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Emergency Care

ISBN: 9780131142312 | 0131142313
Edition: 11th
Format: Hardcover
Publisher: Prentice Hall
Pub. Date: 1/1/2009

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SummaryTable of Contents
For EMT Basic courses.Emergency Care, 10/E has prepared more students to pass state and/or the National Registry Exam than any other text on the market with well-organized, clearly presented content, thorough coverage of patient assessment, an accessible reading level, high quality artwork, and outstanding skill scans of equipment and procedures. Case studies and practical tips from the field tie chapter concepts to real world applications. Each chapter sends students to the Companion Website where there are links to EMS-related sites. A new in... MORE
MODULE Preparatory
Introduction to Emergency Medical Care
4(16)
The Emergency Medical Services System
... MORE(2)
How It Began
6(1)
EMS Today
7(1)
Components of the EMS System
8(9)
Accessing the EMS System
9(1)
Levels of EMS Training
10(1)
Roles and Responsibilities of the EMT-B
10(1)
Traits of a Good EMT-B
11(2)
Where Will You Become a Provider?
13(1)
National Registry of Emergency Medical Technicians
14(1)
Quality Improvement
14(1)
Medical Direction
15(1)
Special Issues
16(1)
Chapter Review
17(1)
Street Scenes
18(2)
The Well-Being of the EMT-Basic
20(23)
Personal Protection
22(3)
Body Substance Isolation (BSI) Precautions
22(1)
Personal Protective Equipment
23(2)
FYI Diseases of Concern
25(5)
Immunizations
30(1)
Emotion and Stress
30(5)
Physiologic Aspects of Stress
30(1)
Types of Stress Reactions
31(2)
Causes of Stress
33(1)
Signs and Symptoms of Stress
33(1)
Dealing with Stress
33(2)
Scene Safety
35(6)
Hazardous Materials Incidents
35(2)
Rescue Operations
37(1)
Violence
37(4)
Chapter Review
41(1)
Street Scenes
42(1)
Medical/Legal and Ethical Issues
43(16)
Scope of Practice
45(1)
Patient Consent and Refusal
45(5)
Consent
45(1)
When a Patient Refuses Care
46(3)
Do Not Resuscitate Orders
49(1)
Other Legal Aspects
50(6)
Negligence
50(1)
Duty to Act
51(1)
Good Samaritan Laws
51(1)
Confidentiality
51(1)
Special Situations
52(1)
Crime Scenes
53(2)
Special Crimes and Reporting
55(1)
Chapter Review
56(1)
Street Scenes
57(2)
The Human Body
59(40)
Anatomical Terms
61(4)
Directional Terms
61(2)
Positional Terms
63(2)
Body Systems
65(16)
Musculoskeletal System
65(4)
Respiratory System
69(2)
Cardiovascular System
71(5)
Nervous System
76(2)
Digestive System
78(1)
Skin
79(1)
Endocrine System
80(1)
FYI Locating Body Organs and Structures
81(12)
Chapter Review
93(4)
Street Scenes
97(2)
Lifting and Moving Patients
99(27)
Protecting Yourself: Body Mechanics
101(2)
Protecting Your Patient: Emergency, Urgent, and Non-Urgent Moves
103(18)
Emergency Moves
103(3)
Urgent Moves
106(1)
Non-Urgent Moves
107(14)
Chapter Review
121(1)
Street Scenes
122(4)
MODULE Airway
Airway Management
126(50)
Respiration
128(5)
Adequate and Inadequate Breathing
129(4)
Opening the Airway
133(4)
Head-Tilt, Chin-Lift Maneuver
135(1)
Jaw-Thrust Maneuver
136(1)
