Mosby's Paramedic Textbook

by ; ; ;
Edition: 3rd
Format: Hardcover
Pub. Date: 2006-07-21
Publisher(s): Elsevier Science Health Science div
List Price: $180.77

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Summary

The Revised Third Edition is updated to reflect the 2005 emergency cardiac care guidelines, and includes an all-new DVD-ROM featuring 64 medical animations that showcase anatomy & physiology and procedures. This book gives you everything you want in a paramedic textbook... and more! Updated, expanded, and packed with valuable new support materials, Mosby's Paramedic Textbook, 3rd Edition, is a comprehensive learning tool for both first-time and refresher paramedic students. Offering complete coverage of the 1998 U.S. D.O.T. National Standard Curriculum (NSC) for the EMT-Paramedic, as well as enhanced content for further learning, this comprehensive textbook contains everything in one convenient volume. Instructor resources are available; please contact your Elsevier sales representative for details. Perfect for review, each chapter includes a bulleted Summary and a list of References. Chapter openers set the stage for learning with Objectives and Key Terms with definitions. Boxed Critical Thinking questions aid in understanding concepts and how chapter content impacts patient care. ALS skills are presented step-by-step in full-color to demonstrate emergency care procedures. Content is updated to reflect the 2005 emergency cardiac care guidelines. Plus, new content has been added on bird flu, coronary bypass, endocarditis, adult IO infusion, new fluid resuscitation guidelines for trauma patients, drugs of abuse (Vicodin, Oxycontin), management of hypothermia and drowning, prediabetes, and a new airway algorithm. The book includes an additional DVD-ROM with 64 medical animations, which showcases anatomy and physiology and procedures. Detailed, up-to-date content throughout the text, and all chapters comply with the 1998 U.S. D.O.T. National Standard Curriculum for the EMT-Paramedic. Two new chapters! Life Span Development and Bioterrorism and Weapons of Mass Destruction. Two expanded chapters! Injury Prevention, and General Principles of Pathophysiology. A space-efficient design and reorganized table of contents make this edition more student-friendly and easier to read. Approximately 150 new illustrations, primarily photographs, accurately present different techniques and skills and are relevant to the material presented in the text. More than 900 illustrations in all! New appendix covers Advance Practice Procedures for the Critical Care Paramedic. A new skills DVD-ROM features step-by-step videos of 13 ALS skills and printable National Registry Skills Sheets for practicing required skills. RAPID Paramedic pocket guide contains quick reference information useful both in the classroom and in the field. Available separately or as part of a package. New herbal appendix for pharmacology chapter. An updated emergency drug index in the book provides a quick reference for approximately 60 emergency drugs. Mosby's Essential Drugs - available on Evolve with book purchase - is an online database designed specifically for Mosby's Paramedic Textbook, offering instant access to comprehensive, up-to-date information on the drugs that paramedics are most likely to encounter in practice. It includes Generic Drug Name/Trade Name of the medication, Description, Mechanism of Action, Pharmacokinetics, Indications/Dosage, Administration Guideline, Contraindications, Drug Interactions, and Adverse Reactions. Money-saving packages are available. Completely revised instructor resources make class preparation easier.

