Emergency Care and Transportation of the Sick and Injured

Title Page......Page 2
Celebrating 45 years of EMS education and innovation......Page 1
Brief Contents......Page 5
Contents......Page 7
Skill Drills......Page 32
Prepare for Class with Navigate 2 Digital Curriculum Solution Packages......Page 34
Acknowledgments......Page 37
Section 1: Preparatory......Page 60
CHAPTER 1 EMS Systems......Page 62
Course Description......Page 64
EMT Training: Focus and Requirements......Page 67
History of EMS......Page 69
Levels of Training......Page 71
Emergency Medical Responders......Page 76
Paramedic......Page 77
Components of the EMS System......Page 78
Public Access......Page 80
Communication Systems......Page 81
Clinical Care......Page 82
Legislation and Regulation......Page 83
Evaluation......Page 84
System Finance......Page 86
Education Systems......Page 87
Prevention and Public Education......Page 88
EMS Research......Page 90
Roles and Responsibilities of the EMT......Page 91
Professional Attributes......Page 93
Prep Kit......Page 97
CHAPTER 2 Workforce Safety and Wellness......Page 102
General Health and Wellness......Page 104
Wellness and Stress Management......Page 105
Sleep......Page 110
Infectious and Communicable Diseases......Page 112
Routes of Transmission......Page 113
Risk Reduction and Prevention for Infectious and Communicable Diseases......Page 115
Establishing an Infection Control Routine......Page 126
Immunity......Page 130
General Postexposure Management......Page 132
Scene Safety......Page 133
Scene Hazards......Page 134
Protective Clothing: Preventing Injury......Page 143
Turnout Gear......Page 144
Gloves......Page 145
Helmets......Page 146
Boots......Page 147
Ear Protection......Page 148
Caring for Critically Ill and Injured Patients......Page 149
Responses of the Critical Patient......Page 150
Techniques for Communicating With the Critical Patient......Page 152
Helping the Family......Page 154
The Grieving Process......Page 155
What Can the EMT Do?......Page 156
Stress Management on the Job......Page 157
Emotional Aspects of Emergency Care......Page 161
Stressful Situations......Page 162
Cultural Diversity on the Job......Page 166
Substance Abuse......Page 168
Injury and Illness Prevention......Page 169
Prep Kit......Page 174
CHAPTER 3 Medical, Legal, and Ethical Issues......Page 178
Consent......Page 180
Implied Consent......Page 181
Minors and Consent......Page 182
Forcible Restraint......Page 183
The Right to Refuse Treatment......Page 184
Advance Directives......Page 186
Presumptive Signs of Death......Page 189
Definitive Signs of Death......Page 191
Medical Examiner Cases......Page 192
Organ Donors......Page 193
Scope of Practice......Page 194
Standards of Care......Page 195
Standards Imposed by Local Custom......Page 196
Professional or Institutional Standards......Page 197
Standards Imposed by Textbooks......Page 198
Standards Imposed by States......Page 199
Abandonment......Page 200
Defamation......Page 201
Records and Reports......Page 202
Other Reporting Requirements......Page 203
Ethical Responsibilities......Page 204
The EMT in Court......Page 206
Prep Kit......Page 211
CHAPTER 4 Communications and Documentation......Page 217
Introduction......Page 219
Therapeutic Communication......Page 220
Age, Culture, and Personal Experience......Page 221
Nonverbal Communication......Page 222
Verbal Communication......Page 223
Written Communications and Documentation......Page 237
Patient Care Report......Page 238
Types of Forms......Page 241
Reporting Errors......Page 246
Documenting Refusal of Care......Page 248
Base Station Radios......Page 253
Mobile and Portable Radios......Page 254
Repeater-Based Systems......Page 255
Digital Equipment......Page 256
Other Communications Equipment......Page 257
Radio Communications......Page 259
Responding to the Scene......Page 260
Communicating With Medical Control and Hospitals......Page 262
Maintenance of Radio Equipment......Page 267
Prep Kit......Page 271
CHAPTER 5 Medical Terminology......Page 276
Introduction......Page 277
Prefixes......Page 278
Suffixes......Page 279