Techniques of Artificial Ventilation
137(7)
Mouth-to-Mask Ventilation
138(2)
Bag-Valve Mask
140(4)
Flow-Restricted, Oxygen-Powered Ventilation Device
144(1)
Airway Adjuncts
144(7)
Rules for Using Airway Adjuncts
146(1)
Oropharyngeal Airways
146(1)
Nasopharyngeal Airways
147(4)
Suctioning
151(4)
Suctioning Devices
151(2)
Techniques of Suctioning
153(2)
Oxygen Therapy
155(13)
Importance of Supplemental Oxygen
155(1)
Oxygen Therapy Equipment
156(4)
Hazards of Oxygen Therapy
160(1)
Administering Oxygen
161(7)
Special Considerations
168(2)
Chapter Review
170(6)
MODULE Patient Assessment
Scene Size-up
176(18)
Scene Size-up
178(14)
Scene Safety
178(6)
Nature of the Call
184(7)
Number of Patients and Adequacy of Resources
191(1)
Chapter Review
192(2)
The Initial Assessment
194(16)
The Initial Assessment
196(1)
Form a General Impression
196(1)
Cultural Considerations
197(6)
Assess Mental Status
200(1)
Assess the ABCs
200(1)
Determine Priority
201(2)
Patient Characteristics and Initial Assessment
203(5)
Comparing the Initial Assessments
206(2)
Chapter Review
208(1)
Street Scenes
209(1)
Vital Signs and Sample History
210(20)
Gathering the Vital Signs and History
212(1)
Vital Signs
212(12)
Pulse
213(2)
Respiration
215(1)
Skin
216(2)
Pupils
218(1)
Blood Pressure
218(4)
Oxygen Saturation
222(2)
Sample History
224(1)
Cultural Considerations
224(2)
Chapter Review
226(3)
Street Scenes
229(1)
Assessment of the Trauma Patient
230(39)
Focused History and Physical Exam for the Trauma Patient
232(15)
Trauma Patient with No Significant Mechanism of Injury
233(3)
Applying a Cervical Collar
236(1)
Trauma Patient with a Significant Mechanism of Injury
237(10)
Cultural Considerations
247(7)
Some General Principles
253(1)
Detailed Physical Exam
254(7)
Trauma Patient with a Significant Mechanism of Injury
254(7)
Trauma Patient with No Significant Mechanism of Injury
261(1)
Comparing Assessments
261(5)
Chapter Review
266(2)
Street Scenes
268(1)
Assessment of the Medical Patient
269(17)
Focused History and Physical Exam for a Medical Patient
271(9)
Responsive Medical Patient
271(6)
Unresponsive Medical Patient
277(3)
Comparing Assessments
280(4)
Chapter Review
284(1)
Street Scenes
285(1)
Ongoing Assessment
286(10)
Ongoing Assessment
288(3)
Components of the Ongoing Assessment
289(1)
Observing Trends
290(1)
Ongoing Assessment for Stable and Unstable Patients
291(1)
Comparing Assessments
291(3)
Chapter Review
294(1)
Street Scenes
294(2)
Communications
296(12)
Communications Systems and Radio Communication
298(5)
Communications Systems
298(1)
Radio Communication
299(4)
The Verbal Report
303(1)
Interpersonal Communication
303(3)
Chapter Review
306(2)
Documentation
308(22)
Prehospital Care Report
310(7)
Functions of the Prehospital Care Report
310(4)
Elements of the Prehospital Care Report
314(3)
Cultural Considerations
317(1)
Special Documentation Issues
318(8)
Legal Issues
318(4)
Special Situations
322(4)
Chapter Review
326(4)
MODULE Medical Emergencies
General Pharmacology
330(12)
Medications EMT-Basics Can Administer
332(3)
Medications on the Ambulance
332(1)
