دانلود کتاب Advanced EMT: A Clinical Reasoning Approach

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Cover
Title Page
Copyright Page
Dedication
Brief Contents
Detailed Contents
Photo Scans
Letter to Students
Preface
Acknowledgments
About the Authors
A Guide to Key Features
Section 1 Preparing for Advanced Emergency Medical Technician Practice
1 Introduction to Advanced Emergency Medical Technician Practice
Introduction
EMS and EMS Providers
The Contemporary EMS Profession
EMS Provider Levels
Advanced EMT Roles and Responsibilities
Emergency Vehicle Readiness and Operations
Safety
Scene Leadership, Management, and Teamwork
Patient Assessment and Management
Maintaining Certification or Licensure
Interprofessional Teamwork
Advanced EMT Professional Characteristics
2 Emergency Medical Services, Health Care, and Public Health Systems
Introduction
Evolution of the EMS System
Transportation of the Sick and Injured
Emergency Prehospital Care
Military Influence
Key Events in EMS
Key Documents in EMS
Key People in EMS
Components of an EMS System
Legislation and Regulation
EMS Provider Education
National EMS Certification
EMS System Configuration and Workforce
Communication and System Access
Medical Direction
Evaluation
Health Care and Public Health
The Health Care System
The Public Health System
Getting to the Future
3 Workforce Wellness and Personal Safety
Introduction
Health of the Nation
Wellness and Emergency Medical Services
Wellness and Maslow’s Hierarchy of Needs
Stress
Physical Wellness
Infectious Disease Prevention
Sleep
Nutrition
Physical Fitness
Other Physical Health Considerations
Other Aspects of Wellness
4 Ethical and Medical/Legal Considerations in Advanced EMT Practice
Introduction
Ethics
Branches of Government and General Areas of Law
Authorization to Practice
Scope of Practice
Medical Direction
Consent and Refusal of Emergency Medical Care
Decision-Making Capacity
Informed Consent
Refusal of Consent
Implied Consent
Minor’s Consent
Legal Issues Related to Consent
Resuscitation Decisions and Recognizing Death
Advance Directives
Present Directives
Presumptive Signs of Death
Withholding or Terminating Resuscitation
Matters of Civil Law
Establishing the Elements of Negligence
Other Civil Claims
High-Risk Situations
Criminal Law Issues
Legal Protections
Crime Scenes
Other Legal Situations
5 Ambulance Operations and Responding to EMS Calls
Introduction
Phases of EMS Calls
Preparation
Receiving and Responding
On-Scene Care and Preparation for Transport
Transporting the Patient
Transferring Patient Care
Terminating the Call
Prehospital Environment and Types of Calls
Nonemergency Calls
Emergency Calls
Medical Calls
Trauma Calls
Responding to a Residence
Responding to Roadway Scenes
Rescue Situations
Hazardous Materials Situations
Multiple-Casualty Incidents
Ambulance Design
Vehicle Readiness
Exterior Vehicle and Mechanical Readiness
Patient Care Equipment and Supplies
Emergency Vehicle Operations
Defensive Driving
Speed
Due Regard
Emergency Driving
Safe Backing
Night Driving
Highway Driving
Emergency Response and Use of Warning Devices
Always Pass on the Left
Emergency Patient Transportation
Intersections
Following Other Emergency Vehicles
Parking on a Scene
Occupant Safety and Vehicle Security
Carbon Monoxide in Ambulances
Operational Security
Scene Size-Up
Nature of the Situation
Scene Safety
Number of Patients
Additional Resources
Patient Assessment Aspects of Scene Size-Up
Lifting and Moving Patients
Back Safety
Equipment and Techniques Used to Lift and Move Patients
Air Medical Transport
Advantages and Capabilities of Air Medical Transport
Limitations of Air Medical Transport