Combining Vowels......Page 280
Positions and Directions......Page 281
Directional Terms......Page 284
Movement Terms......Page 288
Other Directional Terms......Page 290
Breaking Terms Apart......Page 291
Abbreviations......Page 292
Master Tables......Page 293
Prep Kit......Page 310
CHAPTER 6 The Human Body......Page 314
The Planes of the Body......Page 316
The Skeletal System: Anatomy......Page 318
The Spinal Column......Page 321
The Appendicular Skeleton......Page 324
The Pelvis......Page 327
The Lower Extremities......Page 329
The Skeletal System: Physiology......Page 331
The Musculoskeletal System: Anatomy......Page 332
Skeletal Muscle......Page 333
The Upper Airway......Page 334
The Lower Airway......Page 337
Lungs......Page 338
Respiration......Page 342
Ventilation......Page 345
Characteristics of Normal Breathing......Page 346
Inadequate Breathing Patterns in Adults......Page 347
The Heart......Page 348
Arteries......Page 354
Capillaries......Page 356
Veins......Page 359
Blood Composition......Page 360
Normal Circulation in Adults......Page 361
Inadequate Circulation in Adults......Page 363
Nervous System Control of the Cardiovascular System......Page 364
The Central Nervous System......Page 368
The Peripheral Nervous System......Page 372
The Integumentary System (Skin): Anatomy......Page 374
The Abdomen......Page 375
Mouth......Page 379
Esophagus......Page 380
Large Intestine......Page 381
Rectum......Page 382
The Endocrine System: Anatomy and Physiology......Page 384
The Urinary System: Anatomy and Physiology......Page 387
The Female Reproductive System and Organs......Page 389
Life Support Chain......Page 391
Respiratory Compromise......Page 392
Shock......Page 394
Alteration of Cellular Metabolism......Page 395
Prep Kit......Page 399
CHAPTER 7 Life Span Development......Page 410
Introduction......Page 411
Neonates (Birth to 1 Month) and Infants (1 Month to 1 Year)......Page 412
Physical Changes......Page 413
Psychosocial Changes......Page 416
Physical Changes......Page 418
Psychosocial Changes......Page 421
Physical Changes......Page 422
Psychosocial Changes......Page 423
Physical Changes......Page 424
Psychosocial Changes......Page 426
Psychosocial Changes......Page 427
Physical Changes......Page 428
Psychosocial Changes......Page 430
Physical Changes......Page 431
Psychosocial Changes......Page 436
Prep Kit......Page 440
CHAPTER 8 Lifting and Moving Patients......Page 443
Introduction......Page 445
The Wheeled Ambulance Stretcher......Page 446
Backboards......Page 447
Moving and Positioning the Patient......Page 448
Anatomy Review......Page 449
Principles of Safe Reaching and Pulling......Page 455
Patient Weight......Page 460
Lifting and Carrying a Patient on a Backboard or Stretcher......Page 461
Moving a Patient With a Stair Chair......Page 465
Moving a Patient on Stairs With a Stretcher......Page 467
Loading a Wheeled Stretcher Into an Ambulance......Page 468
Directions and Commands......Page 472
Emergency Moves......Page 475
Rapid Extrication Technique......Page 477
Nonurgent Moves......Page 482
Direct Ground Lift......Page 483
Extremity Lift......Page 484
Transfer Moves......Page 485
Geriatrics......Page 489
Bariatrics......Page 494
Pneumatic and Electronic Powered Wheeled Stretchers......Page 496
Portable/Folding Stretchers......Page 497
Flexible Stretchers......Page 498
Short Backboards......Page 499
Basket Stretchers......Page 500
Scoop Stretchers......Page 501
Decontamination......Page 502
Medical Restraints......Page 503
Personnel Considerations......Page 505
Prep Kit......Page 510
Section 2: Patient Assessment......Page 515
CHAPTER 9 Patient Assessment......Page 517
Introduction......Page 521
Scene Size-up......Page 523
Ensure Scene Safety......Page 524
Determine Mechanism of Injury/Nature of Illness......Page 527
Take Standard Precautions......Page 528
Determine Number of Patients......Page 530
Consider Additional/Specialized Resources......Page 531
Primary Assessment......Page 534
Form a General Impression......Page 535
Assess Level of Consciousness......Page 537
Assess Breathing......Page 542
Assess Circulation......Page 545