Table of Contents

Emergency Medical Services Systems: Roles and Responsibilitiesp. 2
Emergency Medical Services System Developmentp. 3
Current Emergency Medical Services Systemsp. 6
National Emergency Medical Services Group Involvementp. 10
Paramedic Educationp. 11
Licensure, Certification, and Registrationp. 11
Professionalismp. 11
Roles and Responsibilities of the Paramedicp. 13
Medical Direction for Emergency Medical Servicesp. 15
Improving System Qualityp. 16
Emergency Medical Services Researchp. 17
The Well-Being of the Paramedicp. 22
Wellness Componentsp. 23
Stressp. 32
Dealing with Death, Dying, Grief, and Lossp. 37
Prevention of Disease Transmissionp. 39
Injury Preventionp. 42
Injury Epidemiologyp. 43
Overview of Injury Preventionp. 43
Feasibility of Emergency Medical Services Involvementp. 46
Participation in Prevention Programsp. 50
Medical/Legal Issuesp. 54
Legal Duties and Ethical Responsibilitiesp. 55
The Legal Systemp. 55
Legal Accountability of the Paramedicp. 58
Paramedic-Patient Relationshipsp. 61
Resuscitation Issuesp. 65
Crime Scene Responsibilitiesp. 69
Documentationp. 69
Ethicsp. 72
Ethics Overviewp. 73
A Rapid Approach to Emergency Ethical Problemsp. 76
Ethical Tests in Health Carep. 76
Resolving Ethical Dilemmasp. 76
Ethical Issues in Contemporary Paramedic Practicep. 77
Review of Human Systemsp. 82
Terminologyp. 83
Cell Structurep. 84
Tissuesp. 90
Organ Systemsp. 92
Special Sensesp. 144
General Principles of Pathophysiologyp. 150
Cellular Physiologyp. 152
Basic Cellular Reviewp. 152
Cellular Environmentp. 152
Cellular Injury and Diseasep. 172
Alterations in Cells and Tissuesp. 172
Hypoperfusionp. 176
Self-Defense Mechanismsp. 181
Variances in Immunity and Inflammationp. 185
Stress and Diseasep. 187
Genetics and Familial Diseasesp. 189
Life Span Developmentp. 196
Newbornp. 197
Toddler and Preschool Yearsp. 201
School-Age Yearsp. 203
Adolescencep. 204
Early Adulthoodp. 206
Middle Adulthoodp. 206
Late Adulthoodp. 207
Therapeutic Communicationp. 214
Communicationp. 215
Internal Factors in Effective Communicationp. 216
External Factors in Effective Communicationp. 217
Patient Interviewp. 218
Strategies for Obtaining Informationp. 219
Methods of Assessing Mental Status During the Interviewp. 220
Special Interview Situationsp. 221
History Takingp. 226
Content of the Patient Historyp. 227
Techniques of History Takingp. 228
Special Challengesp. 231
Techniques of Physical Examinationp. 234
Physical Examination: Approach and Overviewp. 235
Mental Statusp. 238
General Surveyp. 240
Anatomical Regionsp. 250
Physical Examination of Infants and Childrenp. 274
Physical Examination of Older Adultsp. 277
Patient Assessmentp. 280
Scene Size-Up and Assessmentp. 281
Patient Assessment Prioritiesp. 282
Initial Assessmentp. 282
Focused History and Physical Examination: Medical Patientsp. 286
Focused History and Physical Examination: Trauma Patientsp. 286
Rapid Trauma Physical Examinationp. 287
Detailed Physical Examinationp. 287
Ongoing Assessmentp. 287
Care of Medical Versus Trauma Patientsp. 288
Clinical Decision Makingp. 290
The Spectrum of Prehospital Carep. 291
Critical Thinking Process for Paramedicsp. 291
Fundamental Elements of Critical Thinking for Paramedicsp. 293
Field Application of Assessment-Based Patient Managementp. 293
Putting it all Together: The Six R'sp. 294
Assessment-Based Managementp. 298
Effective Assessmentp. 299
The Right Stuffp. 302
Optional Take-in Equipmentp. 302
General Approach to the Patientp. 303
Presenting the Patientp. 303
Communicationsp. 306
Phases of Communications during a Typical Emergency Medical Services Eventp. 307
Role of Communications in Emergency Medical Servicesp. 308
Communications Systemsp. 310
Components and Functions of Dispatch Communications Systemsp. 314
