Paramedic Principles and Practice ANZ: A Clinical Reasoning Approach, 1e

Title page
Table of Contents
Inside Front Cover
Copyright
Foreword
Preface
About the authors
Contributors
Reviewers
The key to improving your clinical practice
Acknowledgements
CHAPTER 1: Introduction
	Paramedic principles and practice
	Essential knowledge
	Summary
PART 1: PARAMEDIC PRINCIPLES
	Principles of Paramedic Practice
		CHAPTER 2: The paramedic role in healthcare
			Introduction
			The role of ambulance services in Australia and New Zealand
			Professionalism and professional standards
			Terminology and qualifications
			The future paramedic role
			Summary
		CHAPTER 3: Characteristics of ambulance patients
			Introduction
			Who are ambulance patients?
			From symptom onset to the decision to call an ambulance
			From calling for an ambulance to ambulance arrival
			Summary
	The Clinical Approach
		CHAPTER 4: The structured clinical approach
			Introduction
			Medicine vs paramedicine?
			Using a structured approach to combat complexity
			The emergency model
			The medical interview model
		CHAPTER 5: The clinical reasoning process
			Introduction
			Clinical decision making in the face of uncertainty: the paramedic paradigm
			Problem solving versus decision making
			The myth of the expert
			Developing clinical reasoning skills
			A step-by-step guide to clinical decision making
			Algorithms and cognitive checks
			A syndrome approach to patient management
			Error wisdom
			Summary
		CHAPTER 6: The patient interview
			Introduction
			The structured patient interview
			The science and art of communication
			The paramedic interview setting
			Paramedic–patient interview structure
			Barriers to effective communication
			Summary
	Patient and Paramedic Safety
		CHAPTER 7: Patient safety and paramedicine
			Introduction
			The harm caused by healthcare errors
			Types of medical error
			Models of error
			Reducing diagnostic errors
			Error defence
			Error management
			Evidence-based practice and patient safety
			EBP, individual patients and clinical reasoning
			Summary
		CHAPTER 8: Paramedic health and wellbeing
			Introduction
			Wellbeing
			Paramedic health and safety
			Stress
			Managing emotions
			Fatigue
			Shift work
			Occupational violence
			Injury
			Student paramedics
			Getting help
			Summary
	Paramedic Education
		CHAPTER 9: Paramedic education
			Introduction
			Experience versus education
			The history of paramedic education in Australasia
			International educational standards
			Paramedic education in the university setting
			Course accreditation and professional regulation
			Continuing professional development and postgraduate education
			Educational challenges and future directions
			Summary
	Ethical and Legal Considerations
		CHAPTER 10: Legal and ethical considerations in clinical decision making
			Introduction
			Ethics and the law
			Consent
			Refusal of treatment
			Elements of consent
			Case study 1 evaluation
			Documentation
			Summary
	Clinical Reasoning and Paramedic Model of Research
		CHAPTER 11: Developing a philosophy of practice
			Introduction
			Models of practice
			Building a philosophy of practice
			Summary
PART 2: PARAMEDIC PRACTICE
	ALOC
		INTRODUCTION TO THE PARAMEDIC APPROACH TO THE PATIENT IN AN ALTERED CONSCIOUS STATE
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 12: Hypoglycaemia
			Introduction
			Pathophysiology
			Management of blood glucose
			At the hospital ED
			Hospital admission
			Discharge criteria
			Hypoglycaemia across the lifespan: paediatric considerations
			Future research
			Summary
		CHAPTER 13: Cerebrovascular accidents
			Introduction
			Pathophysiology
			Clinical manifestations
			Ongoing management
			Investigations
			Hospital admission
			Stroke across the lifespan
			Future research
			Summary
		CHAPTER 14: Overdose
			Introduction
			Pathophysiology
			Ongoing treatment
			Investigations
			Hospital management
			Future research
		CHAPTER 15: Seizures
			Introduction
			Pathophysiology
			Seizure classification
			Management
			Ongoing management
			Hospital admission
			Summary
	Respiratory Distress
		INTRODUCTION TO THE PARAMEDIC APPROACH TO THE PATIENT IN RESPIRATORY DISTRESS
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 16: Airway obstruction
			Introduction
			Pathophysiology
			Ongoing management
			Hospital admission
			Follow-up
			Summary
		CHAPTER 17: Asthma
			Introduction
			Pathophysiology
			Ongoing management
			Follow-up
			Long-term impact
			Future research
			Summary
		CHAPTER 18: Acute pulmonary oedema
			Introduction
			Pathophysiology
			Hospital admission
			Long-term impact
			Acute pulmonary oedema across the lifespan
			Ongoing management
