Fundamentals of Applied Pathophysiology for Paramedics E-Book

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

Seitenzahl: 832

Veröffentlichungsjahr: 2024

Beschreibung

Fundamentals of Applied Pathophysiology for Paramedics An essential introduction to pathophysiology for paramedics Paramedics are specialists in out-of-hospital emergency healthcare; they are also capable of operating as generalist clinicians whose work is indispensable in a variety of healthcare settings. The response to the COVID-19 pandemic, especially, has revealed the versatility of the paramedic workforce. Contemporary paramedic practice continues to break new ground as the workforce is called upon to undertake critical roles in support of the wider healthcare sector. However, to perform their crucial work paramedics require a strong understanding of pathophysiology to enable them to make rapid and effective clinical decisions. Fundamentals of Applied Pathophysiology for Paramedics is a comprehensive introduction to this subject for aspiring, early-career, and experienced paramedics. This textbook links theory to practice and supports high-quality care in dynamic, fast-paced environments. Drawing on the latest available evidence and clinical best practice, it promises to support current paramedics, and prepare student paramedics for their future as healthcare professionals. * User-friendly organisation of topics broken down by body systems * Detailed discussion of patient-focused issues, common and specialised diseases, and more * Physiological and psychological alerts to aid in diagnosis and response Fundamentals of Applied Pathophysiology for Paramedics is ideal for all paramedic students and early career paramedics.

Leseprobe

Table of Contents

Cover

Table of Contents

Title Page

Copyright Page

Dedication Page

Contributors

About the Editors

Preface

Acknowledgements

CHAPTER 1: Learning the Language: Terminology

Introduction

Anatomy and Physiology

Anatomy

Physiology

Terminology

Pathophysiology

The Determinants of Health

Using a Medical Dictionary, Hints and Tips

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 2: Cell and Body Tissue Physiology

Introduction

Cell Anatomy and Function

The Cell Membrane

The Cytoplasm

The Nucleus

Cellular Reproduction

Differentiation

Cellular Organelles

Body Tissues

The Ageing Process

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 3: Homeostasis

Introduction

Homeostatic Mechanisms

Thermoregulation

Blood Glucose Homeostasis

Arterial Blood Pressure Homeostasis

Plasma Osmolality and Electrolyte Homeostasis

Acid–Base Homeostasis

Blood Partial Pressure of Carbon Dioxide Homeostasis

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 4: Trauma and Inflammation

Introduction

Pathophysiology of Trauma and Inflammation

Management

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 5: Shock

Introduction

Shock

Pathophysiology of Shock

Burn Shock

Stages of Shock

Identification of Shock

Management of Shock

Summary

Acknowledgement

References

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 6: The Nervous System and Its Associated Disorders

Introduction

Central Nervous System

Peripheral Nervous System

Disorders of the Nervous System

Traumatic Brain Injury

Stroke

Dementia

Seizures and Epilepsy

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 7: The Cardiovascular System and Its Associated Disorders

Introduction

Gross Anatomy

Cardiac Cycle

Diseases of the Heart

Electrical

Diseases of the Vasculature

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 8: The Blood and Associated Disorders

Introduction

Functions of Blood

Composition of Blood

Blood Groups

White Blood Cells

Haemostasis

Areas of Internal Bleeding of Concern

Care and Management of Internal Bleeding

Anaemia

Sepsis

External Considerations

Intracranial Bleeding

Leukaemia

Haemophilia

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 9: The Renal System and Associated Disorders

Introduction

Kidneys

Regulating Blood Pressure: the Renin–Angiotensin–Aldosterone System

Ureters

Urinary Bladder

Urethra

Disorders of the Renal System

Renal Calculi

Urinary Tract Infections

Glomerular Disease

Diabetic Nephropathy

Acute Kidney Injury

Chronic Kidney Disease

Tumours

Ageing and the Renal System

Trauma

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 10: The Respiratory System and Associated Disorders

Introduction

Anatomy and Physiology

Disease Processes of the Respiratory System

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 11: The Gastrointestinal System and Associated Disorders

Introduction

Components of the Gastrointestinal System

Conditions of the Upper Gastrointestinal Tract

Conditions of the Lower Gastrointestinal Tract

The Acute Abdomen

Accessory Organs

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 12: The Endocrine System and Associated Disorders

Introduction

Physiology of the Endocrine System

Hormones

Control of Hormones

Introduction to Common Endocrine Pathologies

Clinical Features of Endocrine Disorders

Pituitary Disorders

Thyroid Disorders

Parathyroid Disorders

Adrenal Disorders

Pancreatic Disorders

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 13: The Reproductive Systems and Associated Disorders

The Female Reproductive System

Antepartum Haemorrhage

The Male Reproductive System

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 14: Pain

Introduction

The Physiology and Pathophysiology of Pain

Nociceptor Transduction

Transmission

Modulation

Perception

Pain Theories

Pathophysiology

Pain Assessment

Adult Assessment

Paediatric Assessment

The Biopsychosocial Approach

Pain Management

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 15: The Musculoskeletal System and Associated Disorders

Introduction

The Musculoskeletal System

Bone Development and Structure

Joints

Muscle

The Nervous System

Common Musculoskeletal Presentations

Lower Back Pain

Arthritis

Osteoporosis

Assessing Musculoskeletal Presentations

Treating Musculoskeletal Presentations

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 16: Fluid, Electrolyte Balance and Associated Disorders

