Completely updated in a new edition and written by the best-selling author team of Bryan E. Bledsoe D.O., F.A.C.E.P., EMT-P, Robert S. Porter M.A., NREMT-P, and Richard A. Cherry, M.S., NREMT-P, this student-friendly easy to understand series covers the DOT National Standard Curriculum. The fourth of 5 titles in the Brady Paramedic Care Principles and Practice series, Volume 4 - Trauma Emergencies - contains trauma and trauma systems, blunt trauma, penetrating trauma, hemorrhage and shock, soft-tissue trauma, burns, musculoskeletal trauma, head/facial/neck trauma, spinal trauma, thoracic trauma, abdominal trauma, and shock trauma resuscitation. Paramedic Level Emergency Responders or Intermediate level responders training to enter into Paramedic.
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Preface
Until the late 1960s, the highest level of medical care available outside of the hospital was Red Cross First Aid. In 1966, the National Academy of Sciences commissioned a research study to examine the inadequacies of emergency medical care in this country. The findings of this study were published in a document called Accidental Death and Disability: The Neglected Disease of Modern Society. This document, commonly referred to as "The White Paper," was the impetus for development of EMS and emergency medicine as we know it today.
The initial emphasis of prehospital training was trauma care. Prehospital personnel received considerable training in bandaging, splinting, and rescue techniques. In the 1980s, prehospital trauma care was again improved through the development of Basic Trauma Life Support (BTLS) and Prehospital Trauma Life Support (PHTLS) training. These courses provided EMTs and paramedics with the additional information needed to care adequately for the trauma patient in the field.
The publication of Paramedic Care: Principles and Practice Volume 4, Trauma Emergencies takes prehospital trauma care to the highest level yet. This volume details the anatomy, physiology, and pathophysiology of trauma. Although trauma is a surgical disease, and in many instances definitive care must be provided in the operating room, there is a significant amount of care that can be provided by prehospital personnel to help reduce both morbidity and mortality.
This book addresses the various types of trauma based on the body systems involved. It is important to remember that many trauma patients have multiple injuries involving multiple body systems. Because of this, it is essential to consider the "whole patient" and not become distracted by a single injury. The chapters of Paramedic Care: Principles and Practice Volume 4, Trauma Emergencies include:
Chapter 1 "Trauma and Trauma Systems" introduces the paramedic student to trauma, the concept of trauma systems, and trauma triage protocols. It has been shown that trauma victims have the best chances of survival if they are cared for in a facility that routinely provides trauma care. In addition, certain patients will require very specialized trauma care, and it is often the responsibility of the paramedic to assure that the patient gets to the correct facility.
Chapter 2 "Blunt Trauma" presents the physics of blunt trauma. It details the effects of blunt trauma on the various body tissues. Blunt trauma can often be very deceiving, as overt signs and symptoms of injury may not be evident at the time paramedics arrive. This chapter encourages the paramedic to evaluate the physics and mechanism of injury, and determine likely injuries.
Chapter 3 "Penetrating Trauma" provides a detailed discussion of the physics and pathophysiology of penetrating trauma. Formerly quite rare, penetrating trauma has become much more commonplace in our society. This chapter emphasizes the importance of considering the physics and mechanism of injury when assessing and treating a patient with penetrating trauma.
Chapter 4 "Hemorrhage and Shock" is a detailed discussion of the body's response to hemorrhage and shock. Regardless of the mechanism of injury, the final common denominator in most trauma patients is the fact that they are losing blood. Severe blood loss can result in the development of shock. The body's physiological responses to hemorrhage and shock are complex. This chapter details the physiological and pathophysiological response to hemorrhage and shock so that the paramedic can recognize the process early and intervene.
Chapter 5 "Soft-Tissue Trauma" provides a comprehensive look at soft-tissue trauma. Soft-tissue trauma is, by far, the most common form of trauma. Although most soft-tissue injuries are not life-threatening, many can be. This chapter provides a detailed review of the anatomy and physiology of the integumentary system and a discussion of the pathophysiology of soft-tissue trauma. It also provides a detailed discussion of soft-tissue treatment, including a discussion of bandaging.
Chapter 6 "Burns" discusses the unique pathophysiology of burn injuries. Although the incidence of burn injuries is declining, burn patients require specialized care. This chapter discusses the anatomy, physiology, and pathophysiology of burn injuries with special emphasis on management of the burn patient.
Chapter 7 "Musculoskeletal Trauma" presents an overview of trauma involving the musculoskeletal system. The incidence of musculoskeletal trauma is second only to soft-tissue injuries in frequency. In this chapter, the student is presented with the various types of musculoskeletal trauma encountered, with special emphasis on treatment and pain control.
Chapter 8 "Head, Facial, and Neck Trauma" provides a detailed review of the anatomy and physiology of the head, face, and neck. Injuries to the head, face, and neck can be severe and life-threatening, and this chapter places special emphasis on recognizing injuries early and protecting the airway.
Chapter 9 "Spinal Trauma" is a comprehensive chapter covering spinal trauma. Although relatively uncommon, spinal trauma can be devastating for the patient. This chapter reviews the appropriate anatomy and physiology of the spine. Following this is a detailed discussion of the prehospital treatment of spinal injuries.
Chapter 10 "Thoracic Trauma" details the impact of chest trauma on the body. The anatomy and physiology of the chest is unique and can require specialized procedures to effect treatment. Special emphasis is placed on recognition and treatment of chest injuries, especially pneumothorax.
Chapter 11 "Abdominal Trauma" addresses the anatomy and physiology of the abdomen and discusses abdominal trauma pathology by organ and organ system. The chapter emphasizes the importance of having a high index of suspicion when treating a trauma patient with potential internal injury.
Chapter 12 "Shock Trauma Resuscitation" serves to tie the various trauma discussions together. Most trauma patients will have more than one body system involved. The paramedic must recognize all potential injuries based on the physical exam and evaluation of the mechanism of injury. Then, the patient must be aggressively treated and transported to a hospital capable of providing the required care. This chapter provides a detailed discussion of assessment of the trauma patient. It also reviews the effects of hemorrhage and shock.
This volume, Trauma Emergencies, details the basic medical knowledge and skills expected of twenty-first century paramedics. This material should be mastered before undertaking actual patient care. --This text refers to an out of print or unavailable edition of this title.
From the Back Cover
- Volume 1: Introduction to Advanced Prehospital Care (includes Airway Management)
- Volume 2: Patient Assessment
- Volume 3: Medical Emergencies
- Volume 4: Trauma Emergencies
- Volume 5: Special Considerations / Operations (includes Assessment-Based Management)
Dr. Bryan E. Bledsoe, lead author of the classic pre-'98 curriculum text Paramedic Emergency Care, along with co-authors Robert Porter and Richard Cherry, has woven together contributions from field experts to provide detailed, yet student-friendly texts that will set the standard for paramedic education for years to come. In developing this series to meet the new curriculum, the goals were threefold:
- Comprehensive coverage. The program includes all material required for the new U.S. DOT curriculum and, where appropriate, expanded information.
- Accuracy. The material reflects the best and latest in scientific and medical practice, written and reviewed by experts.
- Appropriate level. Concepts and terminology are clearly explained. Beginning at the level of the new student and progressing through the development of new and advanced concepts, this series will provide the student with a broad background of knowledge and a firm grasp of how to apply it to paramedic emergency care.
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