			Ongoing management
			Future research
			Summary
		CHAPTER 19: Chronic obstructive pulmonary disease
			Introduction
			Pathophysiology
			Hospital admission
			Investigations
			Follow-up
			Future research
			Summary
		CHAPTER 20: Pneumothorax
			Introduction
			Pathophysiology
			Ongoing management
			Hospital admission
			Long-term impact
			Summary
		CHAPTER 21: Pulmonary embolism
			Introduction
			Pathophysiology
			Risk factors
			Ongoing management
			Investigations
			Hospital admission
			Follow-up
			Research
			Summary
		CHAPTER 22: Pleural effusion
			Introduction
			Pathophysiology
			Ongoing management
			Investigations
			Hospital admission
			Follow-up
			Summary
		CHAPTER 23: The paediatric patient with a noisy airway
			Introduction
			Pathophysiology
			Ongoing management
			Hospital admission
			Long-term impact
			Hospital management
			Future research
			Summary
	Cardiac Emergencies
		INTRODUCTION TO THE PARAMEDIC APPROACH TO THE PATIENT SUFFERING A CARDIAC EMERGENCY
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 24: Chest pain
			Introduction
			Pathophysiology
			Myocardial perfusion and myocardial workload
			Investigations
			Ongoing management
			Hospital admission
			Follow-up
			Acute coronary syndrome across the lifespan
			Future research
			Summary
		CHAPTER 25: Arrhythmias
			Introduction
			Pathophysiology
			Ongoing management
			Hospital admission
			Arrhythmias across the lifespan
			Wolff-Parkinson-White
			Long QT syndrome
			Commotio cordis
			Summary
		CHAPTER 26: Cardiac arrest
			Introduction
			Chain of survival
			Pathophysiology
			Ongoing management
			Long-term outcomes
			Future research
			Summary
	Severe Allergic Reactions
		INTRODUCTION TO THE PARAMEDIC APPROACH TO THE PATIENT WITH A SEVERE ALLERGIC REACTION
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 27: Anaphylaxis
			Introduction
			Pathophysiology
			Investigations
			Ongoing management
			Hospital admission
			Follow-up
			Long-term role
			Anaphylaxis across the lifespan
			Future research
			Summary
	Pain
		INTRODUCTION TO THE PARAMEDIC APPROACH TO THE PATIENT PRESENTING WITH PAIN
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 28: Pain
			Introduction
			Pathophysiology
			Ongoing management
			Future research
			Summary
		CHAPTER 29: Lower back pain
			Introduction
			Pathophysiology
			Ongoing management
			Follow-up
			Outcomes
			Back pain across the lifespan
			Future research
			Summary
		CHAPTER 30: Renal colic
			Introduction
			Pathophysiology
			Hospital emergency management
			Investigations
			Ongoing management
			Hospital admission
			Follow-up
			Long-term role
			Renal stones across the lifespan
			Future research
			Summary
	Trauma
		Introduction
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 31: The structured clinical approach to trauma patients
			Introduction
			Assessment of the trauma patient
			Summary
		CHAPTER 32: Head injuries
			Introduction
			Anatomy
			Pathophysiology
			Ongoing management
			Investigations
			Hospital admission
			Hospital discharge
			Head injuries across the lifespan
			Future research
			Summary
		CHAPTER 33: Chest injuries
			Introduction
			Pathophysiology
			Ongoing management
			Investigations
			Hospital admission
			Long-term role
			Chest trauma across the lifespan
			Future research
			Summary
		CHAPTER 34: Musculoskeletal injuries
			Introduction
			Pathophysiology
			Ongoing management
			Investigations
			Ongoing management of uncomplicated injuries
			Torn muscle repair
			Management of specific fractures
			Complications of musculoskeletal injuries
			Rehabilitation
			Long-term impact
			Future research
			Summary
		CHAPTER 35: Traumatic spinal injuries
			Introduction
			Pathophysiology
			Hospital admission
			Long-term issues and care
			Life expectancy for SCI survivors
			Future research
			Summary
		CHAPTER 36: Burns
			Introduction
			Pathophysiology
			‘Cold burns’
			Hospital admission (burns unit)
			Investigations
			Ongoing management
			Follow-up
			Burns across the lifespan: elderly patients
			Paediatric airway burns
			To intubate or not
			Future research
			Summary
	Environmental Injury
		INTRODUCTION TO THE PARAMEDIC APPROACH TO THE PATIENT PRESENTING WITH ENVIRONMENTAL INJURY
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 37: Hypothermia
			Introduction
			Pathophysiology
			Ongoing management
			Future research
			Summary
		CHAPTER 38: Hyperthermia
			Introduction
			Pathophysiology
			Ongoing management
			Hospital admission
			Investigations
			Follow-up and long-term impact
			Hyperthermia across the lifespan
			Summary
		CHAPTER 39: Decompression injuries
			Introduction
			Pathophysiology
			Ongoing management
