Emergency Medical Services: Clinical Practice and Systems Oversight is the official textbook of the National Association of EMS Physicians™ (NAEMSP™) National EMS Medical Directors Course and Practicum™.
Now paired with a companion website featuring self-assessment exercises, audio and video clips of EMS best practices in action, and more, this essential study aid guides students through the core knowledge they need to successfully complete their training and begin their careers as EMS physicians.
Emergency Medical Services: Clinical Practice and Systems Oversight consists of:
- Volume 1: Clinical Aspects of EMS
- Volume 2: Medical Oversight of EMS
- Companion website featuring supportive self-assessment exercises, audio and video clips
Table of Contents
Contributors viii
Foreword xiv
Preface xv
Abbreviations, xvi
About the companion website, xix
Volume 1: Clinical aspects of EMS
1 History of EMS 1
Robert R. Bass
Section I: Airway
2 EMS airway management 19
Francis X. Guyette and Henry E. Wang
3 Airway procedures 30
Jestin N. Carlson, and Henry E. Wang
4 Airway management: special situations 43
Brendan Anzalone and Henry E. Wang
Section II: Breathing
5 Respiratory distress 53
Jason Oost and Mohamud Daya
6 Oxygenation and ventilation 60
Vincent N. Mosesso and Angus M. Jameson
Section III: Circulation
7 Hypotension and shock 69
Ronald N. Roth, Raymond L. Fowler and Francis X. Guyette
8 Vascular access 78
Jocelyn M. De Guzman, Bryan B. Kitch and Jeffrey D. Ferguson
Section IV: Medical Problems
9 The challenge of the undifferentiated patient 87
Andrew Travers and Ronald D. Stewart
10 Altered mental status 92
Mark R. Quale and Jefferson G. Williams
11 Cardiac arrest systems of care 98
Bryan McNally, Paul M. Middleton and Marcus Ong
12 Cardiac arrest: clinical management 109
Jon C. Rittenberger and Vincent N. Mosesso, Jr
13 Chest pain and acute coronary syndrome 120
Joseph P. Ornato, Michael R. Sayre and James I. Syrett
14 Cardiac dysrhythmias 129
Christian C. Knutsen and Donald M. Yealy
15 Cardiac procedures and managing technology 137
T.J. Doyle
16 Abdominal pain 144
Jeffrey D. Ferguson and Jennifer Monroe
17 Submersion injuries/drowning,= 151
Robert Lowe
18 Choking 155
Gregory H. Gilbert
19 Syncope 158
David J. Schoenwetter
20 Seizures 163
J. Stephen Huff
21 Stroke 171
Todd J. Crocco, Allison Tadros and Stephen M. Davis
22 Allergic reactions 179
Debra G. Perina and Douglas R. Gallo
23 Diabetic emergencies 184
José G. Cabañas, Jorge L. Falcon-Chevere and Jane H. Brice
24 Renal failure and dialysis 190
Bryan B. Kitch and Jocelyn M. De Guzman
25 Infectious and communicable diseases 198
Russell D. MacDonald
Section V: Trauma Problems
26 Trauma Systems of Care 211
Jeffrey P. Salomone and Joseph A. Salomone
27 Blunt trauma considerations 216
Sabina A. Braithwaite and Jeffrey M. Goodloe
28 Motor vehicle crashes 222
Stewart C. Wang and Carla Kohoyda-Inglis
29 Penetrating trauma 228
Michelle Welsford and Alim Pardhan
30 Traumatic brain injury 237
Kraigher O’Keefe
31 Electrical injuries 243
Jeffrey Lubin
32 Blast injury 248
John McManus and Richard B. Schwartz
33 Thermal and chemical burns 253
John McManus, Richard B. Schwartz and Sabina A. Braithwaite
34 Crush injury 261
Ken Miller
35 Hemorrhage control 265
Neil B. Davids and Robert L. Mabry
36 Orthopedic injuries 272
