Emergency Care: United States Edition
Autor Daniel J. Limmer, EMT-P, Michael F. O'Keefe, Harvey Grant, Bob Murray, J. David Bergeron, ED Dickinsonen Limba Engleză Mixed media product – 13 aug 2008
This edition of Emergency Care has been thoroughly updated to reflect important changes in science and practice.
Two new features have also been added that reflect the vital impact EMTs have on their patients: Point of View, which tells stories of EMS care from the patient’s perspective, and Critical Decision Making, which introduces students to real-life decisions they will face on the street.
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Specificații
ISBN-13: 9780135005231
ISBN-10: 013500523X
Pagini: 1296
Dimensiuni: 216 x 276 x 41 mm
Greutate: 2.54 kg
Ediția:Nouă
Editura: Pearson Education
Colecția Prentice Hall
Locul publicării:Upper Saddle River, United States
ISBN-10: 013500523X
Pagini: 1296
Dimensiuni: 216 x 276 x 41 mm
Greutate: 2.54 kg
Ediția:Nouă
Editura: Pearson Education
Colecția Prentice Hall
Locul publicării:Upper Saddle River, United States
Cuprins
Module 1 Preparatory
Chapter 1: Introduction to Emergency Medical Care
Chapter 2: The Well-Being of the EMT-Basic
Chapter 3: Medical/Legal and Ethical Issues
Chapter 4: The Human Body
Chapter 5: Lifting and Moving Patients
Module 2 Airway
Chapter 6: Airway Management
Module 3 Patient Assessment
Chapter 7: Scene Size-Up
Chapter 8: The Initial Assessment
Chapter 9: Vital Signs and SAMPLE History
Chapter 10: Assessment of the Trauma Patient
Chapter 11: Assessment of the Medical Patient
Chapter 12: Ongoing Assessment
Chapter 13: Communications
Chapter 14: Documentation
Module 4 Medical Emergencies
Chapter 15: General Pharmacology
Chapter 16: Respiratory Emergencies
Chapter 17: Cardiac Emergencies
Chapter 18: Acute Abdominal Emergencies
Chapter 19: Diabetic Emergencies and Altered Mental Status
Chapter 20: Allergic Reactions
Chapter 21: Poisoning and Overdose Emergencies
Chapter 22: Environmental Emergencies
Chapter 23: Behavioral Emergencies
Chapter 24: Obstetric and Gynecological Emergencies
Chapter 25: Putting It All Together for the Medical Patient
Module 5 Trauma Emergencies
Chapter 26: Bleeding and Shock
Chapter 27: Soft-Tissue Injuries
Chapter 28: Musculoskeletal Injuries
Chapter 29: Injuries to the Head and Spine
Chapter 30: Putting It All Together for the Trauma Patient
Module 6 Younger and Older Patients
Chapter 31: Infants and Children
Chapter 32: Special Needs Patients
Chapter 33: Geriatric Patients
Module 7 Operations
Chapter 34: Ambulance Operations
Chapter 35: Gaining Access and Rescue Operations
Chapter 36: Special Operations
Chapter 37: Terrorism and EMS
Module 8 Advanced Airway Management
Chapter 38: Advanced Airway Management
Appendix A: ALS Assist Skills
Appendix B: BCLS
Appendix C: The Future of EMS Education
Appendix D: Answers
Chapter 1: Introduction to Emergency Medical Care
Chapter 2: The Well-Being of the EMT-Basic
Chapter 3: Medical/Legal and Ethical Issues
Chapter 4: The Human Body
Chapter 5: Lifting and Moving Patients
Module 2 Airway
Chapter 6: Airway Management
Module 3 Patient Assessment
Chapter 7: Scene Size-Up
Chapter 8: The Initial Assessment
Chapter 9: Vital Signs and SAMPLE History
Chapter 10: Assessment of the Trauma Patient
Chapter 11: Assessment of the Medical Patient
Chapter 12: Ongoing Assessment
Chapter 13: Communications
Chapter 14: Documentation
Module 4 Medical Emergencies
Chapter 15: General Pharmacology
Chapter 16: Respiratory Emergencies
Chapter 17: Cardiac Emergencies
Chapter 18: Acute Abdominal Emergencies
Chapter 19: Diabetic Emergencies and Altered Mental Status
Chapter 20: Allergic Reactions
Chapter 21: Poisoning and Overdose Emergencies
Chapter 22: Environmental Emergencies
Chapter 23: Behavioral Emergencies
Chapter 24: Obstetric and Gynecological Emergencies
Chapter 25: Putting It All Together for the Medical Patient
Module 5 Trauma Emergencies
Chapter 26: Bleeding and Shock
Chapter 27: Soft-Tissue Injuries
Chapter 28: Musculoskeletal Injuries
Chapter 29: Injuries to the Head and Spine