Regulationp. 315
Procedures for Emergency Medical Services Communicationsp. 315
Documentationp. 318
Importance of Documentationp. 319
General Considerationsp. 320
The Narrativep. 320
Elements of a Properly Written Emergency Medical Services Documentp. 325
Systems of Narrative Writingp. 326
Special Considerations of Documentationp. 327
Document Revision/Correctionp. 328
Consequences of Inappropriate Documentationp. 328
Pharmacologyp. 332
Drug Informationp. 334
Historical Trends in Pharmacologyp. 334
Mechanisms of Drug Actionp. 337
General Properties of Drugsp. 337
Drug Interactionsp. 347
Drug Forms, Preparations, and Storagep. 348
Drug Profiles and Special Considerations in Drug Therapyp. 348
Drugs that Affect the Nervous Systemp. 351
Review of Anatomy and Physiologyp. 351
Drugs that Affect the Cardiovascular Systemp. 364
Review of Anatomy and Physiologyp. 364
Drugs that Affect the Bloodp. 368
Anticoagulants, Fibrinolytics, and Blood Componentsp. 368
Drugs that Affect the Respiratory Systemp. 370
Review of Anatomy and Physiologyp. 370
Drugs that Affect the Gastrointestinal Systemp. 372
Review of Anatomy and Physiologyp. 372
Drugs that Affect the Eye and Earp. 374
Treatment of Eye Disordersp. 374
Drugs that Affect the Endocrine Systemp. 375
Review of Anatomy and Physiologyp. 375
Drugs that Affect the Reproductive Systemp. 376
Treatment of Disorders of the Reproductive Systemp. 376
Drugs Used in Neoplastic Diseasesp. 377
Antineoplastic Agentsp. 377
Drugs Used in Infectious Disease and inflammationp. 378
Treatment of Infectious Disease and Inflammationp. 378
Drugs that Affect the Immunological Systemp. 381
Review of Anatomy and Physiologyp. 381
Appendix
Herbsp. 385
Herbal Productsp. 385
Herbal Supplementsp. 385
Venous Access and Medication Administrationp. 388
Mathematical Equivalents Used in Pharmacologyp. 389
Drug Calculationsp. 391
Drug Administrationp. 396
Medical Asepsisp. 397
Universal Precautions in Medication Administrationp. 397
Enteral Administration of Medicationsp. 397
Parental Administration of Medicationsp. 399
Administration of Percutaneous Medicationsp. 420
Special Considerations for Pediatric Patientsp. 423
Obtaining a Blood Samplep. 423
Disposal of Contaminated Items and Sharpsp. 425
Universal Precautions: Measures to Prevent Transmission of the Human Immunodeficiency Virus (HIV)p. 427
Airway Management and Ventilationp. 430
Respiratory Physiologyp. 431
Mechanics of Respirationp. 431
Measurement of Gasesp. 437
Pulmonary Circulationp. 438
Respiratory Pathophysiologyp. 449
Foreign Body Airway Obstructionp. 449
Aspiration by Inhalationp. 452
Airway Evaluationp. 453
Essential Parameters of Airway Evaluationp. 453
Supplemental Oxygen Therapyp. 455
Ventilationp. 459
Airway Managementp. 464
Suctionp. 466
Mechanical Adjuncts in Airway Managementp. 469
Advanced Airway Proceduresp. 472
Pharmacological Adjuncts to Airway Management and Ventilationp. 490
Translaryngeal Cannula Ventilationp. 492
Cricothyrotomyp. 494
Trauma Systems and Mechanism of Injuryp. 501
Epidemiology of Traumap. 501
Kinematicsp. 503
Energyp. 503
Blunt Traumap. 504
Blunt Traumap. 504
Restraintsp. 506
Organ Collision Injuriesp. 508
Other Motorized Vehicular Collisionsp. 510
Pedestrian Injuriesp. 511
Other Causes of Blunt Traumap. 511
Penetrating Traumap. 514
Penetrating Traumap. 514
Hemorrhage and Shockp. 520
Hemorrhagep. 521
Definition of Shockp. 522
Tissue Oxygenationp. 522
The Body as a Containerp. 523
Capillary-Cellular Relationship in Shockp. 524
Classifications of Shockp. 526
Stages of Shockp. 527
Uncompensated Shockp. 527
Management and Treatment Plan for the Patient in Shockp. 529
Integration of Patient Assessment and the Treatment Planp. 536
Soft Tissue Traumap. 538
