Emergency Medical Services E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 3625

Veröffentlichungsjahr: 2015

Beschreibung

Emergency Medical Services: Clinical Practice and Systems Oversight is the official textbook of the National Association of EMS Physicians(TM) (NAEMSP(TM)) National EMS Medical Directors Course and Practicum(TM). Now paired with a companion website featuring self-assessment exercises, audio and video clips of EMS best practices in action, and more, this essential study aid guides students through the core knowledge they need to successfully complete their training and begin their careers as EMS physicians. Emergency Medical Services: Clinical Practice and Systems Oversight consists of: * Volume 1: Clinical Aspects of EMS * Volume 2: Medical Oversight of EMS * Companion website featuring supportive self-assessment exercises, audio and video clips

Leseprobe

CONTENTS

Cover

Volume 1

Title page

Copyright page

Contributors

Foreword

Preface

Reference

Abbreviations

About the companion website

Chapter 1: History of EMS

Before 1966: historical perspectives

1966: the NAS-NRC report

1973: the Emergency Medical Services Systems Act

1973–1978: rapid growth of EMS systems

Personnel

Public education

Communications

Transportation

Hospitals

1978–1981: EMS at midpassage

Financing

Research

1981: the Omnibus Budget Reconciliation Act

1982–1996: changing federal roles

EMS physicians 1982–1996

Training 1982–1996

Transportation 1982–1996

1996–2008: the role of the federal government matures, the United States faces terrorism, and EMS is at breaking point

2009–2013: a period of incremental progress

Acknowledgments

References

Section I: Airway

Chapter 2: EMS airway management

The skills of airway management

Introduction

The challenges of airway management in the prehospital setting

Which airway, when, and how?