Sean Kivlehan, Benjamin T. Friedman and Mary P. Mercer
37 Ocular trauma 280
Eric Hawkins and Michael D. Mills MD, MPH
38 Bites, stings, and envenomations 284
Adam Frisch, Andrew King and Stephanie Outterson
39 Field trauma triage 289
Hiren Patel and Scott M. Sasser
40 Trauma-stabilizing procedures 297
Derek R. Cooney and David P. Thomson
Section VI: Obstetrics and Gynecological Problems
41 Physiology of pregnancy: EMS implications 307
David J. Hirsch
42 Emergencies of pregnancy 312
W. Scott Gilmore
43 Normal childbirth 318
Stephanie A. Crapo
44 Childbirth emergencies 322
Angus M. Jameson and Micha Campbell
45 Perimortem cesarean section 325
Christian Martin-Gill
Section VII: Toxicological Problems
46 Principles of toxicology 333
Christine M. Murphy
47 Treatment and evaluation of specific toxins 341
Michael C. Beuhler
Section VIII: Environmental Problems
48 Cold exposure illness and injury 351
Jonnathan Busko
49 Heat-related illness 358
Gerald (Wook) Beltran
50 High-altitude illnesses 363
Hawnwan Philip Moy, MD
51 Effects of flight 368
David P. Thomson
52 Diving injury 372
Anthony J. Frank Jr
Section IX: Special Populations
53 The special needs of children 381
Susan Fuchs
54 Pediatric medical priorities 386
Toni Gross and Susan Fuchs
55 Pediatric trauma priorities 393
Joseph L. Wright
56 Technology-dependent children 397
Brent D. Kaziny and Manish I. Shah
57 Approach to the geriatric patient 401
Thomas V. Caprio and Manish N. Shah
58 Bariatric patient challenges 407
Jeremy T. Cushman
59 Behavioral health emergencies 412
Jay H. Reich and Aaron Stinton
Section X: Special Considerations
60 Intimate partner violence 423
Petra Norris
61 Sexual assault 430
Petra Norris
62 Child maltreatment 435
Deborah Flowers and Molly Berkoff
63 Ethical challenges 439
Dave W. Lu and James G. Adams
64 End-of-life issues 444
Aaron Case, Dana Zive, Jennifer Cook and Terri A. Schmidt
65 Termination of resuscitation in the out-of-hospital setting, 453
Laurie J. Morrison, Ian R. Drennan, and P. Richard Verbeek
66 Family and bystanders, 462
Lynne Dees
67 Analgesia, 470
Michael T. Hilton and Paul M. Paris
68 Point-of-care testing in EMS, 477
Alix J.E. Carter
69 Ultrasound applications in EMS, 483
Rachel Liu
Section XI: Safety and Quality
70 Culture of patient safety, 491
Blair L. Bigham and P. Daniel Patterson
71 A historical view of quality concepts and methods, 500
Dia Gainor and Robert Swor
72 Defining, measuring, and improving quality, 509
Kevin E. Mackey and Scott S. Bourn
73 Data management and information systems, 517
Greg Mears
74 EMS quality improvement and the law, 526
Maria B. Abrahamsen
Appendix, 531
Index, 541
Volume 2: Medical Oversight of EMS
Section I: System Infrastructure
1 Principles of EMS system designs 3
Mic Gunderson
2 Air medical services 17
Thomas Judge and Stephen H. Thomas
3 Interfacility transportation 29
Jacob B. Keeperman
4 Legislation, regulation, and ordinance 36
Dan Manz
5 State EMS offices 44
Douglas F. Kupas, Lee B. Smith, and Dean Cole
6 EMS personnel 51
David C. Cone
7 Principles of finance 60
Paul Hinchey and Jeffrey M. Goodloe
Section II: Clinical Leadership and Oversight
8 Medical oversight of EMS systems 71
Robert R. Bass, Benjamin Lawner, Debra Lee, and Jose V. Nable
9 Leadership and team building 85
Mike Taigman and Stephen Dean
10 EMS dispatch 94
Jeff J. Clawson
11 Communications 113
Kevin McGinnis