			Hospital admission
			Long-term impact
			Summary
		CHAPTER 40: Snake bites
			Introduction
			Pathophysiology
			Ongoing management
			Hospital management
			Investigations
			Hospital admission
			Long-term impact
			Snake bites across the lifespan
			Future research
			Summary
		CHAPTER 41: Spider bites
			Introduction
			Pathophysiology
			Ongoing hospital management
			Hospital admission
			Long-term impact
			Spider bites across the lifespan
			Summary
		CHAPTER 42: Marine envenomation
			Introduction
			Pathophysiology
			Hospital management
			Long-term impact
			Envenomation across the lifespan
			Hospital management
			Future research
			Summary
	Unwell Patients: Specific Challenges
		INTRODUCTION TO THE PARAMEDIC APPROACH TO THE UNWELL PATIENT: SPECIFIC CHALLENGES TO PARAMEDIC REASONING
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 43: Acute abdominal pain
			Introduction
			Anatomy
			Pathophysiology
			Ongoing management
			Hospital admission
			Appendicitis across the lifespan
			Ongoing management
			AAA across the lifespan
			Ongoing management
			Bowel obstruction across the lifespan
			Summary
		CHAPTER 44: Sepsis
			Introduction
			Pathophysiology
			Ongoing management
			Hospital admission
			Sepsis across the lifespan
			Research
			Summary
		CHAPTER 45: Bleeding from the gastrointestinal or urinary tract
			Introduction
			Pathophysiology
			Ongoing management
			GI/urinary tract haemorrhage in the field
			Hospital management
			Summary
	Complex Cases
		INTRODUCTION TO THE PARAMEDIC APPROACH TO COMPLEX CASES: SPECIFIC CHALLENGES TO PARAMEDIC REASONING AND MANAGEMENT
			IN THIS SECTION
			At the completion of this section you should be able to
		CHAPTER 46: The socially isolated patient
			Introduction
			Background
			Ongoing management
			Hospital admission
			Summary
		CHAPTER 47: The dying patient
			Introduction
			Pathophysiology
			Ongoing management
			Hospital admission
			Death and dying across the lifespan
			Summary
		CHAPTER 48: The patient on out-of-hospital dialysis
			Introduction
			Pathophysiology
			Dialysis
			Ongoing management
			Follow-up
			Long-term role
			ESKD across the lifespan
			Future research
			Summary
		CHAPTER 49: Indigenous Australian patients
			Introduction
			Kinship
			Culture
			Distribution
			Epidemiological profile
			Summary
		CHAPTER 50: Māori patients
			Introduction
			Specific aspects of healthcare for Mori
			Epidemiological profile
			Delayed access to healthcare
			Death among Mori populations
			Summary
	Abnormal Behaviour
		INTRODUCTION TO THE PARAMEDIC APPROACH TO THE PATIENT DISPLAYING ABNORMAL BEHAVIOUR
			IN THIS SECTION
			At the completion of this section you should be able to
		CHAPTER 51: The patient displaying abnormal behaviour
			Introduction
			Pathophysiology
			Explanatory models
			Law and mental health
			Specific treatment guidelines
			Investigations
			Hospital admission
			Long-term treatment and impacts
			Mental illness across the lifespan
			Summary
		CHAPTER 52: De-escalation in the pre-hospital environment
			Introduction
			Theories of aggression
			Management of aggression
			Principles of de-escalation
			De-escalation in practice
	Obstetric and Neonatal
		INTRODUCTION TO THE PARAMEDIC APPROACH TO OBSTETRIC AND NEONATAL EMERGENCIES
			IN THIS SECTION
			AT THE COMPLETION OF THIS SECTION YOU SHOULD BE ABLE TO
		CHAPTER 53: Imminent birth
			Introduction
			Physiology
			Hospital admission
			Investigations
			Follow-up
			Further research
			Summary
		CHAPTER 54: Neonatal resuscitation
			Introduction
			Pathophysiology
			Identifying the newborn at risk of disorders during transition
			Failure to breathe effectively at birth
			Failure to establish effective ventilation after birth
			Preparing for the birth of a baby
			Newborn airway management
			Ongoing management
			Documentation
			Birth during transport
			Discontinuing resuscitation
			Hospital admission
			Investigations
			Follow-up
			The preterm baby
			Long-term role
			Hospital management
			Future research
			Summary
PART 3: ESSENTIAL KNOWLEDGE
	Introduction
		IN THIS SECTION
	Perfusion
		Introduction
		What is perfusion?
		The basics of normal perfusion
		Disturbances of perfusion
		Assessment of perfusion
		Principles of medical management of perfusion
		Summary
	Autonomic Response
		Introduction
		What is the autonomic nervous system?
		Assessment of autonomic nervous system function
		Principles of management
		Summary
	Inflammatory Response
		Introduction
		What is inflammation?
		The basics of normal inflammation
		Abnormal inflammation
		Summary
APPENDIX 1: Professional role guide
APPENDIX 2: Medications commonly encountered in community emergency health
Glossary
Index