Anatomy and Physiologyp. 539
Pathophysiologyp. 540
Pathophysiology and Assessment of Soft Tissue Injuriesp. 542
Management Principles for Soft Tissue Injuriesp. 547
Hemorrhage and Control of Bleedingp. 549
Dressing Materials Used with Soft Tissue Traumap. 551
Management of Specific Soft Tissue Injuries Not Requiring Closurep. 552
Special Considerations for Soft Tissue Injuriesp. 556
Burnsp. 558
Incidence and Patterns of Burn Injuryp. 559
Classifications of Burn Injuryp. 561
Pathophysiology of Burn Shockp. 565
Assessment of the Burn Patientp. 566
General Principles in Burn Managementp. 567
Inhalation Burn Injuryp. 569
Chemical Burn Injuryp. 570
Electrical Burn Injuriesp. 573
Radiation Exposurep. 576
Head and Facial Traumap. 580
Maxillofacial Injuryp. 581
Ear, Eye, and Dental Traumap. 585
Anterior Neck Traumap. 590
Head Traumap. 593
Brain Traumap. 596
Injury Rating Systemsp. 603
Spinal Traumap. 606
Spinal Trauma: Incidence, Morbidity, and Mortalityp. 607
Traditional Spinal Assessment Criteriap. 607
Review of Spinal Anatomy and Physiologyp. 609
General Assessment of Spinal Injuryp. 609
Classifications of Spinal Injuryp. 611
Evaluation and Assessment of Spinal Cord Injuryp. 614
General Management of Spinal Injuriesp. 615
Cord Injury Presentationsp. 626
Nontraumatic Spinal Conditionsp. 627
Assessment and Management of Nontraumatic Spinal Conditionsp. 628
Thoracic Traumap. 630
Skeletal Injuryp. 631
Closed Pneumothoraxp. 633
Heart and Great Vessel Injuryp. 638
Other Thoracic Injuriesp. 640
Abdominal Traumap. 644
Mechanisms of Abdominal Injuryp. 645
Specific Abdominal Injuriesp. 646
Vascular Structure Injuriesp. 649
Assessment of Abdominal Traumap. 649
Management of Abdominal Traumap. 649
Musculoskeletal Traumap. 652
Classifications of Musculoskeletal Injuriesp. 653
Inflammatory and Degenerative Conditionsp. 656
Signs and Symptoms of Extremity Traumap. 658
Assessment of Musculoskeletal Injuriesp. 658
Upper Extremity Injuriesp. 660
Lower Extremity Injuriesp. 664
Open Fracturesp. 668
Straightening Angular Fractures and Reducing Dislocationsp. 669
Referral of Patients with Minor Musculoskeletal Injuryp. 670
Cardiologyp. 674
Risk Factors and Prevention Strategiesp. 676
Anatomy and Physiology of the Heartp. 676
Anatomyp. 676
Physiologyp. 677
Electrophysiology of the Heartp. 681
Electrical Activity of Cardiac Cells and Membrane Potentialsp. 681
Cell Excitabilityp. 682
Electrical Conduction System of the Heartp. 685
Assessment of the Patient with Cardiac Diseasep. 688
Assessmentp. 688
Electrocardiogram Monitoringp. 692
Basic Concepts of Electrocardiogram Monitoringp. 692
Relationship of the Electrocardiogram To Electrical Activityp. 700
Electrocardiogram Interpretationp. 703
Steps in Rhythm Analysisp. 703
Introduction to Dysrhythmiasp. 712
Classification of Dysrhythmiasp. 712
Dysrhythmias Originating in the Sinoatrial Nodep. 713
Dysrhythmias Originating in the Atriap. 720
Dysrhythmias Sustained or Originating in the Atrioventricular Junctionp. 730
Dysrhythmias Originating in the Ventriclesp. 734
Dysrhythmias that Are Disorders of Conductionp. 750
Specific Cardiovascular Diseasesp. 764
Pathophysiology and Management of Cardiovascular Diseasep. 764
Techniques of Managing Cardiac Emergenciesp. 799
Basic Cardiac Life Supportp. 799
Defibrillationp. 802
Implantable Cardioverter Defibrillatorsp. 804
Synchronized Cardioversionp. 805
Transcutaneous Cardiac Pacingp. 806
Cardiac Arrest and Sudden Deathp. 807
Termination of Resuscitationp. 808
Pulmonary Emergenciesp. 802
Pathophysiologyp. 803
Scene Size-up and Rescuer Safetyp. 804
Obstructive Airway Diseasep. 806
Pneumoniap. 811
Adult Respiratory Distress Syndromep. 814
Pulmonary Thromboembolismp. 816
Upper Respiratory Infectionp. 817
Spontaneous Pneumothoraxp. 817