Requesting Air Medical Transport
Setting Up a Landing Zone
Air and Ground Crew Safety
6 Communication and Teamwork
Introduction
Communication
Sender Characteristics
Receiver Characteristics
Message Characteristics
Communication Channels, Interference, and Feedback
Team Dynamics and Communication
EMS System Communication
Oversight, Maintenance, and Coordination
Radio Frequencies and Traffic
Communicating and Documenting Times
Communication Equipment
Guidelines for Radio Communication
Therapeutic Communication and Interviewing Patients
Intercultural and Language Considerations
Trust and Rapport
Control the Environment
Nonverbal Communication
Verbal Communication
Pitfalls in Communication
Special Patient Communication Situations
Documentation
Standardized Data Collection
Sections of the Patient Care Report
Legal Considerations in Documentation
Special Documentation Circumstances
Section 2 Human Development, Health, and Disease
7 Medical Terminology
Introduction
Medical Terminology Basics
Anatomical Terms
Terms by Body System
8 Human Body Systems
Introduction
General Concepts in Anatomy and Physiology
Chemical Basis of Life
Cellular Basis of Life
The Cell Membrane
The Organelles
Tissues
Anatomical Terminology and Topographic Anatomy
Body Cavities
Organs and Body Systems
Support, Movement, and Protection
Skeletal System
Muscular System
Integumentary System
Respiration and Circulation
Respiratory System
Cardiovascular System
Control, Communication, and Integration
The Nervous System
Endocrine System
Nutrition and Excretion
Gastrointestinal System
Urinary System
Reproduction
Reproductive System
9 Life Span Development and Cultural Considerations
Introduction
Psychosocial Development
Piaget’s Theory of Cognitive Development
Erikson’s Theory of Psychosocial Development
Kohlberg’s Theory of Moral Development
Physical Development
Neonates and Infants
Toddlers and Preschoolers
School-Age Children
Adolescents
Young Adulthood
Middle Adulthood
Late Adulthood
Cultural Differences
Health Disparities
Health Care Beliefs and Social Interactions
Grief, Dying, and Death
Elisabeth Ku¨bler-Ross’s Stages of Dying
Children and Grief
Cross-Cultural Perspectives on Death and Dying
Death in the Field
Hospice and Palliative Care
10 Pathophysiology: Selected Impairments of Homeostasis
Introduction
Mechanisms of Disease and Injury
Compensation and Adaptation
Hypoxic Cellular Injury
Aerobic Metabolism
Anaerobic Metabolism
Causes of Hypoxia
Cellular Glucose Use
Acid–Base and Electrolyte Disturbances
Shock
Hypovolemic Shock
Cardiogenic Shock
Distributive Shock
Obstructive Shock
Pathophysiology of Shock
Heat and Cold Emergencies
Section 3 Pharmacology
11 Principles of Pharmacology
Introduction
Medication Sources
Medication Reference Material
Medication Profile
Medication Oversight and Regulation
Legislation
Medication Safety and Regulation
Special Considerations
Medication Names
Medication Forms
Solid Medications
Liquid Medications
Semisolid Medications
Gases
Classifications of Medications
Medications That Affect the Nervous System
Medication Packaging
Pharmacokinetics
Absorption
Distribution
Biotransformation
Elimination
Pharmacodynamics
Receptor Sites
Affinity
Mechanism of Action
Dose–Response Relationship
Factors Influencing Medication Effects
Medication Storage
12 Medication Administration
Introduction
Principles of Safe Medication Administration
Six Rights of Medication Administration
Additional Medication Safety Considerations
Routes of Drug Administration
Drug Orders
Interpreting Drug Orders
Drug Dosage Calculation
Review of the Metric System
Translating the Order to Units to Administer
Techniques of Medication Administration
Aseptic Technique