Preventing common pitfalls of airway management

Protocol development and equipment selection

Strategic approaches to airway management

Total quality management

References

Chapter 3: Airway procedures

Introduction

Basic airway interventions

Advanced airway management

Supraglottic airways

Surgical airways

Confirmation of airway placement

Methods for securing the endotracheal tube and supraglottic airways

Drug-facilitated intubation

Non-invasive positive pressure ventilation

Conclusion

References

Chapter 4: Airway management

Introduction

Ground-level airway management

Face-to-face intubation

Intubating under low light conditions

Minimizing airway management equipment

Telemedicine-assisted airway management

Airway management in the tactical setting

Conclusion

Acknowledgments

References

Section II: Breathing

Chapter 5: Respiratory distress

Introduction

Prehospital assessment and diagnosis

General treatment

Asthma

Chronic obstructive pulmonary disease

Acute decompensated heart failure/acute cardiogenic pulmonary edema

Pneumonia and infectious respiratory disease

Pulmonary embolus

Pneumothorax

Conclusion

References

Chapter 6: Oxygenation and ventilation

Introduction

Assessment of oxygenation

Assessment of ventilation

Assisting oxygenation and ventilation

Pneumothorax

Conclusion

References

Section III: Circulation

Chapter 7: Hypotension and shock

Introduction

Pathophysiology

Evaluation

General approach to shock

Hypovolemic shock

Distributive shock

Obstructive shock

Cardiogenic shock

Shock of unclear etiology

Shock in the pediatric population

Shock interventions

Controversies

Protocol development

Conclusion

References

Chapter 8: Vascular access

Introduction

Benefits

Risks

Peripheral IV access

Intraosseous access

Central intravenous access

Special considerations

The future: ultrasound-guided IV access

Conclusion

References

Section IV: Medical Problems

Chapter 9: The challenge of the undifferentiated patient

Introduction: the call-taking process

En route to the patient

History taking

Physical examination

Adjuncts to the history and physical examination: prehospital diagnostic tests

The truly undifferentiated patient

Strategies for minimizing errors in clinical reasoning

Conclusion

References

Chapter 10: Altered mental status

Introduction

Evaluation

Management

Challenges with the AMS patient

Conclusion and EMS protocol recommendations

Acknowledgment

References

Chapter 11: Cardiac arrest systems of care

Introduction

Epidemiology of cardiac arrest

Elements of a community cardiac arrest care system

Conclusion

References

Chapter 12: Cardiac arrest

Introduction

Specific interventions

Principles of management

Withholding resuscitation

Termination of resuscitation

Postarrest care

Conclusion

References

Chapter 13: Chest pain and acute coronary syndrome

Introduction

General approach

Role of emergency medical dispatch

The 12-lead electrocardiogram

Medications

Prehospital fibrinolysis

Systems of care for ST-elevation myocardial infarction

Emergency medical services transport

Other common causes of chest discomfort

Conclusion

References

Chapter 14: Cardiac dysrhythmias

Introduction

Evaluation

Controversies

Protocols

Conclusion

References

Chapter 15: Cardiac procedures and managing technology

Intraaortic balloon pump

Ventricular assist device

Implanted cardiac devices

Pericardiocentesis

Conclusion

References

Chapter 16: Abdominal pain

Introduction

Approach to the patient with abdominal pain

Anatomy and physiology considerations

History and physical examination

Management

Disposition

Special populations

Conclusion

References

Chapter 17: Submersion injuries/drowning

Epidemiology

Pathophysiology of drowning

Clinical management

Grief reactions

References

Chapter 18: Choking

Introduction

Pathophysiology and epidemiology

Patient assessment

Clinical management

Medical oversight considerations

Controversies

Conclusion

References

Chapter 19: Syncope

Introduction

Pathophysiology

Assessment

Differential diagnosis

Treatment

Disposition

Conclusion

References

Further reading

Chapter 20: Seizures

Introduction

Pathophysiology

Differential diagnosis

Classification of seizure types

EMS evaluation and response

Pharmacological interventions

Seizure-associated trauma

Continuing management

Refractory generalized convulsive status epilepticus

Conclusion

References

Chapter 21: Stroke

Introduction

Overview of stroke

Dispatcher guidelines and call prioritization

EMS personnel on the scene

Prehospital treatment of stroke

Treatment options and the importance of time

Role of the EMS system in promoting early patient arrival

Importance of transport to an appropriate facility

Protocols

Controversies

Conclusion

References

Chapter 22: Allergic reactions

Introduction

Physiology of allergic reactions

Causative agents

Assessment and general approach

Prehospital treatment

Special considerations

Conclusion

References

Chapter 23: Diabetic emergencies

Introduction

Prehospital assessment

Prehospital treatment

Disposition

Protocols

Conclusion

References

Chapter 24: Renal failure and dialysis

Introduction

Definitions and pathophysiology

Epidemiology

Treatment of renal disease

Complications of renal disease

Complications of hemodialysis

Medication concerns

Complications of peritoneal dialysis

Special considerations

EMS pearls

References

Chapter 25: Infectious and communicable diseases

Introduction

Paramedic and patient

General approach and patient assessment

Biological weapons

Other infections

References

Section V: Trauma Problems

Chapter 26: Trauma Systems of Care

Introduction

Trauma system organization

Injury prevention

Conclusion

References

Chapter 27: Blunt trauma considerations

Introduction

Effect on emergency medical services

Training for EMS providers

Resuscitation and initial assessment

Constellations of blunt traumatic injury

Issues in specific patient populations

Medical oversight issues in trauma

Guidelines for out-of-hospital management

Prevention and other public health issues

References

Chapter 28: Motor vehicle crashes

Introduction

Effect on EMS

Motor vehicle crash injury biomechanics

Safety restraints

Motor vehicle crash types

Crashes involving vulnerable road users

EMS crash assessment priorities

Unique motor vehicle crash problems

Emerging technology

Available education

References

Chapter 29: Penetrating trauma

Introduction

Physics and mechanics of penetrating trauma

Ballistics

Types of weapons

High-velocity projectile injury

Resuscitation and initial assessment

Transport issues

Penetrating chest trauma

Penetrating abdominal trauma

Penetrating neck trauma

Penetrating head and facial trauma

Penetrating extremity trauma

Prevention and public health issues

Medicolegal issues

Forensic issues

Prehospital termination of resuscitation in penetrating trauma

Conclusion

References

Chapter 30: Traumatic brain injury

Introduction

Primary assessment