Introduction

Body Fluid Compartments

Composition of Body Fluid

Body Fluid Balance

Osmosis

Electrolytes

Diffusion

Hormones That Regulate Fluid and Electrolytes

Oedema

Pulmonary Oedema

Peripheral Oedema

Disorders Associated with Fluid and Electrolyte Imbalance

Nausea and Vomiting

Nausea

Vomiting

Clinical Investigations

Caring for the Patient with Oedema

Pulmonary Oedema

Peripheral Oedema

Summary

References

Further Reading

Online Resources

Glossary of Terms

Multiple Choice Questions

CHAPTER 17: The Skin and Associated Disorders

Introduction

Anatomy and Physiology

Function of the Skin

Wound Healing

Assessment

Wound Assessment

Skin Infections: Viral, Bacterial and Fungal

Generalised Pustular Psoriasis

Wounds

Types of Wounds

Factitious/Iatrogenic/Self‐Harm Wounds

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 18: The Ears and Eyes

Introduction

The Senses of Equilibrium and Hearing

The Structure of the Ear

Equilibrium

Hearing

Disorders of the Ear

Ménière's Disease

The Sense of Sight

Lacrimal Apparatus

The Eye

The Processing of Visual Information

Disorders of the Eye

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

CHAPTER 19: Death and Dying

Introduction

The Process of Dying

The Grieving Process

Palliative Care

Advance Decision to Refuse Treatment

Assisted Dying

Sudden Unexpected Death in Paediatrics

Paramedic Management of Death and Dying

Summary

References

Further Reading

Online Resources

Glossary

Multiple Choice Questions

Multiple Choice Answers

Index

End User License Agreement

List of Tables

Chapter 1

TABLE 1.1 Anatomical descriptive terms.

TABLE 1.2 Anatomical regions of the head and neck.

TABLE 1.5 Anatomical regions of the lower limbs (legs).

TABLE 1.6 Basic components.

TABLE 1.7 Some prefixes, suffixes, their meaning and examples.

TABLE 1.8 Confusing terminology (Stansfield et al. 2015).

Chapter 3

TABLE 3.1 Electrolytes and their primary functions.

Chapter 4

TABLE 4.1 Key clinical assessments of the patient with major trauma and the ...

TABLE 4.2 Out of hospital medications.

Chapter 5

TABLE 5.1 An overview of the types of shock and their subtypes and major cau...

TABLE 5.2 Haemorrhagic shock classes for adults

TABLE 5.3 The stages of shock.

TABLE 5.4 Treatments by cause of shock.

TABLE 5.5 Common treatments for shock.

Chapter 6

TABLE 6.1 The lobes of the cerebral hemispheres.

TABLE 6.2 Cranial nerves.

TABLE 6.3 Lipid solubility of opioids.

TABLE 6.4 Myotomes.

TABLE 6.5 Vagal manoeuvres.

TABLE 6.6 Physiological effects of the sympathetic and parasympathetic nervo...

TABLE 6.7 The main types of brain herniation.

TABLE 6.8 The Glasgow Coma Scale.

TABLE 6.9 Avoiding iatrogenic rises in intracranial pressure.

TABLE 6.10 Bamford classification of stroke syndromes.

TABLE 6.11 The author's approach to safety netting.

Chapter 7

TABLE 7.1 Cardiac dynamics during the cardiac cycle.

TABLE 7.2 Conduction of electricity through the heart.

TABLE 7.3 Types of myocardial infarction.

TABLE 7.4 Locational of myocardial infarction.

TABLE 7.5 Key occlusive myocardial infarctions (OMI) presentations on ECG.

TABLE 7.6 Heart blocks.

Chapter 8

TABLE 8.1 Blood groups.

TABLE 8.2 Blood clotting factors.

Chapter 9

TABLE 9.1 Common signs and symptoms of disorders of the urinary system.

TABLE 9.2 Stages of chronic kidney disease (CKD) in relation to percentage o...

Chapter 10

TABLE 10.1 Medications management for asthma.

Chapter 11

TABLE 11.1 The stages of digestion.

TABLE 11.2 Common gastrointestinal conditions.

Chapter 12

TABLE 12.1 Endocrine glands and tissues, hormones and action.

Chapter 13

TABLE 13.1 Showing signs, symptoms and treatment options for common STIs....

TABLE 13.2 Definitions of vaginal bleeding.

TABLE 13.3 The International Federation of Gynecology and Obstetrics PALM‐CO...

TABLE 13.4 The World Health Organization (2023) signs and symptoms associate...

TABLE 13.5 Placental abruption and placenta praevia.

TABLE 13.6 Wells and PERC criteria for pulmonary embolism.

Chapter 14

TABLE 14.1 Types of noxious stimulus.

TABLE 14.2 Cancer pain descriptions.

TABLE 14.3 The OPQRST mnemonic for pain assessment.

TABLE 14.4 TEACH mnemonic for patients with communication difficulties.

TABLE 14.5 Options for analgesia.

Chapter 15

TABLE 15.1 The four stages of osteoarthritis.

TABLE 15.2 Clinical flag system.

TABLE 15.3 SOCRATES pain assessment mnemonic.

Chapter 16

TABLE 16.1 Fluid intake and output.

TABLE 16.2 Principal electrolytes and their functions.

Chapter 17

TABLE 17.1 Common types of bacterial skin infections.

TABLE 17.2 Classification of wound types.

TABLE 17.3 Description of types of surgical wound.

TABLE 17.4 Classification of burns.

Chapter 18

TABLE 18.1 Medications associated with Ménière's disease.

List of Illustrations

Chapter 1

FIGURE 1.1 Anatomical position.