Performing a Rapid Exam to Identify Life Threats......Page 553
Determine Priority of Patient Care and Transport......Page 556
History Taking......Page 560
Investigate the Chief Complaint (History of Present Illness)......Page 561
Obtain SAMPLE History......Page 565
Secondary Assessment......Page 572
Systematically Assess the Patient—Secondary Assessment......Page 573
Systematically Assess the Patient—Focused Assessment......Page 578
Assess Vital Signs Using the Appropriate Monitoring Device......Page 607
Reassessment......Page 615
Reassess Patient......Page 616
Prep Kit......Page 620
Section 3: Airway......Page 626
CHAPTER 10 Airway Management......Page 628
Anatomy of the Respiratory System......Page 631
Anatomy of the Upper Airway......Page 632
Anatomy of the Lower Airway......Page 637
Physiology of Breathing......Page 639
Ventilation......Page 640
Respiration......Page 645
Factors in the Nervous System......Page 648
Factors Affecting Pulmonary Ventilation......Page 649
Circulatory Compromise......Page 650
Recognizing Abnormal Breathing......Page 651
Assessment of Respiration......Page 654
Opening the Airway......Page 658
Head Tilt–Chin Lift Maneuver......Page 659
Jaw-Thrust Maneuver......Page 660
Opening the Mouth......Page 664
Suctioning Equipment......Page 665
Techniques of Suctioning......Page 668
Oropharyngeal Airways......Page 671
Nasopharyngeal Airways......Page 673
Maintaining the Airway......Page 678
Supplemental Oxygen Equipment......Page 679
Procedures for Operating and Administering Oxygen......Page 685
Oxygen-Delivery Equipment......Page 689
Nonrebreathing Masks......Page 690
Nasal Cannulas......Page 691
Tracheostomy Masks......Page 692
Humidification......Page 694
Artificial Ventilation......Page 696
Continuous Positive Airway Pressure......Page 708
Mechanism......Page 709
Application......Page 710
Complications......Page 711
Stomas and Tracheostomy Tubes......Page 713
Recognition......Page 715
Emergency Medical Care for Foreign Body Airway Obstruction......Page 717
Facial Bleeding......Page 718
Prep Kit......Page 722
Section 4: Pharmacology......Page 730
CHAPTER 11 Principles of Pharmacology......Page 732
How Medications Work......Page 734
Medication Names......Page 735
Routes of Administration......Page 736
Solutions and Suspensions......Page 739
Topical Medications......Page 740
Gels......Page 741
General Steps in Administering Medication......Page 743
Medication Administration and the EMT......Page 745
Oral Medications......Page 746
Sublingual Medications......Page 751
Intramuscular Medications......Page 754
Intranasal Medications......Page 755
Inhalation Medications......Page 757
Patient Medications......Page 762
Medication Errors......Page 763
Prep Kit......Page 767
Section 5: Shock and Resuscitation......Page 773
CHAPTER 12 Shock......Page 775
Introduction......Page 776
Perfusion......Page 777
Causes of Shock......Page 780
Cardiogenic Shock......Page 782
Obstructive Shock......Page 784
Distributive Shock......Page 786
Respiratory Insufficiency......Page 790
The Progression of Shock......Page 791
Patient Assessment for Shock......Page 792
Emergency Medical Care for Shock......Page 794
Treating Cardiogenic Shock......Page 795
Treating Septic Shock......Page 798
Treating Anaphylactic Shock......Page 799
Treating Psychogenic Shock......Page 800
Treating Shock in Older Patients......Page 801
Prep Kit......Page 806
CHAPTER 13 BLS Resuscitation......Page 810
Elements of BLS......Page 813
The Components of CPR......Page 816
Basic Principles of BLS......Page 818
Special AED Situations......Page 819
Check for Breathing and a Pulse......Page 820
Provide External Chest Compressions......Page 821
Proper Hand Position and Compression Technique......Page 824
Opening the Airway in Adults......Page 826
Recovery Position......Page 829
Provide Artificial Ventilations......Page 830
One-Rescuer Adult CPR......Page 833
Two-Rescuer Adult CPR......Page 834
Devices and Techniques to Assist Circulation......Page 838
Active Compression-Decompression CPR......Page 841
Impedance Threshold Device......Page 842
Mechanical Piston Device......Page 843