Prescribed Medications
333(2)
General Information About Medications
335(2)
Drug Names
335(1)
What You Need to Know When Giving a Medication
336(1)
FYI Medications Patients Often Take
337(2)
Chapter Review
339(3)
Respiratory Emergencies
342(22)
Respiration
344(5)
Respiratory Anatomy and Physiology
344(1)
Adequate Breathing
345(1)
Inadequate Breathing
345(3)
Adequate and Inadequate Artificial Ventilation
348(1)
Breathing Difficulty
349(2)
FYI Respiratory Assessment and Conditions
351(3)
The Prescribed Inhaler
354(2)
FYI Small-Volume Nebulizer
356(4)
Chapter Review
360(3)
Cultural Considerations
363(1)
Cardiac Emergencies
364(41)
Cardiac Anatomy and Physiology
367(1)
Cardiac Compromise
367(2)
Cultural Considerations
369(6)
Management of Cardiac Compromise
369(6)
FYI Causes of Cardiac Compromise
375(3)
Cardiac Arrest
378(3)
Chain of Survival
378(3)
FYI Controlled Hypothermia
381(14)
Management of Cardiac Arrest
381(1)
Automated External Defibrillator (AED)
381(10)
Special Considerations for AED Use
391(4)
FYI Implants and Surgeries
395(6)
Chapter Review
401(1)
Street Scenes
402(3)
Acute Abdominal Emergencies
405(15)
Abdominal Anatomy and Physiology
406(2)
Abdominal Pain and Distress
408(3)
Assessment and Care of Abdominal Distress
408(3)
Cultural Considerations
411(4)
General Abdominal Distress
415(1)
FYI Abdominal Conditions
415(2)
Chapter Review
417(1)
Street Scenes
418(2)
Diabetic Emergencies and Altered Mental Status
420(23)
Diabetes
422(4)
Diabetic Emergencies
422(3)
Blood Glucose Meters
425(1)
Cultural Considerations
426(3)
FYI Additional Information on Diabetes
429(1)
Other Causes of Altered Mental Status
430(2)
Seizure Disorders
430(2)
FYI Types of Seizures
432(8)
Stroke
433(3)
Dizziness and Syncope
436(4)
Chapter Review
440(1)
Street Scenes
441(2)
Allergic Reactions
443(14)
Allergic Reactions
445(6)
Distinguishing Anaphylaxis from Mild Allergic Reaction
447(4)
Self-Administered Epinephrine
451(3)
Chapter Review
454(1)
Street Scenes
455(2)
Poisoning and Overdose Emergencies
457(24)
Poisoning
459(2)
Ingested Poisons
460(1)
FYI Food Poisoning
461(3)
FYI Antidotes
464(4)
Inhaled Poisons
465(3)
FYI Smoke Inhalation
468(1)
Absorbed Poisons
468(1)
Injected Poisons
469(1)
Alcohol and Substance Abuse
469(2)
Alcohol Abuse
469(2)
FYI Poison Control Centers
471(7)
Substance Abuse
473(5)
Chapter Review
478(1)
Street Scenes
479(2)
Environmental Emergencies
481(29)
Exposure to Cold
483(7)
How the Body Loses Heat
483(1)
Generalized Hypothermia
484(4)
Localized Cold Injuries
488(2)
Exposure to Heat
490(3)
Effects of Heat on the Body
490(1)
Patient with Moist, Pale, Normal-to-Cool Skin
491(1)
Patient with Hot, Dry or Moist Skin
492(1)
Water-Related Emergencies
493(5)
Water-Related Accidents
493(1)
Drowning and Near-Drowning
494(4)
Diving Accidents
498(1)
FYI Scuba Diving Accidents
498(2)
FYI Water Rescues; Ice Rescues
500(1)
Bites and Stings
500(7)
Insect Bites and Stings
500(3)
Snakebites
503(2)
Poisoning from Marine Life
505(2)
Chapter Review
507(3)
Behavioral Emergencies
510(14)
Behavioral Emergencies
512(2)
What Is a Behavioral Emergency?