FIGURE 1.2 Anatomical positions.

FIGURE 1.3 Anatomical planes.

FIGURE 1.4 The cavities of the body.

FIGURE 1.5 The determinants of health.

Chapter 2

FIGURE 2.1 The cell cycle.

Chapter 3

FIGURE 3.1 Types of cell signalling. (a) Plasma membrane‐bound receptor sign...

FIGURE 3.2 Five major components of homeostatic mechanisms.

FIGURE 3.3 Thermoregulatory behaviours of humans.

FIGURE 3.3a

FIGURE 3.3b

FIGURE 3.3c

FIGURE 3.4 Glucose homeostasis. ER, endoplasmic reticulum.

FIGURE 3.5 The renin–angiotensin–aldosterone system.

FIGURE 3.6 Control of plasma volume and osmolality.

Chapter 4

FIGURE 4.1 Haemostasis.

FIGURE 4.2 The triad of death.

FIGURE 4.3 Aerobic respiration.

Chapter 5

FIGURE 5.1 Hypovolaemic shock terminology.

FIGURE 5.2 A summary of cardiogenic shock pathology.

FIGURE 5.3 A summary of sepsis pathology.

FIGURE 5.4 Causes of anaphylaxis.

FIGURE 5.5 A simple summary of anaphylaxis pathology.

FIGURE 5.6 A summary of burn pathology.

FIGURE 5.7 A stepwise approach to ‘stop the bleed’ (interventions are listed...

Chapter 6

FIGURE 6.1 Divisions of the nervous system.

FIGURE 6.2 The gross anatomy of the human brain.

FIGURE 6.3 Homunculus.

FIGURE 6.4 The circle of Willis.

FIGURE 6.5 Folds and reflections of the dura mater.

FIGURE 6.6 The spinal cord and the location of the 31 pairs of spinal nerves...

FIGURE 6.7 Dermatome map.

FIGURE 6.8 Head injuries can result from an array of traumatic incidents.

FIGURE 6.9 Continuum of head injuries.

FIGURE 6.10 Physiology of rising intracranial pressure. BP, blood pressure; ...

FIGURE 6.11 Decorticate and decerebrate posturing.

FIGURE 6.12 Brain herniation.

FIGURE 6.13 Thiopentone, an anaesthetic agent.

FIGURE 6.14 Broca's and Wernicke's areas.

FIGURE 6.15 Subtypes of dementia.

FIGURE 6.16 Stepwise decline seen in multi‐infarct dementia.

FIGURE 6.17 Cardinal signs of Parkinson's disease.

FIGURE 6.18 Development of signs and symptoms in Parkinson's disease.

FIGURE 6.19 Incidence of epilepsy.

FIGURE 6.20 Seizure classification.

FIGURE 6.21 Management of status epilepticus. ECG, electrocardiogram; IO, in...

Chapter 7

FIGURE 7.1 Heart location.

FIGURE 7.2 Blood flow through the heart.

FIGURE 7.3 Flow of oxygenated and deoxygenated blood through the cardiovascu...

FIGURE 7.4 Coronary circulation.

FIGURE 7.5 Cardiac cycle.

FIGURE 7.6 Conducting system of the heart.

FIGURE 7.7 The vascular hourglass.

FIGURE 7.8 Pressure differential between arterial and venous systems.

FIGURE 7.9 Classification system for acute coronary syndromes.

FIGURE 7.10 Electrode positions for 12‐ to 15‐lead and 18‐lead ECGs (not sho...

FIGURE 7.11 Ventricular fibrillation.

FIGURE 7.12  Ventricular tachycardia (may be pulsed or pulseless).

FIGURE 7.13 Angiography demonstrating a significant filling defect indicated...

Chapter 8

FIGURE 8.1 Components of blood separated by centrifugation.

FIGURE 8.2 The composition of blood cells

FIGURE 8.3 A red blood cell.

FIGURE 8.4 Blood groups.

FIGURE 8.5 Types of bleeding.

FIGURE 8.6 Pelvic binder.

FIGURE 8.7 Sickle cell anaemia blood cells.

FIGURE 8.8 Petechiae.

Chapter 9

FIGURE 9.1 Renal system, anterior view (female).

FIGURE 9.2 Anatomy of the kidney (anterior view, right kidney).

FIGURE 9.3 Components of a nephron.

FIGURE 9.4 Steps involved in the regulation of blood pressure through the re...

FIGURE 9.5 Layers of the urinary bladder.

FIGURE 9.6 Sagittal section through the pelvis showing the male urethra.

FIGURE 9.7 Sagittal section through the pelvis showing the female urethra....

Chapter 10

FIGURE 10.1 Gross anatomy of the respiratory system.

FIGURE 10.2 Anatomy of the alveoli.

FIGURE 10.3 Total lung capacity by inspiration and expiration cycle.

FIGURE 10.4 Gas exchange within the alveoli.

FIGURE 10.5 Common asthma triggers.

FIGURE 10.6 Normal versus constricted bronchioles due to asthma.

FIGURE 10.7 Emphysema.

FIGURE 10.8 Obstruction of the airway caused by relaxation of the tongue.

Chapter 11

FIGURE 11.1 The gastrointestinal system.

FIGURE 11.2 The salivary glands.

FIGURE 11.3 Swallowing.

FIGURE 11.4 Peristalsis.

FIGURE 11.5 The stomach.

FIGURE 11.6 Gastric glands and cells.

FIGURE 11.7 The small intestine.

FIGURE 11.8 Common sites for peptic ulcer.

FIGURE 11.9 Mc Burney's point.

