Idea Transcript
Emergency Care and Transportation of the Sick and Injured
Series Editor:
Andrew N. Pollak, MD, FAAOS Lead Editors:
Dennis Edgerly, BS, EMT-P Kim D. McKenna, MEd, RN, EMT-P David A. Vitberg, MD
Celebrating 45 years of EMS education and innovation.
In 1971, the American Academy of Orthopaedic Surgeons (AAOS) published the first edition of Emergency Care and Transportation of the Sick and Injured with its now-familiar orange cover and laid the foundation of EMS training. Today, the AAOS’s commitment and dedication to excellence has transformed how EMS education is delivered throughout the world and helped develop and train countless world-class EMS providers. In 1997, the AAOS partnered with Jones & Bartlett Publishers (JB Learning) to release Emergency Care and Transportation of the Sick and Injured, Revised Sixth Edition. Since the publication of that edition, the AAOS and JB Learning have worked together to transform all levels of EMS training, from emergency medical responder to paramedic. Our partnership has resulted in market-leading resources that go beyond initial training into assessment, continuing education, and professional resources to support EMS providers through every step of their education and career. Today, the AAOS suite of EMS educational resources, from first aid and CPR to critical care transport, are the gold standard in training programs with exceptional content and instructional resources that meet the diverse needs of today’s educators and students. JB Learning is proud and honored to congratulate our esteemed partner, the American Academy of Orthopaedic Surgeons, on the 45th anniversary of their first publication of the Orange Book. To explore other AAOS publications, programs, and products on orthopaedic trauma and other practice areas, please visit
www.aaos.org/Education.
Brief Contents Section 1: Preparatory EMS Systems CHAPTER 2 Workforce Safety and Wellness CHAPTER 3 Medical, Legal, and Ethical Issues CHAPTER 4 Communications and Documentation CHAPTER 5 Medical Terminology CHAPTER 6 The Human Body CHAPTER 7 Life Span Development CHAPTER 8 Lifting and Moving Patients CHAPTER 1
Section 2: Patient Assessment CHAPTER 9
Patient Assessment
Section 3: Airway CHAPTER 10 Airway
Management
Section 4: Pharmacology CHAPTER 11 Principles of Pharmacology
Section 5: Shock and Resuscitation CHAPTER 12 Shock CHAPTER 13 BLS Resuscitation
Section 6: Medical CHAPTER 14 Medical Overview CHAPTER 15 Respiratory
Emergencies CHAPTER 16 Cardiovascular Emergencies CHAPTER 17 Neurologic Emergencies CHAPTER 18 Gastrointestinal and Urologic Emergencies CHAPTER 19 Endocrine and Hematologic Emergencies CHAPTER 20 Immunologic Emergencies CHAPTER 21 Toxicology CHAPTER 22 Psychiatric Emergencies CHAPTER 23 Gynecologic Emergencies
Section 7: Trauma CHAPTER 24 Trauma Overview
Bleeding CHAPTER 26 Soft-Tissue Injuries CHAPTER 27 Face and Neck Injuries CHAPTER 28 Head and Spine Injuries CHAPTER 29 Chest Injuries CHAPTER 30 Abdominal and Genitourinary Injuries CHAPTER 31 Orthopaedic Injuries CHAPTER 32 Environmental Emergencies CHAPTER 25
Section 8: Special Patient Populations Obstetrics and Neonatal Care CHAPTER 34 Pediatric Emergencies CHAPTER 35 Geriatric Emergencies CHAPTER 36 Patients With Special Challenges CHAPTER 33
Section 9: EMS Operations Transport Operations CHAPTER 38 Vehicle Extrication and Special Rescue CHAPTER 39 Incident Management CHAPTER 40 Terrorism Response and Disaster Management CHAPTER 37
Section 10: The Team Approach to Health Care CHAPTER 41 GLOSSARY INDEX
A Team Approach to Health Care
Contents Section 1: Preparatory EMS Systems Introduction Course Description EMT Training: Focus and Requirements Licensure Requirements Overview of the EMS System History of EMS Levels of Training Public Basic Life Support and Immediate Aid Emergency Medical Responders Emergency Medical Technician Advanced Emergency Medical Technician Paramedic Components of the EMS System Public Access Communication Systems Clinical Care Human Resources Medical Direction Legislation and Regulation Integration of Health Services Mobile Integrated Healthcare Evaluation Information Systems System Finance Education Systems Prevention and Public Education EMS Research Roles and Responsibilities of the EMT Professional Attributes Prep Kit
CHAPTER 1
Workforce Safety and Wellness Introduction General Health and Wellness Wellness and Stress Management Sleep Infectious and Communicable Diseases Routes of Transmission Risk Reduction and Prevention for Infectious and Communicable Diseases Establishing an Infection Control Routine Immunity General Postexposure Management Scene Safety Scene Hazards Protective Clothing: Preventing Injury Cold Weather Clothing
CHAPTER 2