512(1)
Physical Causes of Altered Behavior
512(1)
Situational Stress Reactions
513(1)
Emergency Care for Behavioral Emergencies
514(7)
Psychiatric Emergencies
514(1)
Suicide
515(2)
Aggressive or Hostile Patients
517(1)
Reasonable Force and Restraint
517(1)
Transport to an Appropriate Facility
518(2)
Medical/Legal Considerations
520(1)
Chapter Review
521(3)
Obstetrics and Gynecological Emergencies
524(31)
Anatomy and Physiology of Childbirth
526(3)
Pregnancy and Delivery
526(1)
Labor
527(1)
Labor Pains
528(1)
Normal Childbirth
529(6)
Role of the EMT-Basic
529(1)
Normal Delivery
530(5)
Cultural Considerations
535(5)
The Newborn
535(1)
Assessing the Newborn
535(3)
Caring for the Mother
538(2)
Childbirth Complications
540(9)
Complications of Delivery
540(5)
Emergencies in Pregnancy
545(4)
FYI Childbirth and Death; Stillbirths; Accidental Death of a Pregnant Woman
549(1)
Gynecological Emergencies
549(2)
Chapter Review
551(4)
Putting It All Together for the Medical Patient
555(11)
Multiple Medical Complaints
556(1)
Managing the Patient with Multiple Medical Complaints
556(1)
Typical Calls
556(1)
Cultural Consisderations
557(3)
Analysis of the Calls
560(1)
Patient Conditions Not Covered in the EMT-B Course
560(2)
Chapter Review
562(4)
MODULE Trauma
Bleeding and Shock
566(25)
Circulatory System
568(1)
Main Components
568(1)
FYI Functions of the Blood
569(1)
Bleeding
569(11)
External Bleeding
569(9)
Internal Bleeding
578(2)
Shock (Hypoperfusion)
580(1)
Causes of Shock
580(1)
FYI Types of Shock
581(1)
Severity of Shock
581(1)
Cultural Considerations
582(6)
Emergency Care
583(5)
Chapter Review
588(1)
Street Scenes
589(2)
Soft-Tissue Injuries
591(42)
Soft Tissues
593(1)
Closed Wounds
594(2)
Types of Closed Wounds
594(2)
Open Wounds
596(5)
Types of Open Wounds
596(4)
Emergency Care for Open Wounds
600(1)
Treating Specific Types of Open Wounds
601(9)
Treating Abrasions and Lacerations
601(1)
Treating Puncture Wounds
601(1)
Treating Impaled Objects
602(3)
Treating Avulsions
605(1)
Treating Amputations
605(1)
Wounds to the Neck
605(1)
Chest Injuries
606(4)
FYI Chest Injury Complications
610(3)
Abdominal Injuries
611(2)
Burns
613(6)
Classifying Burns by Agent and Source
613(2)
Classifying Burns by Depth
615(1)
Determining the Severity of Burns
616(2)
Classifying Burns by Severity
618(1)
Treating Specific Types of Burns and Electrical Injuries
619(4)
Electrical Injuries
622(1)
FYI Specific Chemical Burns
623(2)
Dressing and Bandaging
625(4)
Chapter Review
629(2)
Street Scenes
631(2)
Musculoskeletal Injuries
633(49)
Musculoskeletal System
635(5)
Anatomy of Bone
636(2)
Self-Healing Nature of Bone
638(1)
Muscles, Cartilage, Ligaments, and Tendons
639(1)
General Guidelines for Emergency Care
640(12)
Mechanisms of Musculoskeletal Injury
640(1)
Painful, Swollen, or Deformed Extremity
640(3)
Assessment of Musculoskeletal Injuries
643(1)
Splinting
644(8)
Emergency Care of Specific Injuries
652(27)
Upper Extremity Injuries
653(1)
Lower Extremity Injuries
653(26)
Chapter Review
679(1)
Street Scenes
680(2)
Injuries to the Head and Spine
682(41)
Nervous and Skeletal Systems
684(2)
Nervous System
684(1)
Anatomy of the Head
685(1)
Anatomy of the Spine
686(1)
Injuries to the Skull and Brain
686(2)
Scalp Injuries
686(1)
Skull Injuries
686(1)
Brain Injuries
687(1)
FYI Types of Brain Injuries
688(2)
FYI Glasgow Coma Scale
690(3)
Cranial Injuries with Impaled Objects
692(1)
Injuries to the Face and Jaw
692(1)
Nontraumatic Brain Injuries
693(1)
Injuries to the Spine
693(5)
Mechanisms of Injury
693(5)
Immobilization Issues
698(20)
