BRYAN E. BLEDSOE, D.O., F.A.C.E.P., F.A.A.E.M., F.A.E.P., EMT-P is an emergency physician with special interest in prehospital care. He received his B.S. degree from the University of Texas at Arlington and received his medical degree from the University of North Texas Health Sciences Center / Texas College of Osteopathic Medicine. He completed his internship at Texas Tech University and residency training at Scott and White Memorial Hospital / Texas A&M College of Medicine. Dr. Bledsoe is board-certified in emergency medicine and family practice. He is presently a Ph.D. candidate at Charles Sturt University at Wagga Wagga, New South Wales, Australia.Prior to attending medical school, Dr. Bledsoe worked as an EMT, paramedic, and paramedic instructor. He completed EMT training in 1974 and paramedic training in 1976, and worked for 6 years as a field paramedic in Fort Worth, Texas. In 1979, he joined the faculty of the University of North Texas Health Sciences Center and served as coordinator of EMT and paramedic education programs at the university. Dr. Bledsoe is active in emergency medicine and serves as medical director for several EMS agencies and educational programs.Dr. Bledsoe has authored several EMS books published by Brady including paramedic Emergency Care, Intermediate Emergency Care, Atlas of Paramedic Skills, Prehospital Emergency Pharmacology, and Pocket Reference for EMTs and Paramedics. He is married to Emma Bledsoe. They have two children, Bryan and Andrea, and live in Midlothian, Texas, a suburb of Dallas. He enjoys salt-water fishing and listening to Jimmy Buffett.ROBERT S. PORTER, M.A., NREMT-P has been teaching in Emergency Medical Services for 25 years and currently serves as the Senior Advanced Life Support Educator for Madison County, New York, and as a Flight Paramedic with the Onondaga County Sheriff's Department helicopter service, AirOne. Mr. Porter is a Wisconsin native and received his Bachelor's degree in education from the University of Wisconsin. He completed his Paramedic training at Northeast Wisconsin Technical Institute in 1978 and earned a Master's Degree in Health Education at Central Michigan University in 1990.Mr. Porter has been an EMT and EMS educator and administrator since 1973 and obtained his National Registration as an EMT-Paramedic in 1978. He has taught both basic and advanced level EMS courses in the states of Wisconsin, Michigan, Louisiana, Pennsylvania, and New York. Mr. Porter served for more than ten years as a paramedic program accreditation-site evaluator for the American Medical Association and is a past chair of the National Society of EMT Instructor/Coordinators. He has published numerous articles in EMS periodicals and has authored Brady's Paramedic Emergency Care, Intermediate Emergency Care, Tactical Emergency Care, and Weapons of Mass Destruction: Emergency Care as well as the workbooks accompanying this text, Paramedic Emergency Care, and Intermediate Emergency Care. When not writing or teaching, Mr. Porter enjoys offshore sailboat racing, historic home restoration, and listening to Dr. Bryan Bledsoe complain about the Texas heat.RICHARD A CHERRY, M.S., NREMT-P is Clinical Assistant Professor of Emergency Medicine and Director of Paramedic Training at SUNY Upstate Medical University in Syracuse, N.Y. His experience includes years of classroom teaching and emergency fieldwork. A native of Buffalo, Mr. Cherry earned his Bachelor's degree and teaching certificate at nearby St. Bonaventure University in 1972. He taught high school for the next 10 years while he earned his Master's degree in Education from Oswego State University in 1977. He holds a permanent teaching license in New York State.Mr. Cherry entered the emergency medical service field in 1974 with the DeWitt Volunteer Fire Department where he served his community as a firefighter and EMS provider for over 15 years. He took his first EMT course in 1977 and became an ALS provider two years later. He earned his paramedic certificate in 1985 as a member of the area's first paramedic class. He still answers emergency calls for Brewerton Ambulance.Mr. Cherry has authored several books for Brady. Most notable is EMT Teaching: A Common Sense Approach. He has made presentations at many state, national, and international EMS conferences on a variety of teaching topics. In addition to his paramedic teaching, he is course director, instructor, and instructor trainer for ACLS, PALS, and PHTLS courses conducted for physicians, residents, nurses, medical students, and other house staff. He lives in Parish, New York with his wife Sue, a paramedic with Rural-Metro Medical Services, their children, and many pets.
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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
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