Hyperventilation Syndromep. 818
Lung Cancerp. 818
Neurologyp. 822
Anatomy and Physiology of the Nervous Systemp. 823
Neurological Pathophysiologyp. 828
Pathophysiology and Management of Specific Central Nervous System Disordersp. 833
Endocrinologyp. 850
Anatomy and Physiology of the Endocrine Systemp. 851
Specific Disorders of the Endocrine Systemp. 852
Disorders of the Pancreas: Diabetes Mellitusp. 853
Disorders of the Thyroid Glandp. 863
Disorders of the Adrenal Glandsp. 864
Allergies and Anaphylaxisp. 868
Antigen-Antibody Reactionp. 869
Allergic Reactionp. 869
Localized Allergic Reactionp. 870
Anaphylaxisp. 870
Gastroenterologyp. 878
Gastrointestinal Anatomyp. 879
Assessment of the Patient with Acute Abdominal Painp. 879
Management of the Patient with an Abdominal Emergencyp. 883
Specific Abdominal Emergenciesp. 883
Appendix
Nasogastric Tube Insertionp. 892
Necessary Equipmentp. 892
Procedurep. 892
Possible Complicationsp. 892
Urologyp. 894
Anatomy and Physiology Reviewp. 895
Physical Examination for Patients with Genitourinary Disordersp. 898
Management and Treatment Planp. 898
Managementp. 903
Toxicologyp. 906
Poisoningsp. 907
Poison Control Centersp. 907
General Guidelines for Managing a Poisoned Patientp. 908
Poisoning by Ingestionp. 908
Poisoning by Inhalationp. 918
Poisoning by Injectionp. 921
Poisoning by Absorptionp. 930
Drug Abusep. 931
Toxic Effects of Drugsp. 931
Alcoholismp. 947
Alcohol Dependencep. 941
Ethanolp. 942
Medical Consequences of Chronic Alcohol Ingestionp. 942
Alcohol Emergenciesp. 945
Management of Toxic Syndromesp. 947
General Management Principles for Toxic Syndromesp. 947
Appendix
Toxicology in Emergency Cardiac Carep. 952
Guidelines for Severe Poisoningp. 952
Hematologyp. 956
Blood and Blood Componentsp. 957
Specific Hematological Disordersp. 958
General Assessment and Management of Patients with Hematological Disordersp. 966
Environmental Conditionsp. 970
Thermoregulationp. 971
Hyperthermiap. 974
Hypothermiap. 976
Frostbitep. 979
Submersionp. 981
Diving Emergenciesp. 983
High-Altitude Illnessp. 986
Infectious and Communicable Diseasesp. 990
Public Health Principles Related to Infectious Diseasesp. 997
Pathophysiology of Infectious Diseasep. 995
Physiology of the Human Response to Infectionp. 997
Stages of Infectious Diseasep. 1002
Human Immunodeficiency Virusp. 1002
Hepatitisp. 1007
Tuberculosisp. 1009
Meningococcal Meningitisp. 1011
Pneumoniap. 1013
Tetanusp. 1013
Rabiesp. 1014
Hantavirusp. 1015
Viral Diseases of Childhoodp. 1015
Other Viral Diseasesp. 1017
Sexually Transmitted Diseasesp. 1021
Lice and Scabiesp. 1023
Reporting an Exposure to an Infectious or a Communicable Diseasep. 1024
Paramedic's Role in Preventing Disease Transmissionp. 1025
Behavioral and Psychiatric Disordersp. 1028
Understanding Behavioral Emergenciesp. 1029
Assessment and Management of Behavioral Emergenciesp. 1031
Specific Behavioral and Psychiatric Disordersp. 1034
Special Considerations for Patients with Behavioral Problemsp. 1043
Gynecologyp. 1048
Organs of the Female Reproductive Systemp. 1049
Menstruation and Ovulationp. 1049
Specific Gynecological Emergenciesp. 1052
Obstetricsp. 1058
Normal Events of Pregnancyp. 1059
Specialized Structures of Pregnancyp. 1059
Fetal Growth and Developmentp. 1060
Obstetrical Terminologyp. 1063
Patient Assessmentp. 1063
Complications of Pregnancyp. 1066
Delivery Complicationsp. 1077
Neonatologyp. 1086
Risk Factors Associated with the Need for Resuscitationp. 1087
Physiological Adaptations at Birthp. 1088
Assessment and Management of the Neonatep. 1089
Resuscitation of the Distressed Neonatep. 1091
Routes of Drug Administrationp. 1093
Postresuscitation Carep. 1095
Neonatal Transportp. 1095
Specific Situationsp. 1095