EMS Provider Safety
Oral Medication Administration
Sublingual Medication Administration
Nebulized Medication Administration
Medication Administration by Metered-Dose Inhaler
Nitrous Oxide Administration
Equipment Used for Injections
Drawing Medication from Ampules and Vials
Subcutaneous Injection
Intramuscular Injection
Auto-Injectors
Intravenous Injection
Establishing a Peripheral Intravenous Line
Equipment for Establishing IV Access
Selecting a Suitable Vein
Performing the Venipuncture
Unsuccessful IV Attempts and Discontinuing IV Therapy
Changing an IV Bag
Complications of IV Therapy
Pediatric Intraosseous Access
13 Medications
Introduction
Medications in Patient Care
IV Solutions
IV Fluids
Normal Saline (0.9 Percent Sodium Chloride Solution) for Intravenous Infusion
5 Percent Dextrose in Water for Intravenous Infusion
Lactated Ringer’s Solution
Medications
Albuterol Sulfate
Aspirin
50 Percent Dextrose
Epinephrine 1:1,000
Glucagon
Glucose
Naloxone
Nitroglycerin—Sublingual Tablets and Spray
Nitrous Oxide
Oxygen
Activated Charcoal
Acetaminophen
Ibuprofen
Nerve Agent Antidote Kits
Section 4 Assessment and Initial Management
14 General Approach to Patient Assessment and Clinical Reasoning
Introduction
Purpose and Goals of Patient Assessment
General Approach to Patient Assessment
Components of the Patient Assessment Process
Scene Size-Up
Primary Assessment
Secondary Assessment
Reassessment
Clinical Reasoning and Problem Solving
Readiness for Problem Solving
The Hypothetico–Deductive Approach to Problem Solving
Pattern Recognition
Heuristics: Rules of Thumb
Pitfalls in Clinical Reasoning
15 Scene Size-Up and Primary Assessment
Introduction
Scene Size-Up
Primary Assessment
Assessing the General Appearance
Assessing Level of Responsiveness
Assessing the Airway
Assessing Breathing
Assessing Circulation
Patient Care Decisions
Primary Assessments Compared
Reassessment and Documentation
16 Airway Management, Ventilation, and Oxygenation
Introduction
Anatomy and Physiology Review
Physiology of Air Movement
Upper Airway
Lower Airway
Gas Exchange
Ventilation
Pathophysiology of the Airway, Ventilation, and Oxygenation
Upper Airway Problems
Lower Airway Problems
Ventilation Problems
Assessment of the Airway, Ventilation, and Oxygenation
Scene Size-Up
Primary Assessment
Secondary Assessment and Reassessment
Airway Management
Positioning and Manual Maneuvers
Removing Foreign Bodies and Fluids from the Airway
Airway Adjuncts
Ventilation
Positive Pressure Ventilation
Bag-Valve-Mask Ventilations
Manually Triggered Ventilation Device and the Automatic Transport Ventilator
Continuous Positive Airway Pressure
Oxygenation
Oxygen as a Medication
Oxygen Equipment
Oxygen Safety
Oxygen Delivery Devices
17 Resuscitation: Managing Shock and Cardiac Arrest
Introduction
Pathophysiology of Shock
Hypoperfusion
Mechanisms of Shock
Assessing for Shock
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical Reasoning
Reassessment
Managing Bleeding and Shock
Bleeding Control
Intravenous Access and Fluid Administration
Fluid Resuscitation in Nonhemorrhagic Shock
Pneumatic Anti-Shock Garments
Cardiac Arrest
The Chain of Survival
Cardiopulmonary Resuscitation
Health Care Provider CPR
Scene Size-Up and Primary Assessment
Chest Compressions
Airway and Ventilations
Integrating Advanced Airway Devices
Defibrillation
Intravenous Access and Medications
Resuscitation Outcomes and Postresuscitation Care
CPR in Infants and Children
Secondary Assessment and History Taking in Resuscitation
Ethical and Legal Considerations
Return of Spontaneous Circulation
Management of Body Temperature
18 Vital Signs and Monitoring Devices
Introduction