Load-Distributing Band CPR or Vest CPR......Page 844
Infant and Child CPR......Page 846
Determining Responsiveness......Page 847
Check for Breathing and a Pulse......Page 848
Airway......Page 852
Provide Rescue Breathing......Page 853
When Not to Start CPR......Page 855
When to Stop CPR......Page 857
Recognizing Foreign Body Airway Obstruction......Page 859
Removing a Foreign Body Airway Obstruction in an Adult......Page 860
Removing a Foreign Body Airway Obstruction in a Child......Page 864
Removing a Foreign Body Airway Obstruction in Infants......Page 866
Grief Support for Family Members and Loved Ones......Page 869
Education and Training for the Public......Page 871
Prep Kit......Page 876
Section 6: Medical......Page 883
CHAPTER 14 Medical Overview......Page 885
Types of Medical Emergencies......Page 887
Patient Assessment......Page 888
Scene Time......Page 895
Type of Transport......Page 896
General Management Principles......Page 897
Herpes Simplex......Page 898
HIV Infection......Page 899
Hepatitis......Page 901
Tuberculosis......Page 904
Travel Medicine......Page 906
Conclusion......Page 907
Prep Kit......Page 910
CHAPTER 15 Respiratory Emergencies......Page 914
Anatomy of the Respiratory System......Page 916
Physiology of Respiration......Page 917
Carbon Dioxide Retention and Hypoxic Drive......Page 921
Causes of Dyspnea......Page 923
Upper or Lower Airway Infection......Page 924
Acute Pulmonary Edema......Page 928
Chronic Obstructive Pulmonary Disease......Page 930
Asthma, Hay Fever, and Anaphylaxis......Page 932
Spontaneous Pneumothorax......Page 936
Pleural Effusion......Page 937
Pulmonary Embolism......Page 938
Environmental/Industrial Exposure......Page 941
Patient Assessment......Page 942
Emergency Medical Care......Page 951
Metered-Dose Inhaler and Small-Volume Nebulizer......Page 952
Administration of a Metered-Dose Inhaler......Page 954
Administration of Small-Volume Nebulizer......Page 956
Acute Pulmonary Edema......Page 959
Asthma, Hay Fever, and Anaphylaxis......Page 960
Environmental/Industrial Exposure......Page 961
Asthma......Page 962
Cystic Fibrosis......Page 963
Prep Kit......Page 967
CHAPTER 16 Cardiovascular Emergencies......Page 973
Introduction......Page 975
Anatomy and Physiology......Page 976
Circulation......Page 979
Atherosclerosis......Page 987
Acute Coronary Syndrome......Page 989
Congestive Heart Failure......Page 992
Hypertensive Emergencies......Page 994
Patient Assessment......Page 995
Administering Nitroglycerin......Page 1000
Cardiac Monitoring......Page 1002
Heart Surgeries and Cardiac Assistive Devices......Page 1008
Automatic Implantable Cardiac Defibrillators......Page 1009
Left Ventricular Assist Devices......Page 1010
Automated External Defibrillation......Page 1011
Preparation......Page 1017
Performing Defibrillation......Page 1018
Prep Kit......Page 1027
CHAPTER 17 Neurologic Emergencies......Page 1032
Introduction......Page 1034
Anatomy and Physiology......Page 1035
Headache......Page 1037
Types of Stroke......Page 1039
Signs and Symptoms of Stroke......Page 1042
Conditions That May Mimic Stroke......Page 1043
Causes of Seizures......Page 1046
The Postictal State......Page 1048
Causes of Altered Mental Status......Page 1049
Patient Assessment......Page 1052
Emergency Medical Care......Page 1062
Seizure......Page 1064
Altered Mental Status......Page 1065
Prep Kit......Page 1069
CHAPTER 18 Gastrointestinal and Urologic Emergencies......Page 1073
Introduction......Page 1075
The Genital System......Page 1077
The Urinary System......Page 1078
Pathophysiology......Page 1080
Causes of Acute Abdomen......Page 1081
Kidneys......Page 1086
Other Organ Systems......Page 1087
Patient Assessment......Page 1088
Dialysis Emergencies......Page 1093
Prep Kit......Page 1097
CHAPTER 19 Endocrine and Hematologic Emergencies......Page 1101
Anatomy and Physiology......Page 1103
Pathophysiology......Page 1105
Patient Assessment of Diabetes......Page 1117
Giving Oral Glucose......Page 1120
Altered Mental Status......Page 1123
Anatomy and Physiology......Page 1124
Pathophysiology......Page 1125
Patient Assessment of Hematologic Disorders......Page 1128
