material
			Isolate the Hazardous Material
			Notify Responders About the Hazardous Material
		Hazardous Materials Operations
			Training Levels
			Incident Command
			Personal Protective Equipment
			Decontamination
			Rehabilitation
		Medical Aspects of Hazardous Materials
		Special Considerations in Radiation Incidents
			Radiation Injury
			Treatment for Radiation
	49 Response to Terrorism and Disasters
		Introduction
		General Considerations
		Natural Disasters
		Terrorism and Weapons of Mass Destruction
			Terrorist Groups
			Weapons of Mass Destruction
		Scene Size-Up
		Patient Care
Appendices
	Appendix 1: Endotracheal Intubation
		Introduction
		Equipment
			Laryngoscope
			Endotracheal Tube
			Stylet
			10-mL Syringe
			Magill Forceps
			Suction Unit
			Securing Device
			Tube Placement Confirmation Devices
		Anatomy
		Indications
		Complications
			Hypoxia
			Equipment Malfunction
			Damage to Teeth and Soft Tissues
			Esophageal Intubation
			Endobronchial Intubation
		Endotracheal Intubation Procedures
			Endotracheal Intubation of a Patient with No Suspected Spine Injury
			Endotracheal Intubation of a Patient with Suspected Spine Injury
	Appendix 2: Advanced ECG Recognition
		Introduction
		Standard ECG Monitoring
		ECG Monitors
		ECG Waveforms and Tracings
			Pulseless Electrical Activity
	Appendix 3: Adult Intraosseous Infusion
		Introduction
		Purpose of Intraosseous Access
		Indications
		Contraindications
		Complications
		Procedure for Tibial Intraosseous Access
	Appendix 4: Additional Emergency Medications
		Introduction
		Activated Charcoal, U.S.P.
		Adenosine
		Amiodarone
		Atropine Sulfate
		Calcium Chloride
		Diazepam
		Diltiazem
		Diphenhydramine
		Dopamine
		Epinephrine, 1:10,000
		Fentanyl Citrate
		Furosemide
		Ipratropium Bromide
		Ketamine
		Ketorolac Tromethamine
		Levalbuterol
		Lidocaine Hydrochloride
		Lorazepam
		Magnesium Sulfate
		Midazolam Hydrochloride
		Morphine Sulfate
		Ondansetron
		Sodium Bicarbonate
		Thiamine
		Tranexamic Acid
Answers
Glossary
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Index
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	X
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