Chapter 30: Putting It All Together for the Trauma Patient
Module 6 Younger and Older Patients
Chapter 31: Infants and Children
Chapter 32: Special Needs Patients
Chapter 33: Geriatric Patients
Module 7 Operations
Chapter 34: Ambulance Operations
Chapter 35: Gaining Access and Rescue Operations
Chapter 36: Special Operations
Chapter 37: Terrorism and EMS
Module 8 Advanced Airway Management
Chapter 38: Advanced Airway Management
Appendix A: ALS Assist Skills
Appendix B: BCLS
Appendix C: The Future of EMS Education
Appendix D: Answers
Notă biografică
Daniel Limmer (Author). Dan Limmer, EMT-P, has been involved in EMS for over 25 years. He remains active as a paramedic with Kennebunk Fire Rescue in Kennebunk, Maine, and the Kennebunkport EMS (KEMS) in Kennebunkport, Maine. A passionate educator, Dan teaches EMT and paramedic courses at the Southern Maine Community College in South Portland, Maine, and has taught at the George Washington University in Washington, DC and the Hudson Valley Community College in Troy, New York. He is a charter member of the National Association of EMS Educators and a member of the National Association of EMTs (NAEMT) for which he serves on the Advanced Medical Life Support Committee.
Dan was formerly involved in law enforcement, beginning as a dispatcher and retiring as a police officer in Colonie, New York, where he received three command recognition awards as well as the distinguished service award (Officer of the Year) in 1987. During his 20-year law enforcement career he served in the communications, patrol, juvenile, narcotics, and training units.
In addition to authoring several EMS journal articles, Dan is co-author of a number of EMS textbooks for Brady including First Responder: A Skills Approach, Essentials of Emergency Care, Advanced Medical Life Support, the military and fire service editions of Emergency Care, and others. He speaks frequently at regional, state, and national EMS conferences.
Michael F O'Keefe (Author). Mike O'Keefe, MS, EMT-P, became the Vermont EMS State Training Coordinator in 1989. He has a Master's degree in biostatistics and was an EMT-Intermediate for 16 years before becoming a paramedic 10 years ago.
Mike was chosen to participate in the development of all four U.S. Department of Tranpsortation National Standard EMS Curricula (for First Responders, EMT-Basics, EMT-Intermediates, and EMT-Paramedics). He was also on the steering committee that developed the Geriatric Education for Emergency Medical Services (GEMS) course for the American Geriatrics Society and coauthored a chapter of the textbook for that course.
Mike is co-author of the Brady text Essentials of Emergency Care and is a contributing writer to the Brady text Paramedic Care: Principles & Practice. He is very interested in promoting EMS research, particularly in rural areas. Mike is active as a volunteer EMS provider in northwestern Vermont and is a speaker at EMS conferences.
Edward T. Dickinson (Medical Editor). Edward T. Dickinson, MD, NREMT-P, FACEP, is currently Assistant Professor and Director of EMS Field Operations in the Department of Emergency Medicine of the University of Pennsylvania School of Medicine in Philadelphia. He is Medical Director of the Malvern Fire Company, the Berwyn Fire Company, and the Township of Haverford paramedics in Pennsylvania. He is a residency-trained, board-certified emergency medicine physician who is a Fellow of the American College of Emergency Physicians.
Dr. Dickinson began his career in emergency services in 1979 as a firefighter-EMT in upstate New York. He has remained active in fire service and EMS for the past 25 years. He frequently rides with EMS units and has maintained his certification as a National Registry EMT-Paramedic.
He has served as medical editor for numerous Brady EMT-B and First Responder texts and is the author of Fire Service Emergency Care and co-author of Emergency Care, Fire Service Edition, and Emergency Incident Rehabilitation. He is co-editor of ALS Case Studies in Emergency Care.