Psychological and Emotional Supportp. 1100
Pediatricsp. 1102
The Paramedic's Role in Caring for Pediatric Patientsp. 1103
Emergency Medical Services for Childrenp. 1103
Growth and Development Reviewp. 1104
Anatomy and Physiology Reviewp. 1106
General Principles of Pediatric Assessmentp. 1108
General Principles of Patient Managementp. 1111
Specific Pathophysiology, Assessment, and Managementp. 1111
Infants and Children with Special Needsp. 1138
Recommended Childhood Immunization Schedulep. 1143
Geriatricsp. 1144
Demographics, Epidemiology, and Societal Issuesp. 1145
Living Environments and Referral Sourcesp. 1145
Physiological Changes of Agingp. 1146
General Principles in Assessment of the Geriatric Patientp. 1150
System Pathophysiology, Assessment, and Managementp. 1150
Abuse and Neglectp. 1168
Batteringp. 1169
Elder Abusep. 1172
Child Abusep. 1173
Sexual Assaultp. 1176
Patients with Special Challengesp. 1180
Physical Challengesp. 1181
Mental Challengesp. 1184
Pathological Challengesp. 1185
Culturally Diverse Patientsp. 1189
Terminally Ill Patientsp. 1191
Patients with Communicable Diseasesp. 1191
Financial Challengesp. 1191
Acute Interventions for the Home Health Care Patientp. 1194
Overview of Home Health Carep. 1195
General Principles of and Managementp. 1197
Specific Acute Home Health Care Interventionsp. 1198
Ambulance Operationsp. 1214
Ambulance Standardsp. 1215
Checking Ambulancesp. 1215
Ambulance Stationingp. 1215
Safe Ambulance Operationp. 1216
Aeromedical Transportationp. 1220
Medical Incident Commandp. 1224
Incident Command Systemp. 1225
Mass Casualty Incidentsp. 1230
Principles and Technology of Triagep. 1234
Critical Incident Stress Managementp. 1237
Rescue Awareness and Operationsp. 1240
Appropriate Training for Rescue Operationsp. 1241
Phases of a Rescue Operationp. 1242
Rescuer Personal Protective Equipmentp. 1244
Surface Water Rescuep. 1244
Hazardous Atmospheresp. 1247
Highway Operationsp. 1249
Hazardous Terrainp. 1254
Assessment Procedures During Rescuep. 1257
Crime Scene Awarenessp. 1260
Approaching the Scenep. 1261
Dangerous Residencep. 1262
Dangerous Highway Encountersp. 1262
Violent Street Incidentsp. 1263
Violent Groups and Situationsp. 1263
Safety Tacticsp. 1265
Tactical Patient Carep. 1267
EMS at Crime Scenesp. 1268
Hazardous Materials Incidentsp. 1270
Scope of Hazardous Materialsp. 1271
Laws and Regulationsp. 1271
Identification of Hazardous Materialsp. 1272
Personal Protective Clothing and Equipmentp. 1275
Health Hazardsp. 1277
Response to Hazardous Materials Emergenciesp. 1279
Medical Monitoring and Rehabilitationp. 1282
Emergency Management of Contaminated Patientsp. 1283
Decontamination of Rescue Personnel and Equipmentp. 1285
Appendix
Overview of Training Requirements for EMS Personnel Responding to a Hazardous Materials Incident as Established by OSHA/EPA and the NFPAp. 1288
OSHA/EPA Training Requirementsp. 1288
NPFA 473: Competencies for EMS Personnel Responding to Hazardous Materials Incidentsp. 1288
Bioterrorism and Weapons of Mass Destructionp. 1290
History of Biological Weaponsp. 1291
Critical Biological Agentsp. 1292
Methods of Disseminationp. 1292
Specific Biological Threatsp. 1293
Nuclear and Radiological Threatsp. 1296
Incendiary Threatsp. 1297
Specific Chemical Threatsp. 1297
Explosive Threatsp. 1300
Department of Homeland Securityp. 1300
General Guidelines for Emergency Responsep. 1301
Personal Protective Equipment for Chemical, Biological, Radiological, and Nuclear Agentsp. 1303
Emergency Drug Index (EDI)p. 1305
Glossaryp. 1350
CCT Appendix: Advanced Practice Procedures for the Critical Care Paramedicp. 1402
Illustration Creditsp. 1408
Table of Contents provided by Ingram. All Rights Reserved.

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