Prioritizing Information Collection
Vital Signs
Assessing the Pulse
Assessing Blood Pressure
Orthostatic Vital Signs
Assessing Respirations
Assessing Body Temperature
Assessing the Skin
Assessing the Pupils
Monitoring Devices
Pulse Oximetry
End-Tidal Carbon Dioxide Monitoring
Blood Glucose Level
Cardiac Monitoring
19 History Taking, Secondary Assessment, and Reassessment
Introduction
General Approaches to the Secondary Assessment and History Taking
Medical Patients
Trauma Patients
Field Impression
Reassessment
Documentation
Taking a Medical History
The SAMPLE History
Working from the Presenting Problem or Chief Complaint
Overview of the Physical Examination
Anatomical Approach to Secondary Assessment
Body Systems Approach to Secondary Assessment
Section 5 Medical Emergencies
20 Respiratory Disorders
Introduction
Anatomy and Physiology Review
The Need for Oxygen
Structure and Function of the Lungs
Ventilation
General Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical-Reasoning Process
Treatment
Reassessment
Specific Respiratory Disorders
Chronic Obstructive Pulmonary Disease
Asthma
Pulmonary Embolism
Pulmonary Edema
Spontaneous Pneumothorax
Hyperventilation Syndrome
Infectious Respiratory Diseases
Lung Cancer
Cystic Fibrosis
21 Cardiovascular Disorders
Introduction
Anatomy and Physiology Review
Coronary Circulation
The Vascular System and Blood
Perfusion, Cardiac Output, and Blood Pressure
Cardiac Electrophysiology
General Assessment of Cardiovascular Complaints
Specific Cardiovascular Conditions
Acute Coronary Syndrome
Signs and Symptoms
Heart Failure
Cardiogenic Shock
Hypertension
Aortic Aneurysm and Dissection
Heart Rate Disturbances
22 Neurologic Disorders
Introduction
Anatomy and Physiology Review
Assessment
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical Reasoning and Decision Making
Reassessment
Specific Neurologic Disorders
Altered Mental Status
Syncope
Stroke
Seizures
Headache
Dementia and Delirium
Vertigo
Nontraumatic Back and Neck Pain
Central Nervous System Infections
Other Neurologic Disorders
23 Endocrine Disorders
Introduction
Anatomy and Physiology Review
The Pancreas and Blood Glucose Level
The Thyroid Gland and Metabolism
The Adrenal Glands
Assessment
Scene Size-Up
Primary Assessment
Secondary Assessment
Reassessment
Common Endocrine Disorders
Diabetes and Diabetic Emergencies
Thyroid Disorders
Adrenal Disorders
24 Abdominal Pain and Gastrointestinal Disorders
Introduction
Anatomy and Physiology Review
Stomach and Intestines
Accessory Organs of Digestion
Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical-Reasoning Process
Treatment
Reassessment
General Abdominal Complaints
Abdominal Pain
Nausea and Vomiting
Specific Abdominal Problems
Disorders of the Esophagus
Disorders of the Stomach and Intestines
Pancreatitis
Liver Disease
Cholecystitis
Other Causes of Abdominal Pain
25 Renal, Genitourinary, and Gynecologic Disorders
Introduction
Anatomy and Physiology Review
The Urinary System
Kidneys
Male Reproductive System
Female Reproductive System
Urinary System Disorders
Assessment and Management
Renal Disorders
Urinary Tract Disorders
Reproductive System Emergencies
Male Genitalia
Gynecologic Disorders
Sexually Transmitted Infections
26 Hematologic Disorders
Introduction
Anatomy and Physiology Review
Plasma
Red Blood Cells
White Blood Cells
Platelets
Hemostasis
Blood Groups
Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical-Reasoning Process
Treatment
Reassessment
Hematologic Conditions
Blood Transfusion Reactions
Red Blood Cell Disorders
White Blood Cell Disorders
Clotting Disorders
27 Immunologic Disorders
Introduction
Anatomy and Physiology Review
Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical-Reasoning Process
Treatment
Reassessment
Immunologic Disorders
Allergies and Anaphylaxis
Immunocompromise
Autoimmune Diseases
28 Infectious Illnesses
Introduction
Anatomy and Physiology Review
Infection and Disease Transmission
Pathogens
Infection Control
General Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical-Reasoning Process
Treatment
Reassessment
Infectious Illnesses
Bloodborne Infections
Respiratory Infections
Infections of Regional Concern
Childhood Illnesses
Meningitis and Encephalitis
Other Vectorborne Illnesses
Gastrointestinal Infections and Botulism
Mononucleosis and Herpes
External Parasites and Skin Infections
Sexually Transmitted Infections
29 Nontraumatic Musculoskeletal and Soft-Tissue Disorders
Introduction
Anatomy and Physiology Review
The Skin
Skeletal Muscle
Skeletal System
General Assessment and Management
Soft-Tissue and Musculoskeletal Disorders
Skin and Soft-Tissue Disorders
Joint Disorders
Bone Disorders
Muscular Disorders
Neck and Back Disorders
30 Disorders of the Eye, Ear, Nose, Throat, and Oral Cavity
Introduction
Anatomy and Physiology Review
The Eyes
The Ears
The Nose
The Oral Cavity
The Throat
Assessment and Management
Specific Disorders
Disorders of the Eye
Disorders of the Ear
Disorders of the Nose
Disorders of the Oral Cavity and Throat
31 Mental Illness and Behavioral Emergencies
Introduction
An Overview
Assessment and Management
Scene Size-Up and Primary Assessment
History and Secondary Assessment
Clinical Reasoning
Treatment and Reassessment
Common Disorders
Anxiety Disorders
Cognitive Disorders
Eating Disorders
Factitious Disorders and Somatoform Disorders
Impulse Control Disorders
Mood Disorders
Personality Disorders
Schizophrenia
Substance Abuse, Addiction, and Withdrawal
Alcohol
Suicide
Violent Patients
32 Toxicologic Emergencies
Introduction
Toxicology
Poison Control Centers
Assessment and Management
Scene Size-Up
Primary Assessment
History and Secondary Assessment
Clinical Reasoning
Treatment
Reassessment
Specific Toxicologic Emergencies
Carbon Monoxide
Cyanide
Caustic Substances
Hydrocarbons
Organophosphates
Ethanol and Toxic Alcohols
Food and Plant Toxins
Venom
Over-the-Counter Medications
Prescription Medications
Street Drugs
Section 6 Trauma
33 Trauma Systems and Incident Command
Introduction
Injury Prevention
Trauma Systems
Managing Multiple-Casualty Incidents
Communications
National Incident Management System
Incident Command System
On the Scene
Triage
Treatment
Transport
34 Mechanisms of Injury, Trauma Assessment, and Trauma Triage Criteria
Introduction
Kinematics of Trauma
Kinetics
Classifying Trauma
Assessment of the Trauma Patient
Scene Size-Up
Primary Assessment
Secondary Assessment
Reassessment
35 Soft-Tissue Injuries and Burns
Introduction
Anatomy and Physiology Review
Soft-Tissue Injuries
General Guidelines for Emergency Care
Closed Soft-Tissue Injuries
Open Soft-Tissue Injuries
Bleeding
Burns
Effects of Burns on the Body
Sources of Burns
Classification of Burn Severity
Burn Injury Assessment
Emergency Management of Burn Injuries
Specific Burn Injuries
36 Musculoskeletal Injuries
Introduction
Anatomy and Physiology Review
Skeletal Muscles
Ligaments and Tendons
Cartilage
Bones
Joints
Emergency Care of Musculoskeletal Injuries
Focused Assessment of Musculoskeletal Injuries
Splinting and Care of Musculoskeletal Injuries
Fractures
Types of Fractures
Complications of Fractures
Managing Long-Bone Fractures
Critical Fractures
Joint Injuries
Muscle Injuries
37 Head, Brain, Face, and Neck Trauma
Introduction
Anatomy and Physiology Review
The Skull
The Brain
The Neck
The Face
The Eye
General Assessment and Management