Emergency Medical Care for Hematologic Disorders......Page 1130
Prep Kit......Page 1132
CHAPTER 20 Immunologic Emergencies......Page 1137
Anatomy and Physiology......Page 1139
Pathophysiology......Page 1140
Common Allergens......Page 1143
Insect Stings......Page 1144
Patient Assessment of an Immunologic Emergency......Page 1146
Emergency Medical Care of Immunologic Emergencies......Page 1150
Epinephrine......Page 1151
Prep Kit......Page 1160
CHAPTER 21 Toxicology......Page 1163
Identifying the Patient and the Poison......Page 1165
How Poisons Enter the Body......Page 1169
Inhaled Poisons......Page 1171
Absorbed and Surface Contact Poisons......Page 1172
Ingested Poisons......Page 1174
Injected Poisons......Page 1175
Patient Assessment......Page 1176
Emergency Medical Care......Page 1179
Alcohol......Page 1181
Opiates and Opioids......Page 1183
Sedative-Hypnotic Drugs......Page 1184
Abused Inhalants......Page 1186
Sympathomimetics......Page 1187
Hallucinogens......Page 1189
Cholinergic Agents......Page 1190
Miscellaneous Drugs......Page 1191
Food Poisoning......Page 1192
Plant Poisoning......Page 1195
Prep Kit......Page 1202
CHAPTER 22 Psychiatric Emergencies......Page 1206
Myth and Reality......Page 1208
The Magnitude of Mental Health Disorders......Page 1209
Functional......Page 1210
Safe Approach to a Behavioral Crisis......Page 1211
Patient Assessment......Page 1212
Acute Psychosis......Page 1216
Excited Delirium......Page 1217
Risks Associated With Patient Restraint......Page 1218
The Process of Restraining a Patient......Page 1219
Performing Patient Restraint......Page 1221
The Potentially Violent Patient......Page 1223
Suicide......Page 1225
Signs and Symptoms of PTSD......Page 1227
Caring for the Combat Veteran......Page 1228
Limited Legal Authority......Page 1229
Prep Kit......Page 1234
CHAPTER 23 Gynecologic Emergencies......Page 1238
Anatomy and Physiology......Page 1240
Pathophysiology......Page 1242
Sexually Transmitted Diseases......Page 1243
Patient Assessment......Page 1244
Pelvic Inflammatory Disease......Page 1248
Sexual Assault and Rape......Page 1249
Prep Kit......Page 1255
Section 7: Trauma......Page 1259
CHAPTER 24 Trauma Overview......Page 1261
Energy and Trauma......Page 1263
Vehicular Crashes......Page 1267
Car Versus Bicycle......Page 1279
Car Versus Motorcycle......Page 1280
Falls......Page 1281
Penetrating Trauma......Page 1283
Blast Injuries......Page 1286
Tissues at Risk......Page 1287
Golden Principles of Prehospital Trauma Care......Page 1289
Injuries to the Neck and Throat......Page 1290
Injuries to the Abdomen......Page 1291
Type of Transport......Page 1292
Destination Selection......Page 1293
Special Considerations......Page 1299
Prep Kit......Page 1303
CHAPTER 25 Bleeding......Page 1307
Anatomy and Physiology of the Cardiovascular System......Page 1309
Blood Vessels and Blood......Page 1311
Pathophysiology and Perfusion......Page 1315
The Significance of External Bleeding......Page 1318
Characteristics of External Bleeding......Page 1320
Nature of Illness for Internal Bleeding......Page 1323
Patient Assessment for External and Internal Bleeding......Page 1324
Emergency Medical Care for External Bleeding......Page 1327
Hemostatic Agents......Page 1331
Tourniquets......Page 1333
Splints......Page 1338
Bleeding From the Nose, Ears, and Mouth......Page 1340
Emergency Medical Care for Internal Bleeding......Page 1344
Prep Kit......Page 1349
CHAPTER 26 Soft-Tissue Injuries......Page 1354
Introduction......Page 1356
Anatomy and Physiology of the Skin......Page 1357
Anatomy......Page 1358
Pathophysiology of Closed and Open Injuries......Page 1359
Closed Injuries......Page 1360
Open Injuries......Page 1364
Patient Assessment of Closed and Open Injuries......Page 1375
Emergency Medical Care for Open Injuries......Page 1381
Abdominal Wounds......Page 1384
Impaled Objects......Page 1387
Neck Injuries......Page 1388
Bites......Page 1390
Burns......Page 1394
Burn Severity......Page 1395
Patient Assessment of Burns......Page 1402
Emergency Medical Care for Burns......Page 1405
Management of Specific Burns......Page 1406