FIGURE 11.10 The abdominal quadrants.

Chapter 12

FIGURE 12.1 Tissues involved in endocrine control systems. The top half of t...

FIGURE 12.2 Types of hormone signalling.

FIGURE 12.3 Feedback control of blood glucose via insulin and glucagon.

FIGURE 12.4 Two models of feedback regulating hormone synthesis.

FIGURE 12.5 Effects of stress upon the hypothalamus, anterior pituitary, adr...

FIGURE 12.6 Clinical examination findings and features of common endocrine c...

FIGURE 12.7 Clinical features of severe hyperthyroidism and thyrotoxic crisi...

FIGURE 12.8 Severe hypothyroidism and myxoedema coma.

FIGURE 12.9 The renin angiotensin aldosterone system.

FIGURE 12.10 Acute adrenal (Addisonian) crisis.

FIGURE 12.11 Complications of diabetes.

Chapter 13

FIGURE 13.1 The external female genitalia.

FIGURE 13.2 The uterus and associated structures.

FIGURE 13.3 Types of female genital mutilation. (a) Type 2 FGM with key geni...

FIGURE 13.4 Ectopic pregnancy.

FIGURE 13.5 The male reproductive system.

FIGURE 13.6 The testicle.

FIGURE 13.7 The prostate gland.

Chapter 14

FIGURE 14.1 The pain pathway.

FIGURE 14.2 Spinal cord dorsal horn (spinothalamic tract).

FIGURE 14.3 Myelinated and non‐myelinated axon.

FIGURE 14.4 Location of the thalamus, hypothalamus and reticular formation....

FIGURE 14.5 Gate control theory of pain transmission.

FIGURE 14.6 Examples of referred pain and the origin of tissue damage.

FIGURE 14.7 Abbey pain scale.

FIGURE 14.8 The Wong Baker Faces Scale for paediatric pain assessment.

FIGURE 14.9 The FLACC pain assessment tool.

Chapter 15

FIGURE 15.1 The skeleton.

FIGURE 15.2 Bone structure.

FIGURE 15.3 A synovial joint.

FIGURE 15.4 Gross anatomy skeletal muscle.

Chapter 16

FIGURE 16.1 Fluid compartments.

FIGURE 16.2 Fluid distribution.

FIGURE 16.3 Electrolytes of intracellular and extracellular compartments....

FIGURE 16.4 Simple diffusion.

FIGURE 16.5 Carrier protein (facilitated diffusion).

FIGURE 16.6 Adrenal glands.

FIGURE 16.7 Cross‐section of the adrenal gland.

Chapter 17

FIGURE 17.1 Cross section of a hair.

FIGURE 17.2 Cross‐section of the skin.

FIGURE 17.3 Layers of the epidermis.

FIGURE 17.4 Epidermal ridges and sweat pores.

FIGURE 17.5 Structure of the hair.

FIGURE 17.6 Vitiligo.

FIGURE 17.7 Evisceration of a wound can be frightening for the patient.

FIGURE 17.8 Lund and Browder and ‘rule of nines’ tools.

Chapter 18

FIGURE 18.1 Structure of the ear.

FIGURE 18.2 Inner ear.

FIGURE 18.3 (a, b) Ampulla at rest and in response to movement.

FIGURE 18.4 Hair cells and otolith.

FIGURE 18.5 Action of gravity on the otolith.

FIGURE 18.6 Cross‐section of the cochlea.

FIGURE 18.7 Accessory structures of the eye.

FIGURE 18.8 Anatomy of the eye.

FIGURE 18.9 Refraction of light passing from air (less dense) to water (dens...

FIGURE 18.10 Focal length.

FIGURE 18.11 Accommodation to (a) far and (b) near objects.

FIGURE 18.12 (a) Myopic eye uncorrected and (b) corrected by a concave lens....

FIGURE 18.13 (a) Hyperopic eye uncorrected and (b) corrected by a convex len...

Guide

Cover Page

Table of Contents

Title Page

Dedication

Dedication Page

Contributors

About the Editors

Preface

Acknowledgements

Begin Reading

Multiple Choice Answers

Index

WILEY END USER LICENSE AGREEMENT

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Fundamentals of Applied Pathophysiology for Paramedics

EDITED BY

Ian Peate, OBE FRCN EN(G) RGN DipN(Lond) RNT Bed BEd (Hons) MA(Lond) LLM

Editor in Chief, British Journal of Nursing; Consultant Editor, Journal of Paramedic Practice;Consultant Editor, International Journal for Advancing Practice; Visiting Professor, Northumbria University;Visiting Professor, St Georges University of London and Kingston University London;Professorial Fellow, Roehampton University; Visiting Senior Clinical Fellow, University of Hertfordshire

AND

Simon Sawyer PhD BPara BPsychMan/Mar GCHPE

Director of Education, Australian Paramedical College; Adjunct Senior Lecturer in Paramedicine, Griffith University, Queensland, Australia

This edition first published 2024© 2024 John Wiley & Sons Ltd

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Library of Congress Cataloging‐in‐Publication Data

Names: Peate, Ian, editor. | Sawyer, Simon, editor.Title: Fundamentals of applied pathophysiology for paramedics / edited by Ian Peate, Simon Sawyer.Description: Hoboken, NJ : Wiley‐Blackwell, 2024. | Includes index.Identifiers: LCCN 2023047914 (print) | LCCN 2023047915 (ebook) | ISBN 9781119862802 (paperback) | ISBN 9781119862819 (adobe pdf) | ISBN 9781119862826 (epub)Subjects: MESH: Pathologic processes–diagnosis | Paramedics | Physiological Phenomena | Emergency TreatmentClassification: LCC RC67 (print) | LCC RC67 (ebook) | NLM QZ 140 | DDC 616/.047–dc23/eng/20231201LC record available at https://lccn.loc.gov/2023047914LC ebook record available at https://lccn.loc.gov/2023047915