Injuries to the Head
Scalp Injuries
Skull Injuries
Traumatic Brain Injuries
Cerebral Edema and Increased Intracranial Pressure
Assessment and Management of Traumatic Brain Injury
Specific Brain Injuries
Injuries to the Face
Eye Injuries
Ear Injuries
Avulsed Teeth
Injuries to the Neck
Injuries to the Cervical Spine
Injuries to Blood Vessels
Injuries to the Airway
38 Thoracic Trauma
Introduction
Anatomy and Physiology Review
The Lungs and Ventilation
The Heart
General Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Communication and Documentation
Reassessment
General Categories
Open Chest Injury
Closed Chest Injury
Specific Thoracic Injuries
Rib Fracture
Flail Chest
Pneumothorax
Hemothorax
Traumatic Asphyxia
Blunt Cardiac Injury
Myocardial Contusion
Commotio Cordis
Pericardial Tamponade
39 Abdominal Trauma
Introduction
Anatomy and Physiology Review
General Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Management of Abdominal Trauma
Reassessment
Specific Abdominal Injuries
Penetrating Trauma
Blunt Trauma
40 Spine Injuries
Introduction
Anatomy and Physiology Review
The Spinal Column
The Spinal Cord
Mechanisms of Spine Injury
Spinal-Column Injury Versus Spinal-Cord Injury
Complete and Incomplete Spinal-Cord Injury
Spinal Shock
Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Reassessment
Spinal Motion Restriction
Spinal Trauma Management
Current Trends
Spinal Motion Restriction for Supine and Prone Patients
Spinal Motion Restriction for Seated Patient
Spinal Motion Restriction and Rapid Extrication
Special Considerations
Spinal Motion Restriction for Infants and Children
41 Environmental Emergencies
Introduction
Heat- and Cold-Related Emergencies
Anatomy and Physiology
Risk Factors
General Assessment
Specific Heat-Related Emergencies
Specific Cold-Related Emergencies
Drowning
Pathophysiology of Drowning
Assessment and Management
Diving Emergencies
Effects of Pressure
Assessment and Management
Specific Diving Injuries
High-Altitude Illness
Acute Mountain Sickness
High-Altitude Pulmonary Edema
High-Altitude Cerebral Edema
Lightning Injuries
42 Multisystem Trauma and Trauma Resuscitation
Introduction
Assessment and Management
Scene Size-Up
Primary Assessment
Transport Decision
Secondary Assessment
Multisystem Trauma Patient Packaging
Reassessment
Principles of Trauma Resuscitation
Section 7 Special Patient Populations
43 Obstetrics and Care of the Newborn
Introduction
Anatomy and Physiology
Female Reproductive System
Pregnancy
The Fetus
The Neonate
The Pregnant Patient
Assessment and Management
Obstetrical Complications and Emergencies
Labor and Delivery
Signs and Symptoms
Transport Decision
Preparing for Delivery
Assisting Delivery
Complications
Neonate Assessment and Management
Neonatal Resuscitation
APGAR Score
Vital Signs
Considerations in Neonatal Resuscitation
Complications and Defects
44 Pediatric Emergencies
Introduction
Pediatric Development
Infants
Toddlers and Preschool Children
School-Age Children
Adolescents
Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical-Reasoning Process
Treatment
Reassessment
Pediatric Medical Emergencies
Respiratory Emergencies
Cardiovascular Disorders
Sudden Infant Death Syndrome
Infectious Diseases
Neurologic Disorders
Diabetes
Gastrointestinal Disorders
Eye, Ear, Nose, and Throat Disorders
Behavioral Emergencies
Toxicologic Emergencies
Shock and Trauma in Pediatric Patients
Mechanisms of Injury
Assessment and Management
Considerations in Spinal Motion Restriction
Burns
Drowning
Child Abuse and Neglect
45 Geriatrics
Introduction
Anatomy and Physiology
Psychosocial Aspects of Aging
Assessment and Management
Scene Size-Up
Primary Assessment