Sterile Dressings......Page 1421
Bandages......Page 1423
Prep Kit......Page 1427
CHAPTER 27 Face and Neck Injuries......Page 1431
Anatomy and Physiology......Page 1433
The Eye......Page 1440
Injuries of the Face and Neck......Page 1442
Soft-Tissue Injuries......Page 1443
Dental Injuries......Page 1444
Patient Assessment......Page 1445
Emergency Medical Care......Page 1449
Injuries of the Eyes......Page 1453
Injuries of the Nose......Page 1476
Injuries of the Ear......Page 1482
Facial Fractures......Page 1486
Dental Injuries......Page 1488
Injuries of the Neck......Page 1490
Laryngeal Injuries......Page 1493
Prep Kit......Page 1498
CHAPTER 28 Head and Spine Injuries......Page 1502
Introduction......Page 1504
Nervous System......Page 1505
How the Nervous System Works......Page 1510
Skeletal System......Page 1512
Head Injuries......Page 1514
Skull Fracture......Page 1517
Traumatic Brain Injuries......Page 1521
Intracranial Pressure......Page 1523
Concussion......Page 1526
Patient Assessment......Page 1527
Managing the Airway......Page 1538
Circulation......Page 1540
Immobilization of the Cervical Spine......Page 1543
Supine Patients......Page 1550
Sitting Patients......Page 1558
Standing Patients......Page 1559
Spinal Immobilization Devices......Page 1562
Preferred Method......Page 1565
Alternate Method......Page 1569
Prep Kit......Page 1575
CHAPTER 29 Chest Injuries......Page 1579
Anatomy and Physiology......Page 1581
Mechanics of Ventilation......Page 1583
Injuries of the Chest......Page 1586
Signs and Symptoms of Chest Injury......Page 1588
Patient Assessment......Page 1589
Pneumothorax......Page 1594
Hemothorax......Page 1601
Cardiac Tamponade......Page 1603
Rib Fractures......Page 1604
Flail Chest......Page 1605
Other Fractures......Page 1606
Commotio Cordis......Page 1607
Laceration of the Great Vessels......Page 1608
Prep Kit......Page 1613
CHAPTER 30 Abdominal and Genitourinary Injuries......Page 1617
Abdominal Quadrants......Page 1619
Hollow and Solid Organs......Page 1621
Injuries to the Abdomen......Page 1623
Closed Abdominal Injuries......Page 1624
Open Abdominal Injuries......Page 1626
Hollow Organ Injuries......Page 1629
Solid Organ Injuries......Page 1630
Patient Assessment of Abdominal Injuries......Page 1631
Assessment of an Isolated Abdominal Injury......Page 1635
Open Abdominal Injuries......Page 1636
Anatomy of the Genitourinary System......Page 1641
Injuries to the Urinary Bladder......Page 1644
Injuries of the Female Genitalia......Page 1645
Patient Assessment of the Genitourinary System......Page 1646
External Male Genitalia......Page 1649
Sexual Assault and Rape......Page 1650
Prep Kit......Page 1654
CHAPTER 31 Orthopaedic Injuries......Page 1657
Introduction......Page 1659
Muscles......Page 1660
The Skeleton......Page 1663
Musculoskeletal Injuries......Page 1672
Mechanism of Injury......Page 1673
Fractures......Page 1676
Dislocations......Page 1684
Sprains......Page 1686
Complications......Page 1687
Assessing the Severity of Injury......Page 1688
Patient Assessment......Page 1690
Emergency Medical Care......Page 1693
Splinting......Page 1695
Injuries of the Clavicle and Scapula......Page 1710
Dislocation of the Shoulder......Page 1714
Fracture of the Humerus......Page 1716
Elbow Injuries......Page 1718
Fractures of the Forearm......Page 1723
Injuries of the Wrist and Hand......Page 1724
Fractures of the Pelvis......Page 1726
Dislocation of the Hip......Page 1729
Fractures of the Proximal Femur......Page 1731
Injuries of Knee Ligaments......Page 1732
Fractures About the Knee......Page 1733
Injuries of the Tibia and Fibula......Page 1736
Foot Injuries......Page 1737
Amputations......Page 1740
Compartment Syndrome......Page 1741
Prep Kit......Page 1746
CHAPTER 32 Environmental Emergencies......Page 1750
Factors Affecting Exposure......Page 1753
Hypothermia......Page 1754
Local Cold Injuries......Page 1757
Assessment of Cold Injuries......Page 1760
General Management of Cold Emergencies......Page 1762
Emergency Care of Local Cold Injuries......Page 1763
Heat Exposure......Page 1764
Heat Stroke......Page 1765