Cover Design: WileyCover Images: © Brian Jackson/Adobe Stock Photos; Anatomy Insider/Adobe Stock Photos

To all those health and care professionals all around the world who worked tirelessly during the COVID‐19 pandemic

Contributors

George Bell‐Starr FdSc MCParaGeorge began his career in paramedicine studying at the University of Worcester before starting with South Western Ambulance Foundation Trust as a newly qualified paramedic in 2017. He has continued to study, focusing particularly on clinical reasoning. His key areas of interest include mentoring, developing paramedic practice and frailty. In late 2020, he began training as an advanced practitioner in primary care within the Mid‐Dorset Primary Care Network.

Carl Clare RN DipN MSc (Lond) PGDE (Lond)Carl began his nursing a career in 1990 as a nursing auxiliary. He later undertook three years of student nurse training at Selly Oak Hospital (Birmingham), moving to the Royal Devon and Exeter Hospitals, then Northwick Park Hospital, and finally the Royal Brompton and Harefield NHS Trust as a resuscitation officer and honorary teaching fellow of Imperial College (London). Since 2006, he has worked at the University of Hertfordshire as a senior lecturer in adult nursing. His key areas of interest are long term illness, physiology, sociology and cardiac care. Carl has previously published work in cardiac care, resuscitation and pathophysiology.

Neil Coleman MScOfficer in the National Ambulance Service, Ireland With a wealth of experience spanning over two decades in the National Ambulance Service, Neil is an Advanced Paramedic, Assistant Professor at University College Dublin, and former soldier and firefighter. Neil has actively contributed to the development and presentation of courses from entry‐level first aid to the accreditation of a BSc programme. He has overseen several large‐scale medical education programmes, including International Trauma Life Support, the Advanced Paramedic Programme (Ireland), and served as the Global Education Manager for a European‐based College. Neil is dedicated to advancing healthcare education to ensure a lasting impact on the profession and the training of future paramedic professionals.

Sadie Diamond‐Fox MCP ACCP (mFICM) BSc (Hons) RN PGCAHP NMP (V300) FHEASadie qualified as an adult nurse in 2008 and has since worked in various critical care departments. She progressed to her current advanced practice roles, which include advanced critical care practitioner, assistant professor in advanced critical care practice (FHEA) and regional advancing practice supervision and assessment lead for Health Education England. Sadie is also currently a second‐year PhD candidate. She has an extensive teaching portfolio spanning multiple disciplines within postgraduate healthcare education, making a wide range of contributions at local and international levels. Her key areas of interest are postgraduate healthcare education, acute, emergency and critical care, physiology and pharmacology, advanced‐level practice and simulation and virtual reality education modalities.

Terry Dore MSc PGDip HPE PGDip AP PGCertTerry worked for 20 years in Dublin Fire Brigade as a firefighter/paramedic and progressed to advanced paramedic after study at University College Dublin (UCD). He subsequently undertook a research MSc at UCD and a BSc (Hons) in paramedic studies in University of Limerick. He studied at the Royal College of Surgeons in Ireland and gained a postgraduate diploma in health professions education, becoming a clinical educator. He currently teaches advanced paramedic practitioners for the National Ambulance Service in Ireland and has recently begun an MSc in health, safety, and human factors at the Technological University Dublin. He has a keen interest in prehospital research and wishes to progress evidence‐based prehospital practice. Terry is certified with both the Health and Care Professions Council and the Pre‐Hospital Emergency Care Council as a paramedic and advanced paramedic in the United Kingdom and Ireland, respectively.

Sarah Eastwood (nee Lumley) BHSc (Hons) BNurs (Hons) PGradDipSarah began her paramedic career with Queensland Ambulance Service in Brisbane in 2012 while studying a double degree in paramedicine and nursing. Sarah then moved to Cairns upon qualifying as an advance care paramedic. Sarah undertook her postgraduate qualifications in paramedic science through Monash University and then completed her training as a critical care paramedic in 2021. Sarah also works as a flight care paramedic with the Queensland Ambulance Service. After working casually as an academic for Central Queensland University, Sarah recently accepted a lecturer position, where her main areas of interest are electrophysiology and clinical education. This is Sarah's first published writing.

Derek Fox MSc EMSDerek is employed as a district officer/advanced paramedic and has been a member of Dublin Fire Brigade for 32 years. He currently holds a diploma in emergency medical technology from North‐eastern University in the USA. He also holds a Graduate Diploma in Emergency Medical Science and a Masters (MSc) in emergency medical science, both from University College Dublin, giving him advanced paramedic status in Ireland. He is currently a facilitator and a national examiner for the Pre‐Hospital Emergency Care Council. He has been involved in the training and ‘on road’ supervision of advanced paramedics and paramedics for Dublin Fire Brigade and emergency medical technicians for a private company.