Dan was formerly involved in law enforcement, beginning as a dispatcher and retiring as a police officer in Colonie, New York, where he received three command recognition awards as well as the distinguished service award (Officer of the Year) in 1987. During his 20-year law enforcement career he served in the communications, patrol, juvenile, narcotics, and training units.
In addition to authoring several EMS journal articles, Dan is co-author of a number of EMS textbooks for Brady including First Responder: A Skills Approach, Essentials of Emergency Care, Advanced Medical Life Support, the military and fire service editions of Emergency Care, and others. He speaks frequently at regional, state, and national EMS conferences.
Michael F O'Keefe (Author). Mike O'Keefe, MS, EMT-P, became the Vermont EMS State Training Coordinator in 1989. He has a Master's degree in biostatistics and was an EMT-Intermediate for 16 years before becoming a paramedic 10 years ago.
Mike was chosen to participate in the development of all four U.S. Department of Tranpsortation National Standard EMS Curricula (for First Responders, EMT-Basics, EMT-Intermediates, and EMT-Paramedics). He was also on the steering committee that developed the Geriatric Education for Emergency Medical Services (GEMS) course for the American Geriatrics Society and coauthored a chapter of the textbook for that course.
Mike is co-author of the Brady text Essentials of Emergency Care and is a contributing writer to the Brady text Paramedic Care: Principles & Practice. He is very interested in promoting EMS research, particularly in rural areas. Mike is active as a volunteer EMS provider in northwestern Vermont and is a speaker at EMS conferences.
Edward T. Dickinson (Medical Editor). Edward T. Dickinson, MD, NREMT-P, FACEP, is currently Assistant Professor and Director of EMS Field Operations in the Department of Emergency Medicine of the University of Pennsylvania School of Medicine in Philadelphia. He is Medical Director of the Malvern Fire Company, the Berwyn Fire Company, and the Township of Haverford paramedics in Pennsylvania. He is a residency-trained, board-certified emergency medicine physician who is a Fellow of the American College of Emergency Physicians.
Dr. Dickinson began his career in emergency services in 1979 as a firefighter-EMT in upstate New York. He has remained active in fire service and EMS for the past 25 years. He frequently rides with EMS units and has maintained his certification as a National Registry EMT-Paramedic.
He has served as medical editor for numerous Brady EMT-B and First Responder texts and is the author of Fire Service Emergency Care and co-author of Emergency Care, Fire Service Edition, and Emergency Incident Rehabilitation. He is co-editor of ALS Case Studies in Emergency Care.
Caracteristici noi
The content of the 11thedition is summarized below, with emphasis on “what’s new” in each module of this edition:
Module 1, PREPARATORY:
Chapters 1-5
The first module sets a framework for all the modules that follow by introducing some essential concepts, information, and skills. The EMS system and the role of the basic-level EMT within the system are introduced. Issues of EMT safety and well-being and legal and ethical issues are covered. Basic anatomy and physiology and techniques of safe lifting and moving are also included in this first module.
What’s New in the Preparatory Module
“Introduction to Emergency Medical Care” a section has been added on forthcoming changes to EMSeducation standards and levels of certification and training
“The Well-Being of the EMT” new sections have been added on hepatitis C andAvian flu as well as scene safety at a potential terrorist incident.
Chapter 5 “Lifting and Moving Patients,” automatic power stretchersand updated stair chairs are described and illustrated.
Module 2, AIRWAY MANAGEMENT: Chapter 6
There is only one chapter in Module 2, but it may be considered the most important module in the text, because no patient will survive without an open airway. Basic airway management techniques that meet newly revised American Heart Association guidelines are covered in detail.
What’s New in the Airway Management Module?
Chapter 6, “Airway Management,” information on the Venturi mask has been added.
Module 3, ASSESSMENT:
Chapters7-14
The ability to perform a thorough and accurate assessment, treat for life-threatening conditions, and initiate transport to the hospital within optimum time limits are the essence of the EMT’s job. In this module, all of the steps of the assessment and their application to different types of trauma and medical patients, plus the skills of measuring vital signs, taking a patient history, communication, and documentation, are explained and illustrated.
What’s New in the Assessment Module?