Assessment of Heat Emergencies......Page 1766
Heat Cramps......Page 1768
Heat Exhaustion......Page 1769
Heat Stroke......Page 1771
Spinal Injuries in Submersion Incidents......Page 1773
Ascent Emergencies......Page 1778
Assessment of Drowning and Diving Emergencies......Page 1780
Emergency Care for Drowning or Diving Emergencies......Page 1782
Lightning......Page 1783
Bites and Envenomations......Page 1784
Spider Bites......Page 1785
Snake Bites......Page 1787
Scorpion Stings......Page 1791
Tick Bites......Page 1792
Injuries From Marine Animals......Page 1794
Prep Kit......Page 1800
Section 8: Special Patient Populations......Page 1805
CHAPTER 33 Obstetrics and Neonatal Care......Page 1807
Anatomy and Physiology of the Female Reproductive System......Page 1810
Diabetes......Page 1813
Bleeding......Page 1814
Abuse......Page 1817
Special Considerations for Trauma and Pregnancy......Page 1818
Cultural Value Considerations......Page 1819
Patient Assessment......Page 1820
Stages of Labor......Page 1823
Preparing for Delivery......Page 1824
The Delivery......Page 1828
Postdelivery Care......Page 1834
Neonatal Assessment and Resuscitation......Page 1836
Additional Resuscitation Efforts......Page 1837
The Apgar Score......Page 1839
Breech Delivery......Page 1842
Presentation Complications......Page 1843
Multiple Gestation......Page 1845
Premature Birth......Page 1846
Fetal Demise......Page 1847
Postpartum Complications......Page 1848
Prep Kit......Page 1852
CHAPTER 34 Pediatric Emergencies......Page 1856
Communication With the Patient and the Family......Page 1860
The Infant......Page 1861
The Toddler......Page 1863
The Preschool-Age Child......Page 1865
School-Age Years......Page 1867
Adolescents......Page 1868
Anatomy and Physiology......Page 1869
The Respiratory System......Page 1870
The Nervous System......Page 1873
Patient Assessment......Page 1874
Respiratory Emergencies and Management......Page 1897
Airway Obstruction......Page 1898
Asthma......Page 1903
Bronchiolitis......Page 1904
Airway Adjuncts......Page 1905
Oxygen Delivery Devices......Page 1911
Shock......Page 1917
Seizures......Page 1919
Meningitis......Page 1922
Gastrointestinal Emergencies and Management......Page 1923
Poisoning Emergencies and Management......Page 1924
Dehydration Emergencies and Management......Page 1927
Fever Emergencies and Management......Page 1928
Drowning Emergencies and Management......Page 1929
Injury Patterns......Page 1930
Injuries to Specific Body Systems......Page 1931
Burns......Page 1936
Pain Management......Page 1938
Disaster Management......Page 1939
Signs of Abuse......Page 1941
Sexual Abuse......Page 1945
Scene Assessment......Page 1946
Communication and Support of the Family After the Death of a Child......Page 1947
Apparent Life-Threatening Event......Page 1950
Prep Kit......Page 1953
CHAPTER 35 Geriatric Emergencies......Page 1960
Introduction......Page 1962
Generational Considerations......Page 1963
Communication Techniques......Page 1964
Changes in the Body......Page 1965
Pathophysiology......Page 1967
Pathophysiology......Page 1968
Anatomy and Physiology......Page 1971
Pathophysiology......Page 1973
Pathophysiology......Page 1976
Pathophysiology......Page 1977
Changes in the Immune System......Page 1978
Pathophysiology......Page 1979
Toxicology......Page 1980
Suicide......Page 1982
The GEMS Diamond......Page 1983
Special Considerations in Assessing a Geriatric Medical Patient......Page 1985
Trauma and Geriatric Patients......Page 1989
Anatomic Changes and Fractures......Page 1990
Environmental Injury......Page 1991
Special Considerations in Assessing Geriatric Trauma Patients......Page 1992
Response to Nursing and Skilled Care Facilities......Page 1997
Advance Directives......Page 1998
Elder Abuse and Neglect......Page 1999
Assessment of Elder Abuse......Page 2000
Signs of Physical Abuse......Page 2001
Prep Kit......Page 2006
CHAPTER 36 Patients With Special Challenges......Page 2010
Intellectual Disability......Page 2013
Down Syndrome......Page 2014
Visual Impairment......Page 2016
Hearing Impairment......Page 2018
Cerebral Palsy......Page 2021