Alexandra Gatehouse MCP ACCP (mFICM) Bsc (Hons) Physiotherapy NMP (V300)Alex graduated from Nottingham University in 2000 with a Bsc (Hons) in physiotherapy. Following junior rotations in the Newcastle Hospitals NHS Foundation Trust she specialised in respiratory physiotherapy in adult critical care, also working in New Zealand. In 2012, she trained as an advanced critical care practitioner, completing a Masters in clinical practice in critical care and qualifying in 2014. Alex subsequently completed her non‐medical prescribing qualification and continues to rotate within all of the critical care units in Newcastle Upon Tyne, also enjoying teaching on the regional transfer course. She is a co‐founder of the Advanced Critical Care Practitioner Northern Region Group and is a committee member of the North East Intensive Care Society. Alex has presented abstracts at the European Society of Intensive Care Medicine and the North East Intensive Care Society conferences.

Ashley Ingram BSc (Hons) MCParaAshley began his career with South Western Ambulance Foundation Trust as an ambulance care assistant. Over the space of seven years, he worked his way up to a registered paramedic, training while working full time. He worked as an ambulance paramedic for three years, during which time he took a keen interest in palliative and end‐of‐life care. He has recently embarked on a primary care role as a frailty practitioner. Working within a multidisciplinary team, he focuses on admission avoidance with patients who reside in care homes in Dorset, UK. He looks forward to developing this role in the future.

Noleen P. Jones RN RNT Adv Dip in Leadership and Management BSc Nursing Med FHEANoleen's nursing background is mainly in critical care, where she worked for 26 years. During that period, she additionally held the posts of senior sister and lead nurse for education and training before moving onto clinical practice development for the Gibraltar Health Authority. This role enhanced her interest in education. She increasingly taught on the pregraduate nursing programmes, leading on to her undertaking a teaching and learning course and moving into teaching fulltime. Noleen is also a basic life support and moving and handling instructor for the organisation. Noleen is Principal Lecturer (Ag) at the Gibraltar Health Authority School of Health Studies. Noleen teaches in the BSc and diploma and access (adult) nursing courses at the University of Gibraltar. Her key interests include cardiac and respiratory care, simulation and teaching practice skills.

Kylie Kendrick BNurs BSc Paramedicine Registered Paramedic GC.paramedicine MPH PhD(C) FHEAKylie joined Rural Ambulance Victoria in 2008, working as a clinical mentor until transitioning into higher education. Kylie has undertaken a Master's in public health. Her research investigated the sleep health in undergraduate students. She has now transitioned to a PhD, where her research remains relevant to sleep health, although she has moved to the paramedic cohort. Kylie has undertaken a variety of roles in higher education, including programme development and accreditation, and has received citations for outstanding contributions to student learning through innovative practice.

Ian Macleod BParamedicSc DipVET Dip WHSIan is a career paramedic with 20 years' experience in a range of operational contexts and leadership roles. He has a strong passion for facilitating quality training and development for students and colleagues. Ian lives in South Australia with his supportive paramedic wife Stacey and 10‐year‐old stepson Levi. In addition to paramedicine, Ian works in mines and industrial fire and rescue and training content writing, and is an accredited rock‐climbing guide. While currently engaged as a remote area paramedic in outback South Australia, Ian is completing a Master of Medical and Health Science through research, concentrating on virtual reality as a pedagogical platform for mass casualty triage training. He retains a strong interest in emergency and disaster management. At home, Ian has an extensive LEGO collection, enjoys four‐wheel‐driving, camping and trailbike riding.

Tom E. Mallinson BSc (Hons) MBChB PGCHE MRCGP MCPara MCoROM FHEA FAWM FRGSTom initially trained as a paramedic with the University of Hertfordshire and the London Ambulance Service NHS Trust before completing his medical degree at the University of Warwick. He is currently a prehospital care doctor and rural GP in Scotland. Tom is also Co‐Director of Prehospital Care with BASICS Scotland and a lecturer in remote paramedic practice for the College of Remote and Offshore Medicine, Malta.

Tim Millington BSc (Hons) Paramedic Science BSc (Hons) Physiology/Pharmacology MSc Advance Clinical PracticeTim began working as a paramedic at Doncaster Ambulance station in 2009.He went on to establish himself in a busy emergency department in Rotherham, working throughout the COVID‐19 pandemic as an advanced clinical practitioner and non‐medical prescriber. He is presently a PHD candidate with the University of Hertfordshire. He has a research interest in resuscitation and has published work in the Journal of Paramedic Practice. He is also an experienced advanced life support instructor with the Resuscitation Council UK. He currently works as a consultant paramedic practitioner with the Yorkshire Ambulance Service NHS Trust and an advanced clinical practitioner in emergency medicine with Rotherham Hospital Foundation Trust.

Ian Peate OBE FRCNIan began his nursing career at Central Middlesex Hospital, becoming an enrolled nurse practising in an intensive care unit. He later undertook three years of student nurse training at Central Middlesex and Northwick Park hospitals, becoming a staff nurse and then a charge nurse. He has worked in nurse education since 1989. His key areas of interest are nursing practice and theory. Ian has published widely. He is editor in chief of the British Journal of Nursing, founding consultant editor of the Journal of Paramedic Practice and consultant editor International Journal for Advancing Practice. Ian was awarded an OBE for his services to nursing and nurse education and was granted a fellowship from the Royal College of Nursing. Ian is visiting professor at Northumbria University, St George’s University of London and Kingston University London, professorial fellow Roehampton University and visiting senior clinical fellow at the University of Hertfordshire.