12 Emergency care regionalization 123
Raymond L. Fowler
13 EMS–public health interface 134
John P. Serra and Christopher A. Kahn
14 Political realities for the medical director 140
Norm Dinerman
15 EMS physicians as public spokespersons 146
Paul E. Pepe, Linda B. Pepe, Robert M. Davis, Paul Mann, and Robin Whitmeyer
16 Legal issues 160
W. Ann “Winnie” Maggiore
17 Due process 182
E. Fremont Magee and Sarah M. Sette
18 Risk management 192
Karen Pickard, Raymond L. Fowler, and Melanie J. Lippmann
Section III: Human Resources
19 EMS provide reducation 201
Beth Lothrop Adams and Debra Cason
20 EMS provider wellness 211
P. Daniel Patterson, Matthew D.Weaver, and David Hostler
21 Occupational injury prevention and management 217
P. Daniel Patterson, Matthew D. Weaver, and David Hostler
22 Ambulance safety and crashes 222
Brian J. Maguire
23 Medical surveillance of emergency response personnel 231
Mike McEvoy
24 Prevention and intervention for psychologically stressful events 236
Richard Gist and Vickie Harris Taylor
25 Protection of EMS personnel from occupationally acquired infections 243
Sandy Bogucki
Section IV: Extraordinary Circumstances
26 Incident command system and national incident management system 257
Sandy Bogucki, Craig DeAtley, and Kevin Schulz
27 Medical management of mass gatherings 264
John F. Brown, Joshua G. Smith, and Katie Tataris
28 Disaster preparedness and management 272
Alexander P. Isakov
29 The federal medical response to disasters 278
Kevin Horahan and Richard C. Hunt
30 Special considerations in disaster zones 283
Ryan Carter
31 Prehospital triage for mass casualties 288
E. Brooke Lerner, Richard B. Schwartz, and Joanne E. McGovern
32 Mass casualty management 292
Charles M. Miramonti, Dan P. O’Donnell, Andrew C. Stevens, Elizabeth Weinstein, Josh D. Mugele, Kacy L. Allgood, and Bobby A. Courtney
33 Mass casualty evacuation and patient movement 303
Joanne McGovern and Sandy Bogucki
34 Temporary treatment facilities 313
Roy L. Alson
Section V: Special Hazards
35 Medical support for hazardous materials response 323
Thomas Blackwell, Kenneth Brennan, Craig DeAtley, and Allen Yee
36 Chemical properties of hazardous materials 334
Joshua B. Gaither and Robert N.E. French
37 Radiation and radiation injury 339
John C. White
38 Weapons of mass destruction 349
Jonathan L. Burstein
Section VI: Special Environments
39 Tactical EMS 355
David K. Tan, William P. Bozeman, and Denis FitzGerald
40 EMS on the fireground 363
Edward T. Dickinson, Sandy Bogucki, and Carin M. van Gelder
41 Confined space and limited access situations 373
David C. Cone
42 Care in the wilderness 377
Seth C. Hawkins, Michael G. Millin, and William “Will” R. Smith
43 Telemedicine and emerging telecommunications 392
David G. Ellis, Kaori P. Tanaka, and Brian M. Clemency
Section VII: Advancing Knowledge
44 EMS research basics 403
E. Brooke Lerner, David C. Cone, and Donald M. Yealy
45 Informed consent for EMS research 410
Lynn J. White
46 Cardiac arrest-related research methodology 415
Michael R. Sayre
47 Trauma-related research methodology 420
Peter P. Taillac and Edward P. Sloan
48 Pediatric-related research methodology 427
David Markenson
49 Economic evaluation of EMS-related interventions 433
Graham Nichol
50 Data handling and statistics essentials 439
Craig D. Newgard and Roger J. Lewis
Appendix, 449