Tips for Applying a Cervical Collar
698(1)
Tips for Immobilizing a Seated Patient
698(5)
Tips for Applying a Long Backboard
703(5)
Tips for Dealing with a Standing Patient
708(4)
Patient Found Wearing a Helmet
712(6)
FYI Selective Spine Immobilization
718(2)
Chapter Review
720(3)
Putting It All Together for the Trauma Patient
723(13)
Multiple Trauma
724(1)
Cultural Considerations
724(1)
Managing the Multiple-Trauma Patient
725(4)
A Typical Call
725(2)
Analysis of the Call
727(1)
General Principles of Multiple-Trauma Management
728(1)
FYI Trauma Scoring
729(2)
Chapter Review
731(5)
MODULE Younger and Older Patients
Infants and Children
736(52)
Developmental Characteristics of Infants and Children
738(7)
Psychological and Personality Characteristics
741(1)
Anatomical and Physiological Differences
741(2)
Interacting with the Pediatric Patient
743(1)
The Adolescent Patient
744(1)
Supporting the Parents or Other Care Providers
745(1)
Assessing the Pediatric Patient
746(11)
Pediatric Assessment Triangle (PAT)
746(1)
Scene Size-up and Safety---Pediatric
747(1)
Initial Assessment---Pediatric
747(2)
Focused History and Physical Exam---Pediatric
749(1)
Detailed Physical Exam---Pediatric
750(5)
Ongoing Assessment---Pediatric
755(1)
Comparing Assessments
755(2)
Special Concerns in Pediatric Care
757(9)
Maintaining an Open Airway
757(2)
Clearing an Airway Obstruction
759(3)
Infant and Child BCLS Review
762(1)
Providing Supplemental Oxygen and Ventilations
762(2)
Caring for Shock (Hypoperfusion)
764(1)
Protecting Against Hypothermia
765(1)
Medical Emergencies
766(1)
Respiratory Disorders
766(1)
Respiratory Distress
766(1)
FYI Respiratory Diseases
767(2)
FYI Meningitis
769(6)
Fever
770(1)
Diarrhea and Vomiting
771(1)
Seizures
771(1)
Altered Mental Status
772(1)
Poisoning
773(1)
Near-Drowning
773(1)
Sudden Infant Death Syndrome
774(1)
Trauma
775(3)
Injury Patterns
775(2)
Pneumatic Anti-Shock Garments
777(1)
Burns
777(1)
Child Abuse and Neglect
778(3)
Physical and Sexual Abuse
778(3)
Role of the EMT-B in Cases of Suspected Abuse or Neglect
781(1)
Cultural Considerations
781(1)
Infants and Children with Special Needs
782(2)
Tracheostomy Tubes
782(1)
Home Artificial Ventilators
783(1)
Central Intravenous Lines
783(1)
Gastrostomy Tubes and Gastric Feeding
783(1)
Shunts
784(1)
The EMT-B and Pediatric Emergencies
784(1)
Chapter Review
785(1)
Street Scenes
786(2)
Geriatric Patients
788(16)
The Geriatric Patient
789(3)
Communicating with the Geriatric Patient
790(1)
Assessing the Geriatric Patient
791(1)
Cultural Considerations
792(8)
Reasons the Elderly Encounter EMS
795(5)
Chapter Review
800(1)
Street Scenes
800(4)
MODULE Operations
Ambulance Operations
804(36)
Preparing for the Ambulance Call
806(8)
Ambulance Supplies and Equipment
807(4)
Ensuring Ambulance Readiness for Service
811(3)
Receiving and Responding to a Call
814(8)
Role of the Emergency Medical Dispatcher
814(2)
Operating the Ambulance
816(6)
Transferring the Patient to the Ambulance
822(1)
Transporting the Patient to the Hospital
823(3)
Preparing the Patient for Transport
823(2)
Caring for the Patient en Route
825(1)
Transferring the Patient to the Emergency Department Staff
826(1)
Terminating the Call
826(8)
At the Hospital
828(2)
En Route to Quarters
830(1)
In Quarters
831(3)
Air Rescue
834(3)
When to Call for Air Rescue
834(1)
How to Call for Air Rescue
835(1)
How to Set Up a Landing Zone
835(1)
How to Approach a Helicopter
836(1)
Chapter Review
837(1)
Street Scenes
838(2)
Gaining Access and Rescue Operations
840(24)
Vehicle Rescue
842(19)
Preparing for the Rescue
842(1)