Rory Prevett GDip BSc (Hons) Dip NQEMT APRory began his prehospital paramedic career in 2004, becoming a firefighter/paramedic with Dublin Fire Brigade. He later undertook a postgraduate diploma with University College Dublin to become an advanced paramedic, winning the Pantridge Award for academic excellence. With a keen interest in education and training, he became an instructor for International Trauma Life Support, Ireland, and a member of the teaching faculty for International Trauma Life Support Dublin Fire Brigade/Royal College of Surgeons in Ireland. He has a deep interest in airway management. He has in the past sat on the statutory regulator (PHECC) Medical Advisory Committee and was a prehospital governance assessor for Pre‐Hospital Emergency Care Council. He currently holds the position of Chief Practitioner for the Order of Malta Ambulance Corps, Ireland, and was previously the clinical manager for Medicore Private Ambulance Service, Dublin.

Liam Rooney BSc (Hons) GDip Dip NQEMT‐APLiam has worked as a firefighter/paramedic since 2007, when he completed his Diploma in Emergency Medical Technology – Paramedic with the Royal College of Surgeons, Ireland. In 2016, he completed a BSc (Hons) in Paramedic Studies at the University of Limerick, winning the Graduate Entry Medical School Award for overall performance. In 2017, he undertook a graduate Diploma in Emergency Medical Science through University College Dublin. Liam currently practices as an advanced paramedic with Dublin Fire Brigade. He joined the faculty of DX2 Institute of Pre‐Hospital Education in 2017, where he delivers multiple courses in prehospital education, and is also a tutor at University College Dublin. He has a keen interest in geriatric medicine and pain management in dementia patients.

Simon Sawyer PhD, BPara, BPsychMan/Mar, GCHPESimon has worked as an advanced life support paramedic in Victoria, Australia, since 2012. He began designing andteaching paramedic programmes as a lecturer at Monash University in 2015. Simon holds an adjunct senior lecturer position with the Paramedicine Department at Griffith University, where he studies family and domestic violence, paramediceducation and paramedic wellbeing. Simon completed a PhD on the paramedic response to family violence and teachesparamedics how to respond to patients experiencing family and domestic violence. Simon is currently the Director ofEducation at the Australian Paramedical College and still works as a paramedic.

Melanie Stephens BSc (Hons) MA PGCAP PhDMelanie commenced her career at Manchester Royal Infirmary in 1991 as a registered general nurse and is currently a senior lecturer in adult nursing within the School of Health and Society. Melanie is a health and social care researcher with specific research interests in pressure redistributing properties of seating, tissue viability, and interprofessional working and learning. She has undertaken research to provide an evidence base for products used in the 24‐hour management of pressure ulcers and affective domain development of student nurses. Melanie co‐led an amendment to the UK Tissue Viability Society seating guidelines with service users and is using this work to impact policy and practice. She is currently leading a feasibility study on the impact of interprofessional student training care homes on residents, care home staff and students. Experienced in mixed methods of enquiry, working with practitioners and commerce to develop research for the use in the clinical environment.

Scott Stewart PhD(VU) MBus(VU) DipHealthSci(AOTC) DipEd(Monash) BSc (Monash) MACPara Registered ParamedicScott dabbled in zoology before working as a biology and maths teacher in a secondary school and then joining Ambulance Victoria in 1992. Scott's Master's research evaluated customer satisfaction in ambulance services while his PhD focused on the teaching of evidence‐based practice. He has lectured in paramedicine at Monash University, Victoria University, St George's University of London and is currently paramedicine national professional practice lead and senior lecturer at the Australian Catholic University. Scott was involved in the Gibraltar Ambulance Service transitioning to paramedic level and was a consultant for the South East Coast Ambulance Service, UK, on the development of a critical care paramedic level. He is currently engaged in developing the Timor‐Leste ambulance service. Scott is a member of the Global Paramedic Higher Education Council.

Matt Wilkinson BP(H1) PhD(C)Matt is a practicing emergency paramedic and medical researcher. He is currently a Westpac Scholar and inaugural University of Melbourne MDHS PhD Award recipient, and his undergraduate thesis won a University Medal and Best Presentation at two international medical conferences. As well as working clinically, he also tutors Indigenous undergraduates. He lives on the Sunshine Coast with his partner and their beautiful golden retriever puppy (called Waffles).

Aimee Yarrington FCPara BSc (Hons) MScAimee has been a qualified midwife since 2003. She has worked in all areas of midwifery practice, from high‐risk consultant‐led units to low‐risk stand‐alone midwife‐led units. She left full‐time midwifery practice to join the ambulance service, starting as an emergency care assistant and working her way up to paramedic, while always keeping her midwifery practice up to date. She has worked in several areas within the ambulance service, including the emergency operations centre and the education and training department. Her work towards improving the education of prehospital maternity care has led to her being awarded a fellowship award from the College of Paramedics. Aimee strives to improve the teaching and education for clinicians dealing with prehospital maternity care.

David Yore GDip Dip NQEMT PDavid has a background in paramedicine and more recently in education and training. He has developed a keen interest in research and professional development. He began working in the field in 2016 and has since progressed to work in a statutory emergency ambulance service following the completion of a diploma in paramedical science from University College Cork, Ireland. David is undertaking a Master's in specialist paramedic practice and hopes to continue his research, particularly in the areas of paramedicine and prehospital care.

About the Editors

Ian Peate OBE FRCNIan began his nursing career at Central Middlesex Hospital, becoming an enrolled nurse practising in an intensive care unit. He later undertook three years of student nurse training at Central Middlesex and Northwick Park hospitals, becoming a staff nurse and then a charge nurse. He has worked in nurse education since 1989. His key areas of interest are nursing practice and theory. Ian has published widely. He is editor in chief of the British Journal of Nursing, founding consultant editor of the Journal of Paramedic Practice and consultant editor International Journal for Advancing Practice. Ian was awarded an OBE for his services to nursing and nurse education and was granted a fellowship from the Royal College of Nursing. Ian is visiting professor at Northumbria University, St George’s University of London and Kingston University London, professorial fellow Roehampton University and visiting senior clinical fellow at the University of Hertfordshire.