Chapter 7, “Scene Size-up,” there is an expanded section on falls.
Chapter 9, “Vital Signs and SAMPLE History,” includes new information on the definition and consequences of hypertension. The automatic blood pressure monitor is introduced, and the pluses and minuses of the new CO-oximeters are discussed.
Chapter 13, “Communications,” expanded cautions are included on the reliability of cell phone communications.
Chapter 14, “Documentation,” Continuous Quality Improvement (CQI) systems are discussed.
Module 4, MEDICAL EMERGENCIES:
Chapters15-25
The Medical Emergencies module begins with a chapter on pharmacology in which the medications the basic-level EMT can administer or assist with under the 1994 curriculum are introduced. The module continues with chapters on respiratory, cardiac, abdominal, diabetic, allergy, poisoning and overdose, environmental, behavioral, and obstetric/gynecological emergencies. It ends with a new chapter on caring for patients with multiple medical complaints.
What’s New in the Medical Emergencies Module?
Chapter 15, “General Pharmacology” the table of Medications Patients Often Take has been extensively updated to remove medications no longer available or recommended to to add medications that have recently come into use.
Chapter 19, “Diabetic Emergencies and Altered Mental Status,” blood glucose meters that allow blood to be taken from areas such as the forearm instead of the finger are described.
Chapter 22, “Environmental Emergencies,” in accordance with recent World Health Organization and American Heart Association guidelines,the term “near-drowning” is no longer used (“drowning” is used for all such incidents, whether or not the patient survives).
Chapter 23, “Behavioral Emergencies,” information has been added regarding restraint of a patient when it is necessary in order for the patient to receive medical care.
Module 5, TRAUMA:
Chapters 26-30
The Trauma module begins with a chapter on bleeding and shock; continues with chapters on soft-tissue injuries, musculoskeletal injuries, and injuries to the head and spine; and ends with a chapter on caring for multiple-trauma patients.
What’s New in the Trauma Module?
Chapter 26, “Bleeding and Shock,” the terms “golden hour” and “platinum ten minutes” are deemphasized with greater emphasis placed on the general principle of improving patient outcomes by limiting time on scene and reducing the time from injury to operating suite. New information is added on narrowing pulse pressure as a sign of shock.
Chapter 27, “Soft-Tissue Injuries,” more material is included on specific chest injuries. A segment on flail segment has been added.
Chapter 29, “Injuries to the Head and Spine,” has added a discussion of how spine immobilization protocols may differ by the patient’s age (child, adult, elderly).
Module 6, SPECIAL PATIENT POPULATIONS:
Chapters 31-33
Special considerations apply to younger and older patients as well as to patients who rely on advanced medical devices at home. The chapters in this module explore the physical and psychological differences among younger, older, and special needs patients while emphasizing how to serve all of these patients by applying the basics of patient assessment and care that the student has already learned.
What’s New in the Special Patient Populations Module?
Chapter 31 “Infants and Children”: Following American Heart Association guidelines, now addresses only two age categories: infant (birth to age 1) and child (age 1 to puberty). (The “child” category was formerly split as ages 1 to 8 and 8 to adult. Discussion and illustration of the [Pediatric Assessment Triangle have been updated to conform to the latest American Association of Pediatrics standards. A new emphasis throughout the chapter is keeping the ambulance compartment warm when transporting pediatric patients, who are especially susceptiable to hypothermia.
Chapter 32, “Special Needs Patients” is a new chapter in this edition that concerns patients who rely on advanced medical devices at home. Various types of advanced devices are discussed (respiratory devices, cardiac devices, gastrourinary devices, and central IV catheters) as are types of physical impairments. Discussions center on how to treat patients for problems not related to their special devices, on how to fix problems with the devices that may occur, and on how to use normal patient assessment and basic life support measures to support patients when their special devices fail.
Module 7, OPERATIONS: Chapters34-37
This module deals with nonmedical operations and special situations, including ambulance operations, motor-vehicle collision rescues, multiple-casualty and hazardous materials incidents, and EMS response to terrorism.
What’s New in the Operations Module?
Chapter 34, Ambulance Operations”:
An expanded discussion of special kits for the treatment of exposures to specific chemicals and poisons. An added emphasis on the safety of EMTs in the patient compartment of the ambulance. A new discussion of helicopter transport of medical patients (in addition to trauma and cardiac arrest patients).