Turnout Gear Gloves Helmets Boots Eye Protection Ear Protection Skin Protection Body Armor Long/Loose Hair, Rings, Jewelry Caring for Critically Ill and Injured Patients Responses of the Critical Patient Techniques for Communicating With the Critical Patient Locate and Notify Family Members Injured and Critically Ill Children Dealing With the Death of a Child Helping the Family Death and Dying The Grieving Process What Can the EMT Do? Dealing With the Patient and Family Members Stress Management on the Job Emotional Aspects of Emergency Care Stressful Situations Workplace Issues Cultural Diversity on the Job Avoiding Sexual Harassment Substance Abuse Suicide Prevention Injury and Illness Prevention Prep Kit Medical, Legal, and Ethical Issues Introduction Consent Expressed Consent Implied Consent Involuntary Consent Minors and Consent Forcible Restraint The Right to Refuse Treatment Confidentiality HIPAA Advance Directives Physical Signs of Death Presumptive Signs of Death Definitive Signs of Death Medical Examiner Cases Special Situations Organ Donors Medical Identification Insignia Scope of Practice Standards of Care Standards Imposed by Local Custom Standards Imposed by Law Professional or Institutional Standards
CHAPTER 3
Standards Imposed by Textbooks Standards Imposed by States Duty to Act Negligence Abandonment Assault and Battery and Kidnapping Defamation Good Samaritan Laws and Immunity Records and Reports Special Mandatory Reporting Requirements Abuse of Children, Older People, and Others Injury During the Commission of a Felony Drug-Related Injuries Childbirth Other Reporting Requirements Scene of a Crime The Deceased Ethical Responsibilities The EMT in Court Prep Kit Communications and Documentation Introduction Therapeutic Communication Age, Culture, and Personal Experience Nonverbal Communication Verbal Communication Written Communications and Documentation Patient Care Report Types of Forms Reporting Errors Documenting Refusal of Care Special Reporting Situations Communications Systems and Equipment Base Station Radios Mobile and Portable Radios Repeater-Based Systems Digital Equipment Cellular/Satellite Telephones Other Communications Equipment Radio Communications Responding to the Scene Communicating With Medical Control and Hospitals Maintenance of Radio Equipment Prep Kit
CHAPTER 4
Medical Terminology Introduction Anatomy of a Medical Term Word Roots Prefixes Suffixes Combining Vowels Word Building Rules Plural Endings
CHAPTER 5
Special Word Parts Numbers Colors Positions and Directions Common Direction, Movement, and Position Terms Directional Terms Movement Terms Other Directional Terms Anatomic Positions Breaking Terms Apart Abbreviations, Acronyms, and Symbols Abbreviations Symbols Master Tables Prep Kit The Human Body Introduction Topographic Anatomy The Planes of the Body The Skeletal System: Anatomy The Axial Skeleton The Spinal Column The Thorax The Appendicular Skeleton The Pelvis The Lower Extremities The Skeletal System: Physiology The Musculoskeletal System: Anatomy Skeletal Muscle The Musculoskeletal System: Physiology The Respiratory System: Anatomy The Upper Airway The Lower Airway Lungs The Respiratory System: Physiology Respiration Ventilation Characteristics of Normal Breathing Inadequate Breathing Patterns in Adults The Circulatory System: Anatomy The Heart Arteries Capillaries Veins The Spleen Blood Composition The Circulatory System: Physiology Normal Circulation in Adults Inadequate Circulation in Adults The Function of Blood Nervous System Control of the Cardiovascular System The Nervous System: Anatomy and Physiology The Central Nervous System The Peripheral Nervous System
CHAPTER 6
The Integumentary System (Skin): Anatomy The Integumentary System (Skin): Physiology The Digestive System: Anatomy The Abdomen Mouth Oropharynx Esophagus Stomach Pancreas Liver Small Intestine Large Intestine Appendix Rectum The Digestive System: Physiology The Lymphatic System: Anatomy and Physiology The Endocrine System: Anatomy and Physiology The Urinary System: Anatomy and Physiology The Genital System: Anatomy and Physiology The Male Reproductive System and Organs The Female Reproductive System and Organs Life Support Chain Pathophysiology Respiratory Compromise Shock Alteration of Cellular Metabolism Prep Kit Life Span Development Introduction Neonates (Birth to 1 Month) and Infants (1 Month to 1 Year) Physical Changes Psychosocial Changes Toddlers (1 to 3 Years) and Preschoolers (3 to 6 Years) Physical Changes Psychosocial Changes School-Age Children (6 to 12 Years) Physical Changes Psychosocial Changes Adolescents (12 to 18 Years) Physical Changes Psychosocial Changes Early Adults (19 to 40 Years) Physical Changes Psychosocial Changes Middle Adults (41 to 60 Years) Physical Changes Psychosocial Changes Older Adults (61 Years and Older) Physical Changes Psychosocial Changes Prep Kit
CHAPTER 7
Lifting and Moving Patients Introduction
CHAPTER 8
The Wheeled Ambulance Stretcher Backboards Moving and Positioning the Patient Body Mechanics Anatomy Review Principles of Safe Reaching and Pulling Principles of Safe Lifting and Carrying Patient Weight Lifting and Carrying a Patient on a Backboard or Stretcher Mov...