Emergency Medical Patients: Assessment, Care, and Transport

Series
Prentice Hall
Author
Twink J. Dalton / Daniel J. Limmer / Joseph J. Mistovich / Howard Werman / - NAEMSP / San Francisco Paramedic Association  
Publisher
Pearson
Cover
Softcover
Edition
1
Language
English
Total pages
528
Pub.-date
March 2011
ISBN13
9780135119143
ISBN
0135119146
Related Titles


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9780135119143
Emergency Medical Patients: Assessment, Care, and Transport
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Description

For courses in Adult Medical Emergencies.

 

EMPACT (Emergency Medical Patients: Assessment, Care & Transport) offers a practical approach to common medical emergencies. Formerly published as AMLS (Advanced Medical Life Support), EMPACT is updated and revised to conform to the 2010 American Heart Association guidelines. Providing foundational chapters on assessment, critical thinking/decision making, and the difficult airway, the text moves on to cover common medical complaints, such as shock/hypoperfusion, dyspnea, chest discomfort or pain, and more. Presenting a realistic approach to the care of the patient, each chapter moves from assessment- and complaint-based primary assessment (identifying and controlling immediate life threats) to field diagnosis and management of immediately treatable underlying diseases. Intended for students with paramedic or other advanced-level training; a familiarity with anatomy, physiology, and pathophysiology; and an overall understanding of the nature of medical emergencies.

Features

For courses in Adult Medical Emergencies.

 

EMPACT (Emergency Medical Patients: Assessment, Care & Transport) offers a practical approach to common medical emergencies. Formerly published as AMLS (Advanced Medical Life Support), EMPACT is updated and revised to conform to the 2010 American Heart Association guidelines. Providing foundational chapters on assessment, critical thinking/decision making, and the difficult airway, the text moves on to cover common medical complaints, such as shock/hypoperfusion, dyspnea, chest discomfort or pain, and more. Presenting a realistic approach to the care of the patient, each chapter moves from assessment- and complaint-based primary assessment (identifying and controlling immediate life threats) to field diagnosis and management of immediately treatable underlying diseases. Intended for students with paramedic or other advanced-level training; a familiarity with anatomy, physiology, and pathophysiology; and an overall understanding of the nature of medical emergencies.

 

Hallmark Features:

 

Chapter features designed-to help with study and review.

  • "Possibilities to Probabilities” in Chapter 1 walks students through a reasoning process of patient assessment.
  • A scenario with an end-of-chapter follow-up presents chapter content in a realistic context.
  • Terms and definitions are highlighted and are defined in the margins.
  • “Clinical Insights” provide special perspectives on assessing and managing the patient.
  • Summaries of important information appear in boxes.
  • Typical findings associated with various etiologies are summarized in tables.
  • A “Treatment Pathway” in algorithm format appears at the end of each complaint-based chapter.
  • A “Further Reading” bibliography suggests sources to consult for additional information.

ThreeThree appendices-provide valuable reference information.

  • Waveform Capnography (new to this edition)
  • Electrocardiographic Interpretation
  • Normal Laboratory Values

A “Pharmacology Index” and “Anatomy and Physiology Illustrations”-are available, along with other supplemental materials, online at www.MyBradyKit.com.

 

An Instructor's Course Guide and slide program-are available to accompany the text.

New to this Edition

Offers updated coverage-of many topics.

  • Conforms to the 2010 American Heart Association guidelines.
  • Contains new information on how responses to painful stimuli may elicit misleading reflex responses or non-responses and how to avoid such misinterpretations.
  • Discussion of effects of medications on heart rate updated to include calcium channel blockers as well as beta blockers.

New Chapter 2-Introduction to Critical Thinking and Decision Making.

  • Emphasizes skills of problem-solving in the challenging environment of EMS where decisions must often be made quickly, under pressure, and without the laboratory and diagnostic equipment available at the hospital.
  • Emphasizes how the EMS provider may advance in the ability to deliver patient care through levels of proficiency from novice to expert. Explores the purposes and processes of differential diagnosis.

Heavily revised Chapter 3-The Difficult Airway.

  • De-emphasizes routine intubation and, instead, emphasizes airway management decisions for two situations: the difficult airway and the failed airway.
  • Includes discussions of pre-oxygenation, possible impediments to effective BVM ventilation, and assessment to detect potential difficulties in securing an airway.

Heavily revised Chapter 4-Shock and States of Hypoperfusion.