Secondary Assessment
Clinical-Reasoning Process
Treatment
Reassessment
Additional Considerations
Common Medical Disorders
Respiratory Disorders
Cardiovascular Disorders
Neurologic Disorders
Renal and Genitourinary Disorders
Gastrointestinal Disorders
Endocrine Disorders
Infectious Disease
Musculoskeletal Disorders
Hematologic Disorders
Behavioral Emergencies
Toxicologic Emergencies
Trauma in the Geriatric Population
Mechanisms of Injury
Shock
Fractures
Burns
Environmental Emergencies
46 Patients with Special Challenges
Introduction
Sensory and Speech Impairments
Hearing Impaired
Vision Impaired
Speech Impairment
Cognitive Impairment
Developmental Impairments
Brain-Injured Patients
Paralyzed Patients
Bariatric Patients
Homeless and Impoverished Patients
Abused Patients
Child Abuse
Elder Abuse
Technology-Dependent Patients
Medical Oxygen
Apnea Monitors
Tracheostomy Tubes
CPAP and BiPAP
Mechanical Ventilators
Vascular Access Devices
Dialysis Shunts
Gastrointestinal and Genitourinary Devices
Ventriculostomy Shunts
Hospice Care
Section 8 Rescue and Special Operations
47 Rescue Operations and Vehicle Extrication
Introduction
Personal and Patient Safety
Personal Protective Equipment
Patient Safety
Phases of Rescue Operations
Phase One: Arrival and Size-Up
Phase Two: Hazard Control
Phase Three: Patient Access
Phase Four: Medical Treatment
Phase Five: Disentanglement
Phase Six: Patient Packaging
Phase Seven: Removal/Transport
Types of Rescue Operations
Hazardous Atmosphere
Disentanglement and Extrication
Vehicle Extrication
Scene Size-Up
Hazards
Vehicle Stabilization
Impact Damage and Extrication
Interior of the Vehicle
Gaining Access
Extrication Tools
48 Hazardous Materials
Introduction
Initial Recognition and Response
Recognize the Hazardous Material
Avoid the Hazardous Material
Isolate the Hazardous Material
Notify Responders About the Hazardous Material
Hazardous Materials Operations
Training Levels
Incident Command
Personal Protective Equipment
Decontamination
Rehabilitation
Medical Aspects of Hazardous Materials
Special Considerations in Radiation Incidents
Radiation Injury
Treatment for Radiation
49 Response to Terrorism and Disasters
Introduction
General Considerations
Natural Disasters
Terrorism and Weapons of Mass Destruction
Terrorist Groups
Weapons of Mass Destruction
Scene Size-Up
Patient Care
Appendices
Appendix 1: Endotracheal Intubation
Introduction
Equipment
Laryngoscope
Endotracheal Tube
Stylet
10-mL Syringe
Magill Forceps
Suction Unit
Securing Device
Tube Placement Confirmation Devices
Anatomy
Indications
Complications
Hypoxia
Equipment Malfunction
Damage to Teeth and Soft Tissues
Esophageal Intubation
Endobronchial Intubation
Endotracheal Intubation Procedures
Endotracheal Intubation of a Patient with No Suspected Spine Injury
Endotracheal Intubation of a Patient with Suspected Spine Injury
Appendix 2: Advanced ECG Recognition
Introduction
Standard ECG Monitoring
ECG Monitors
ECG Waveforms and Tracings
Pulseless Electrical Activity
Appendix 3: Adult Intraosseous Infusion
Introduction
Purpose of Intraosseous Access
Indications
Contraindications
Complications
Procedure for Tibial Intraosseous Access
Appendix 4: Additional Emergency Medications
Introduction
Activated Charcoal, U.S.P.
Adenosine
Amiodarone
Atropine Sulfate
Calcium Chloride
Diazepam
Diltiazem
Diphenhydramine
Dopamine
Epinephrine, 1:10,000
Fentanyl Citrate
Furosemide
Ipratropium Bromide
Ketamine
Ketorolac Tromethamine
Levalbuterol
Lidocaine Hydrochloride
Lorazepam
Magnesium Sulfate
Midazolam Hydrochloride
Morphine Sulfate
Ondansetron
Sodium Bicarbonate
Thiamine
Tranexamic Acid
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