Simon Sawyer PhD, BPara, BPsychMan/Mar, GCHPESimon has worked as an advanced life support paramedic in Victoria, Australia, since 2012. He began designing and teaching paramedic programmes as a lecturer at Monash University in 2015. Simon holds an adjunct senior lecturer position with the Paramedicine Department at Griffith University, where he studies family and domestic violence, paramedic education and paramedic wellbeing. Simon completed a PhD on the paramedic response to family violence and teaches paramedics how to respond to patients experiencing family and domestic violence. Simon is currently the Director of Education at the Australian Paramedical College and still works as a paramedic.

Preface

We are delighted to have been asked to edit this new text Fundamentals of Applied Pathophysiology for Paramedics. There are 19 chapters in the text, a systems approach has been generally adopted. This textbook offers readers an introduction to pathophysiology related to the paramedic setting in a variety of academic programmes at colleges, universities or a vocational setting. Key disorders are described, together with a number of additional conditions that provide information on diseases with distinguishing features for each.

The Fundamentals of Applied Pathophysiology for Paramedics has been written by experienced clinicians and academics, primarily for the student undertaking programmes of study that are related to paramedic practice, with the aim of making the subject understandable, stimulating and related to your work as a paramedic. The human body has an amazing capacity to respond to illness in a number of physiological and psychological ways; humans are able to compensate as a result of the changes that occur due to the disease and pathophysiological processes, and the impact that they can have on a person. The Fundamentals of Applied Pathophysiology for Paramedics can assist in developing the paramedic's critical thinking, encouraging innovation and creativity related to the health and wellbeing of the people to whom you offer care and support. Critical thinking and clinical reasoning will lead to correct clinical judgements and practice; they are fundamental requirements in paramedicine.

Pathophysiology addresses the cellular and organ changes occurring when disease is present, as well as the impact that these changes can have on a person's ability to function. When there is an interruption to normal physiological functioning (e.g. illness), this becomes a pathophysiological issue. It has to be remembered that normal health is not and will never be exactly the same in any two people, because of this the term ‘normal’ has to be treated with caution. An understanding of pathophysiological ‘normal’ and ‘abnormal’ can assist when helping the patient in a competent, compassionate, safe and effective manner. The Fundamentals of Applied Pathophysiology for Paramedics is a foundation text, helping the reader to grow personally and professionally concerning the provision of care. It is primarily intended for those who come into contact with people who may present with physical health problems in various settings. The text focuses on the adult person. Illness and disease are discussed explicitly, highlighting the fact that people do become ill and they do experience disease.

The Fundamentals of Applied Pathophysiology for Paramedics considers diseases, their aetiology and acquired diseases. Chapters address signs and symptoms, investigations and diagnosis, with the purpose of revealing the cause of the signs and symptoms to make a diagnosis. Another important part of the pathophysiology is the prescription of any treatment that the paramedic is required to provide and administer. To do this effectively, it is essential that you have a sound knowledge of pathophysiology. Pathophysiology also allows the paramedic to offer a prognosis, referring to a patient's chance of survival or recovery; depending on the disease, the prognosis can be a full recovery, partial recovery, or fatal.

The early chapters help to prepare the reader for some of the more complex discussions that are to follow. Chapters commence and conclude with questions that aim to trigger reflection and encourage further thought. In the snapshots (case studies), pseudonyms are used to maintain confidentiality. Where appropriate, we have included boxed information that will help you when you are offering care and support to people. Red flags are also incorporated; these flags contain significant information warning you to be cautious in your approach. Orange flags alert the reader to psychological considerations and information concerning the management of medicines as related to the chapter. The snapshots generally include data concerning the patient's vital signs, control and dispatch information, pertinent background information, a ‘windscreen’ report and an ABCDE approach. These elements can help to relate important concepts to care, offering more insight into the patient's condition and therefore to their needs. This approach has been taken to help you to in learn as you apply the concepts being discussed.

We encourage you to ask questions such as ‘Why is the patient experiencing this?’, ‘Why are they, all of a sudden, experiencing this change?’, ‘What do we need to do to help this patient?’, ‘Is this an emergency?’ and then to go on and answer these questions. When you are able to understand what is going on in a person's body at the cellular level, you will be helped to understand it. Understanding pathophysiology and pathophysiological changes can help you as you respond and react to abnormal changes in patients in a faster, more accurate way. This understanding can make a significant difference in your role as a paramedic and to positive patient care outcomes.

We do not expect you to read the Fundamentals of Applied Pathophysiology for Paramedics from cover to cover; you are instead encouraged to dip in and out of it. The aim is to invite you in and encourage you; to stimulate your appetite, so you may read and learn further. We truly hope that you enjoy reading the text and applying it to practice situations. We hope that you will enjoy studying the topics that have been presented so as to encourage you to delve deeper. We also wish to stimulate you with a sense of curiosity with enthusiasm, ensuring that the patient is at the centre of all that you do and that the care you offer is safe, effective and appropriate.

Ian Peate

Simon Sawyer

Acknowledgements

Ian would like to thank his partner Jussi Lahtinen for his ongoing encouragement.

Simon would like to thank Ian for the opportunity to collaborate in this project.

We would like to thank the team at Wiley for their enthusiasm, encouragement and support.