Sizing Up the Situation
843(1)
Recognizing and Managing Hazards
844(9)
Stabilizing a Vehicle
853(3)
Gaining Access
856(5)
Chapter Review
861(1)
Street Scenes
862(2)
Special Operations
864(30)
Hazardous Materials
866(11)
Training Required by Law
866(2)
Responsibilities of the EMT-B
868(4)
Establish a Treatment Sector
872(5)
Multiple-Casualty Incidents
877(13)
Multiple-Casualty Incident Operations
877(1)
Incident Command System
878(4)
Scene Management
882(5)
Transportation and Staging Logistics
887(3)
FYI Psychological Aspects of MCIs
890(1)
Chapter Review
891(3)
EMS Response to Terrorism
894(34)
Defining Terrorism
895(1)
Domestic Terrorism
895(1)
International Terrorism
895(1)
Types of Terrorism Incidents
896(1)
Terrorism and EMS
896(2)
First Responders as Targets
896(1)
Identify the Threat Posed by the Event
896(2)
Cultural Considerations
898(2)
Recognize the Harms Posed by the Threat
899(1)
Time/Distance/Shielding
900(1)
Responses to Terrorism
900(5)
Responses to a Chemical Incident
900(1)
Responses to a Biological Incident
901(2)
Responses to a Radiological/Nuclear Incident
903(1)
Responses to an Explosive Incident
904(1)
Dissemination and Weaponization
905(1)
The Respiratory Route
905(1)
Other Routes
905(1)
Weaponization
906(1)
Characteristics of CBRNE Agents
906(11)
Chemical Agents
906(1)
Biological Agents
907(9)
Radioactive/Nuclear Devices
916(1)
Incendiary Devices
917(1)
Strategy and Tactics
917(4)
Isolation
918(1)
Notification
919(1)
Identification
919(1)
Protection
920(1)
Chapter Review
921(3)
Study Guide: Self-Protection in a Terrorist Incident
924(4)
MODULE Advanced Airway Management
Advanced Airway Management
928(2)
Anatomy and Physiology
930(3)
Anatomy
930(1)
Physiology
931(1)
Pediatric Airway
932(1)
Management of the Airway
933(23)
Oropharyngeal Suctioning
933(1)
Orotracheal Intubation
933(15)
Nasogastric Intubation of an Infant or Child
948(2)
Orotracheal Suctioning
950(1)
Multilumen Airways
950(4)
Laryngeal Mask Airway
954(1)
Automatic Transport Ventilators
955(1)
Chapter Review
956
Appendix A ALS-Assist Skills
1(8)
Assisting with Endotracheal Intubation
1(3)
Preparing the Patient for Intubation
1(1)
Ventilating the Tubed Patient
2(1)
Assisting with a Trauma Intubation
3(1)
Applying ECG Electrodes
4(1)
Assisting in IV Therapy
5(2)
Setting Up an IV Fluid Administration Set
5(2)
Maintaining an IV
7(1)
Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP)
7(2)
Assisting with CPAP Devices
8(1)
Appendix B National Registry Skill Sheets
9(13)
Appendix C Basic Cardiac Life Support Review
22(1)
Before Beginning Resuscitation
22(4)
Assessing the Patient
22(1)
Activating EMS
23(1)
Positioning the Patient
24(1)
Opening the Airway
24(2)
Initial Ventilations and Pulse Check
26(1)
Rescue Breathing
26(2)
Mouth-to-Mask Ventilation
28(1)
Gastric Distention
28(1)
Recovery Position
28(1)
CPR
28(6)
Checking for Circulation
28(1)
How to Perform CPR
29(1)
One-Rescuer and Two-Rescuer CPR
29(3)
CPR Techniques for Children and Infants
32(1)
Special Considerations in CPR
32(2)
When Not to Begin or to Terminate CPR
34(1)
Clearing Airway Obstructions
34(1)
Partial Airway Obstruction
35(1)
Complete Airway Obstruction
35
Reference Section
1(13)
Anatomy and Physiology Illustrations
2(12)
Musculoskeletal System
2(2)
Nervous System
4(2)
Cardiovascular System
6(1)
Circulatory System
7(1)
Respiratory System
8(1)
Digestive System
9(1)
Urinary System
10(1)
Reproductive System
11(1)
Integumentary System
12(1)
Senses
13(1)
Atlas of Injuries14(4)
Medical Terminology18
Glossary1(1)
Index1

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