Chapter 37, “EMSResponse to Terrorism” has been revised throughout to conform toNational Incident Management System (NIMS) guidelines.
Module 8, ADVANCED AIRWAY MANAGEMENT (ELECTIVE): Chapter 38
In some states and regions, basic-level EMTs are trained to perform invasive airway management procedures, including orotracheal intubation and, in children, nasogastric intubation. Module 8 is included as an elective to cover these advanced airway management skills.
What’s New in the Advanced Airway Module?
Chapter 38, “Advanced Airway Management,” information has been added on laryngeal mask airway (LMA) is introduced.
Information is included on esophageal detection devices and capnometry to confirm proper endotracheal tube placement and to provide continual monitoring during transport.
Appendices and BCLS Review
There are three appendices to this textbook, covering advanced life support assist skills, a review of the basic cardiac life support course, and a new appendix on the future of EMS education.
What’s New in the Appendices?
“ALS Assist Skills”:information has been added on capnometry and on alternative placement of ECG electrodes.on the extremities in addition to the traditional chest placement.
Appendix C, “The Future of EMSEducation,” is a new appendix on the past, present, and future of EMS education.
Appendix D, “Answer Keys,” includes answers for the Critical Decision Making features, Review Questions, and Street Scenes that appear in the chapters.
Module 1, PREPARATORY:
Chapters 1-5
The first module sets a framework for all the modules that follow by introducing some essential concepts, information, and skills. The EMS system and the role of the basic-level EMT within the system are introduced. Issues of EMT safety and well-being and legal and ethical issues are covered. Basic anatomy and physiology and techniques of safe lifting and moving are also included in this first module.
What’s New in the Preparatory Module
“Introduction to Emergency Medical Care” a section has been added on forthcoming changes to EMSeducation standards and levels of certification and training
“The Well-Being of the EMT” new sections have been added on hepatitis C andAvian flu as well as scene safety at a potential terrorist incident.
Chapter 5 “Lifting and Moving Patients,” automatic power stretchersand updated stair chairs are described and illustrated.
Module 2, AIRWAY MANAGEMENT: Chapter 6
There is only one chapter in Module 2, but it may be considered the most important module in the text, because no patient will survive without an open airway. Basic airway management techniques that meet newly revised American Heart Association guidelines are covered in detail.
What’s New in the Airway Management Module?
Chapter 6, “Airway Management,” information on the Venturi mask has been added.
Module 3, ASSESSMENT:
Chapters7-14
The ability to perform a thorough and accurate assessment, treat for life-threatening conditions, and initiate transport to the hospital within optimum time limits are the essence of the EMT’s job. In this module, all of the steps of the assessment and their application to different types of trauma and medical patients, plus the skills of measuring vital signs, taking a patient history, communication, and documentation, are explained and illustrated.
What’s New in the Assessment Module?
Chapter 7, “Scene Size-up,” there is an expanded section on falls.
Chapter 9, “Vital Signs and SAMPLE History,” includes new information on the definition and consequences of hypertension. The automatic blood pressure monitor is introduced, and the pluses and minuses of the new CO-oximeters are discussed.
Chapter 13, “Communications,” expanded cautions are included on the reliability of cell phone communications.
Chapter 14, “Documentation,” Continuous Quality Improvement (CQI) systems are discussed.
Module 4, MEDICAL EMERGENCIES:
Chapters15-25
The Medical Emergencies module begins with a chapter on pharmacology in which the medications the basic-level EMT can administer or assist with under the 1994 curriculum are introduced. The module continues with chapters on respiratory, cardiac, abdominal, diabetic, allergy, poisoning and overdose, environmental, behavioral, and obstetric/gynecological emergencies. It ends with a new chapter on caring for patients with multiple medical complaints.
What’s New in the Medical Emergencies Module?
Chapter 15, “General Pharmacology” the table of Medications Patients Often Take has been extensively updated to remove medications no longer available or recommended to to add medications that have recently come into use.
Chapter 19, “Diabetic Emergencies and Altered Mental Status,” blood glucose meters that allow blood to be taken from areas such as the forearm instead of the finger are described.