Spina Bifida......Page 2022
Interaction With Patients With Obesity......Page 2023
Tracheostomy Tubes......Page 2024
Mechanical Ventilators......Page 2026
Apnea Monitors......Page 2027
Left Ventricular Assist Devices......Page 2028
Gastrostomy Tubes......Page 2029
Shunts......Page 2031
Home Care......Page 2032
Poverty and Homelessness......Page 2033
Prep Kit......Page 2038
Section 9: EMS Operations......Page 2043
CHAPTER 37 Transport Operations......Page 2046
Introduction......Page 2048
Emergency Vehicle Design......Page 2049
The Preparation Phase......Page 2054
En Route to the Scene......Page 2077
Arrival at the Scene......Page 2078
The Transfer Phase......Page 2082
The Transport Phase......Page 2083
En Route to the Station......Page 2084
The Postrun Phase......Page 2085
Defensive Ambulance Driving Techniques......Page 2086
Driver Characteristics......Page 2087
Safe Driving Practices......Page 2088
Air Medical Operations......Page 2096
Establishing a Landing Zone......Page 2098
Landing Zone Safety and Patient Transfer......Page 2099
Special Considerations......Page 2101
Medivac Issues......Page 2102
Prep Kit......Page 2106
CHAPTER 38 Vehicle Extrication and Special Rescue......Page 2109
Safety......Page 2111
Vehicle Safety Systems......Page 2112
Fundamentals of Extrication......Page 2113
Arrival and Scene Size-up......Page 2115
Hazard Control......Page 2118
Gaining Access......Page 2120
Emergency Care......Page 2124
Removal of the Patient......Page 2125
Transfer of the Patient......Page 2126
Specialized Rescue Situations......Page 2127
Technical Rescue Situations......Page 2128
Search and Rescue......Page 2129
Tactical Emergency Medical Support......Page 2130
Structure Fires......Page 2133
Prep Kit......Page 2137
CHAPTER 39 Incident Management......Page 2141
National Incident Management System......Page 2143
Incident Command System......Page 2144
Incident Command System Roles and Responsibilities......Page 2145
Preparedness......Page 2148
Scene Size-up......Page 2149
Communications......Page 2150
The Medical Branch of Incident Command......Page 2151
Treatment Supervisor......Page 2152
Morgue Supervisor......Page 2153
Mass-Casualty Incidents......Page 2154
Triage......Page 2157
Triage Categories......Page 2158
Triage Tags......Page 2159
START Triage......Page 2160
Destination Decisions......Page 2162
Introduction to Hazardous Materials......Page 2163
Recognizing a Hazardous Material......Page 2164
Containers......Page 2166
Other Considerations......Page 2172
References......Page 2175
Identification......Page 2180
HazMat Scene Operations......Page 2181
Classification of Hazardous Materials......Page 2184
Personal Protective Equipment Level......Page 2185
Caring for Patients at a HazMat Incident......Page 2187
Prep Kit......Page 2192
CHAPTER 40 Terrorism Response and Disaster Management......Page 2200
What Is Terrorism?......Page 2202
Weapons of Mass Destruction......Page 2206
Recognizing a Terrorist Event (Indicators)......Page 2207
Response Actions......Page 2208
Vesicants (Blister Agents)......Page 2211
Pulmonary Agents (Choking Agents)......Page 2213
Nerve Agents......Page 2214
Metabolic Agents (Cyanides)......Page 2217
Viruses......Page 2219
Bacteria......Page 2222
Neurotoxins......Page 2227
Other EMT Roles During a Biologic Event......Page 2231
Sources of Radiologic Material......Page 2233
Symptomatology......Page 2235
Protective Measure......Page 2236
Mechanisms of Injury......Page 2237
Prep Kit......Page 2243
Section 10: The Team Approach to Health Care......Page 2250
CHAPTER 41 A Team Approach to Health Care......Page 2252
Introduction......Page 2253
An Era of Team Health Care......Page 2254
Groups Versus Teams......Page 2255
Interdependent......Page 2256
Clear Roles and Responsibilities......Page 2257
Effective Collaboration and Communication......Page 2258
Supportive and Coordinated Leadership......Page 2259
General Guidelines......Page 2261
Assisting with Placement of Advanced Airways......Page 2262
Vascular Access......Page 2272
Troubleshooting Team Conflicts......Page 2279
Prep Kit......Page 2284
GLOSSARY......Page 2288
INDEX......Page 2328