  • Adds new information throughout, including the following: new emphasis on physical findings and patterns of symptoms/symptom progression; a new section on the respiratory system; buildup and response to accumulation of metabolic acids, damage from acidosis and toxic blood; emphasis on EtCO2 monitoring; expanded information regarding tension pneumothorax, cardiac tamponade, pulmonary emboli; causes and care of neurogenic shock, anaphylactic shock, and septic shock; obtaining glucose and lactic acid levels as management priorities.

Updated Chapter 5-Dyspnea.

  • Adds confusion/agitation as clues to severity of respiratory distress; beta blockers and ACE inhibitors as patient medications to be aware of; possible low-grade fever with MI; emphasis on obtaining a pre-hospital ECG to assist in early identification of ST-segment-elevation MI. The section on pre-hospital treatment of heart failure (medications, CPAP) has been extensively revised. The table “Causes of Dyspnea: Typical Findings” has been updated.

Increased emphasis in Chapter 6-Chest Discomfort or Pain-on identifying segment elevation MI (STEMI) with pre-hospital 12-lead ECG.

  • Includes new information on pre-hospital care and medications when STEMI is suspected or identified.
  • Contains a scoring system for quantifying the risk of pulmonary embolism.

New emphasis in Chapter 7-Altered Mental Status-on obtundation and on the ascending reticular activating system (ARAS).

  • Controversies surrounding hyperventilation in the presence of altered mental status are discussed.
  • Refinements are introduced in the recommendations on administration of dextrose to a hypoglycemic patient with possible stroke or other intracranial condition.

New emphasis in Chapter 8-Acute Abdominal Pain-on identifying patient's condition as critical, unstable, potentially unstable, or stable.

  • New emphasis on determining involvement of related body systems.
  • New information on pain receptors, on irritation leading to diarrhea, on effects of medications on mucous protection in the stomach, on types of aortic aneurysms.
  • A new section on the uterus and other gynecological sources of abdominal pain.

Chapter 9: Gastrointestinal Bleeding includes new information-on tearing of the esophageal sphincter and esophageal spasm as causes of GI bleeding.

  • New information on anemia-related assessment information and effects of anemia on 12-lead ECG findings.
  • Section on treatment adds discussion of CPAP and application of a cardiac monitor.

Chapter 10: Seizures and Seizure Disorders-contains updated information on medications overall, including the addition of levatiracetum (Keppra) as a common anti-seizure medication.

  • Oxygen administration guidelines have been updated to rely on pulse oximetry and other indications of patient condition.

Chapter 11: Syncope has been updated-with exceptions added to the rule that syncope requires little intervention, citing ominous cases such as cardiac syncope from rhythm disturbances, congestive heart failure, or with associated chest pain or discomfort.

  • New emphasis on history elicit circumstances of syncopal episode.
  • Physical exam section adds neurological exams and assessment of body systems possibly associated with the cause of syncope.

Updated Chapter 12-Headache, Nausea, and Vomiting.

  • Headache classifications follow those established by the International Headache Society as primary, secondary, or cranial neuralgias/facial pain/and other headaches.
  • Etiology and description of migraine, cluster, and tension-type headaches revised to reflect recent research.
  • Discussion underscores the controversies and dangers regarding hyperventilation of head-injured patients with evidence of herniation.
  • Drugs and medications updated throughout.

New Appendix A: Waveform Capnography-provides a comprehensive, fully illustrated text on the topic of waveform capnography.

 

Appendix B: Electrocardiographic Interpretation-includes, throughout the appendix, increased emphasis on ST-segment-elevation myocardial infarction (STEMI) identification.

  • Emphasis on importance of pre-hospital ECG in reducing “door to balloon” and “door to drug” time.
  • New information on placement of additional leads to view right and posterior portions of the heart.
  • New information on drugs and conditions than can alter the QT interval.
  • New information on presence of left bundle branch block as indication to consider angioplasty or fibrinoltyic therapy.

Table of Contents

Chapter 1: Assessment of the Medical Patient

Chapter 2: Critical Thinking and Decision Making

Chapter 3: The Difficult Airway (Sample Chapter)

Chapter 4: States of Hypoperfusion and Shock

Chapter 5: Dyspnea, Respiratory Distress, or Respiratory Failure

Chapter 6: Chest Discomfort or Pain

Chapter 7: Altered Mental Status

Chapter 8: Acute Abdominal Discomfort or Pain

Chapter 9: Gastrointestinal Bleeding

Chapter 10: Seizures and Seizure Disorders

Chapter 11: Syncope

Chapter 12: Headache, Nausea, and Vomiting

 

Appendix A: Waveform Capnography

Appendix B: Electrocardiographic Interpretation           

Appendix C: Normal Laboratory Values


Instructor Resources