Chapter 22, “Environmental Emergencies,” in accordance with recent World Health Organization and American Heart Association guidelines,the term “near-drowning” is no longer used (“drowning” is used for all such incidents, whether or not the patient survives).
Chapter 23, “Behavioral Emergencies,” information has been added regarding restraint of a patient when it is necessary in order for the patient to receive medical care.
Module 5, TRAUMA:
Chapters 26-30
The Trauma module begins with a chapter on bleeding and shock; continues with chapters on soft-tissue injuries, musculoskeletal injuries, and injuries to the head and spine; and ends with a chapter on caring for multiple-trauma patients.
What’s New in the Trauma Module?
Chapter 26, “Bleeding and Shock,” the terms “golden hour” and “platinum ten minutes” are deemphasized with greater emphasis placed on the general principle of improving patient outcomes by limiting time on scene and reducing the time from injury to operating suite. New information is added on narrowing pulse pressure as a sign of shock.
Chapter 27, “Soft-Tissue Injuries,” more material is included on specific chest injuries. A segment on flail segment has been added.
Chapter 29, “Injuries to the Head and Spine,” has added a discussion of how spine immobilization protocols may differ by the patient’s age (child, adult, elderly).
Module 6, SPECIAL PATIENT POPULATIONS:
Chapters 31-33
Special considerations apply to younger and older patients as well as to patients who rely on advanced medical devices at home. The chapters in this module explore the physical and psychological differences among younger, older, and special needs patients while emphasizing how to serve all of these patients by applying the basics of patient assessment and care that the student has already learned.
What’s New in the Special Patient Populations Module?
Chapter 31 “Infants and Children”: Following American Heart Association guidelines, now addresses only two age categories: infant (birth to age 1) and child (age 1 to puberty). (The “child” category was formerly split as ages 1 to 8 and 8 to adult. Discussion and illustration of the [Pediatric Assessment Triangle have been updated to conform to the latest American Association of Pediatrics standards. A new emphasis throughout the chapter is keeping the ambulance compartment warm when transporting pediatric patients, who are especially susceptiable to hypothermia.
Chapter 32, “Special Needs Patients” is a new chapter in this edition that concerns patients who rely on advanced medical devices at home. Various types of advanced devices are discussed (respiratory devices, cardiac devices, gastrourinary devices, and central IV catheters) as are types of physical impairments. Discussions center on how to treat patients for problems not related to their special devices, on how to fix problems with the devices that may occur, and on how to use normal patient assessment and basic life support measures to support patients when their special devices fail.
Module 7, OPERATIONS: Chapters34-37
This module deals with nonmedical operations and special situations, including ambulance operations, motor-vehicle collision rescues, multiple-casualty and hazardous materials incidents, and EMS response to terrorism.
What’s New in the Operations Module?
Chapter 34, Ambulance Operations”:
An expanded discussion of special kits for the treatment of exposures to specific chemicals and poisons. An added emphasis on the safety of EMTs in the patient compartment of the ambulance. A new discussion of helicopter transport of medical patients (in addition to trauma and cardiac arrest patients).
Chapter 37, “EMSResponse to Terrorism” has been revised throughout to conform toNational Incident Management System (NIMS) guidelines.
Module 8, ADVANCED AIRWAY MANAGEMENT (ELECTIVE): Chapter 38
In some states and regions, basic-level EMTs are trained to perform invasive airway management procedures, including orotracheal intubation and, in children, nasogastric intubation. Module 8 is included as an elective to cover these advanced airway management skills.
What’s New in the Advanced Airway Module?
Chapter 38, “Advanced Airway Management,” information has been added on laryngeal mask airway (LMA) is introduced.
Information is included on esophageal detection devices and capnometry to confirm proper endotracheal tube placement and to provide continual monitoring during transport.
Appendices and BCLS Review
There are three appendices to this textbook, covering advanced life support assist skills, a review of the basic cardiac life support course, and a new appendix on the future of EMS education.
What’s New in the Appendices?
“ALS Assist Skills”:information has been added on capnometry and on alternative placement of ECG electrodes.on the extremities in addition to the traditional chest placement.
Appendix C, “The Future of EMSEducation,” is a new appendix on the past, present, and future of EMS education.
Appendix D, “Answer Keys,” includes answers for the Critical Decision Making features, Review Questions, and Street Scenes that appear in the chapters.