From the Inside Flap
Congratulations on your decision to further your EMS career by undertaking the course of education required for certification as an Emergency Medical Technician-Paramedic! The world of paramedic emergency care is one that you will find both challenging and rewarding. Whether you will be working as a volunteer or paid paramedic, you will find the field of advanced prehospital care very interesting.
This textbook program will serve as your guide and reference to advanced out-of-hospital care. It is based upon the 1998 United States Department of Transportation EMT-Paramedic: National Standard Curriculum and is divided into five volumes. The first volume is entitled Introduction to Advanced Prehospital Care and addresses the fundamentals of paramedic practice, including pathophysiology, pharmacology, medication administration and advanced airway management. The second volume, Patient Assessment, builds on the assessment skills of the basic EMT with special emphasis on advanced patient assessment at the scene. The third volume of the series, Medical Emergencies, is the most extensive and addresses paramedic level care of medical emergencies. Particular emphasis is placed upon the most common medical problems as well as serious emergencies, such as respiratory and cardiovascular emergencies. Trauma Emergencies, the fourth volume of the text, discusses advanced prehospital care from the mechanism of injury analysis to shock/trauma resuscitation. The last volume in the series addresses Special Considerations/Operations including neonatal, pediatric, geriatric, home health care, and specially challenged patients, and incident command, ambulance service, rescue, hazardous material, and crime scene operations. These five volumes will help prepare you for the challenges of prehospital care.
The psychomotor skills of fluid and medication administration, advanced airway care, ECG monitoring and defibrillation, and advanced medical and trauma patient care are best learned in the classroom, skills laboratory, and then the clinical and field setting. Common advanced prehospital skills are discussed in the text as well as outlined in the accompanying procedure sheets. Review these before and while practicing the skill. It is important to point out that this or any other text cannot teach skills. Care skills are only learned under the watchful eye of a paramedic instructor and perfected during your clinical and field internship.
HOW TO USE THIS TEXTBOOK
Paramedic Care: Principles & Practice is designed to accompany a paramedic education program that follows the 1998 United States Department of Transportation EMT-Paramedic: National Standard Curriculum. The education program should include ample classroom, practical laboratory, in-hospital clinical, and prehospital field experience. These educational experiences must be guided by instructors and preceptors with special training and experience in their areas of participation in your program.
It is intended that your program coordinator will assign reading from Paramedic Care: Principles & Practice in preparation for each classroom lecture and discussion section. The knowledge gained from reading this text will form the foundation of the information you will need in order to function effectively as a paramedic in your EMS system. Your instructors will build upon this information to strengthen your knowledge and understanding of advanced prehospital care so that you may apply it in your practice. The in-hospital clinical and prehospital field experiences will further refine your knowledge and skills under the watchful eyes of your preceptors.
In preparing for each classroom session, read the assigned chapter carefully. First, review the chapter objectives. They will identify important concepts to be learned from the reading. Read the Case Study to get a feeling of why a chapter is important and how the knowledge it contains can be applied in the field. Read the chapter content carefully, while keeping the chapter objectives in mind. Read the You Make the Call feature and answer the questions to assure you understand the application of the knowledge presented in the chapter. Last, re-read the chapter objectives and be sure that you are able to answer each one completely. If you cannot, reread the section of the chapter to which the objective relates. If you still do not understand the objective or any portion of what you have read, ask your instructor to explain it at your next class session.
Ideally, you should read this entire text series at least three times. The volume chapter should be read in preparation for the class session, the entire volume should be read before the division or course test, and the entire text series should be reread before the program final exam and/or certification testing. While this might seem like a lot of reading, it will improve your classroom performance, your knowledge of emergency care, and ultimately, the care you provide to emergency patients.
The workbook that accompanies this text can also assist in improving classroom performance. It contains information, sample test questions, and exercises designed to assist learning. Its use can be very helpful in identifying the important elements of paramedic education, in exercising the knowledge of prehospital care, and in helping you self-test your knowledge.
Paramedic Care: Principles & Practice presents the knowledge of emergency care in as accurate, standardized, and clear a manner as is possible. However, each EMS system is uniquely different, and it is beyond the scope of this text to address all differences. You must count heavily on your instructors, the program coordinator, and ultimately the program medical director to identify how specific emergency care procedures are applied in your system.
Preface to Volume 1, Introduction to Advanced Prehospital Care
Modern EMS is based upon sound principles and practice. The paramedic of the twentyfirst century must be knowledgeable in all aspects of EMS. This begins with a fundamental understanding of EMS operations and basic medical science. The paramedic curriculum follows the medical model. Students are first educated in the basic sciences. Then, they are introduced to the clinical sciences reinforcing the basic science knowledge attained earlier. The 1998 U.S. D.O.T EMT-Paramedic: National Standard Curriculum has markedly expanded both the basic science and clinical science knowledge base of paramedics. With Paramedic Care: Principles and Practice, we have followed the D.O.T curriculum and provide the preparatory material in Volume 1, Introduction to Advanced Prehospital Care.
This book provides paramedic students with the principles of advanced prehospital care and EMS operations. The first five chapters detail EMS operations and paramedic roles and responsibilities. There is an added emphasis on personal wellness and injury and illness prevention. The next two chapters deal with the medical-legal aspects of emergency care and ethics. Both are increasingly important in twenty-first century EMS. With the development of the new curriculum, there is increased emphasis on pathophysiology and the disease process. This material is presented in detail so that the paramedic student will have insight into the various disease and injury concepts presented in the clinical portions of the book. The last four chapters are comprehensive discussions of pharmacology, airway management, and other essential advanced prehospital skills. This book provides the paramedic student with the basic science knowledge necessary to delve into the clinical portions of the curriculum including patient assessment, medical emergencies, trauma emergencies, and special situations.
Chapter 1 "Introduction to Advanced Prehospital Care" introduces the paramedic student to the world of paramedicine and the new D.O.T. curriculum. It summarizes the expanding roles of the paramedic as well as the importance of professionalism.
Chapter 2 "The Well-Being of the Paramedic" presents material crucial to the survival of the paramedic in EMS. It addresses such important issues as physical fitness, nutrition, and personal protection from disease. It details the role of stress in EMS and presents important coping strategies.
Chapter 3 "EMS Systems" reviews the history of EMS and provides an overview of EMS today. It details the various, integrated aspects of EMS system design and operation. It emphasizes the importance of medical direction in all aspects of prehospital care.
Chapter 4 "Roles and Responsibilities of the Paramedic" is a detailed discussion of the expectations and responsibilities of the modern paramedic. It emphasizes the importance of ethical behavior, appearance, and patient advocacy in a field that is becoming more technical and more impersonal.
Chapter 5 "Illness and Injury Prevention" addresses the importance of illness and injury prevention in EMS. It emphasizes the importance of scene safety and the role the paramedic has in assuring the safety of all rescuers. It als --This text refers to an out of print or unavailable edition of this title.