Emergency Care

by Daniel Limmer EMT-P, Michael O'Keefe, Edward Dickinson Medical Editor

Overview

Over 1.6 million students have succeeded using this book, more than any other EMT-Basic training text. For over thirty years, Emergency Care has provided students with clear, complete coverage of the U.S. D.O.T. EMT-Basic National Standard Curriculum. The Ninth Edition provides updated content, a new interior design, and enhanced pedagogical features—to keep pace with today's students' needs and advances in prehospital care. A state-of-the-art multimedia package, featuring a student CD-ROM and a text-specific Companion Website, provides students with greater coverage of chapter material.

Product Details

ISBN-13:	9780136681168
Publisher:	Pearson Education
Publication date:	05/27/2020
Edition description:	New Edition
Pages:	1456
Sales rank:	110,989
Product dimensions:	8.50(w) x 10.70(h) x 2.00(d)

About the Author

Daniel Limmer began working in EMS in 1978. He became an EMT in 1980 and a paramedic in 1981. Currently, he is a lecturer at Central Washington University in Ellensburg, Washington, and an adjunct faculty member at Eastern Maine Community College in Bangor, Maine. He especially enjoys teaching patient assessment and believes critical thinking and decision-making skills are the key to successful clinical practice of EMS. In addition to his EMS experience, was a dispatcher and police officer in upstate New York.
Daniel works part time as a freelance photojournalist and is working on a documentary project photographing EMS people and agencies throughout the United States.
Daniel lives in Maine with his wife, Stephanie, and daughters Sarah and Margo. He is a Jimmy Buffett fan (Parrothead) who attends at least one concert each year.
Michael F. O’Keefe is an EMT Provider Level Leader for National EMS Education Standards. He served as an expert writer for 1994 revision of EMT-Basic curriculum. He has been an EMS volunteer since college in 1976. He is a member of the development group for the National EMS Education Agenda for the Future: A Systems Approach and The National EMS Scope of Practice Model. Michael has a special interest in EMS research, and earned a master’s degree in biostatistics. He is a past chairperson of the National Council of State EMS Training Coordinators. Michael’s interests include science fiction, travel, foreign languages, and stained glass.
Edward T. Dickinson is the medical director of the Malvern, Berwyn, and Radnor Fire Companies in Pennsylvania. He was first certified as an EMT in 1979 in upstate New York and has been continuously certified as a National Registry Paramedic since 1983. In 1985, was the first volunteer firefighter to receive the top award from Firehouse Magazine for heroism for the rescue of two elderly women trapped in a house fire.
Edward has a full-time academic emergency medicine practice at Penn Medicine in Philadelphia where he also serves as the Medical Director for PENNStar Flight. He is board certified in both Emergency Medicine and Emergency Medical Services. He has served as medical editor for numerous Brady EMT and First Responder texts.
Edward lives in Chester County, Pennsylvania, where he is married to Debbie and has two sons, Steve and Alex.

Read an Excerpt

PREFACE:

PREFACE

Emergency Care has set the standard for EMT-B training texts for over 30 years. The famous "yellow book" has been used by over 1.6 million students to pass the National Registry and state exams. More than any other text, this book has defined the field. The thoroughly revised Ninth Edition continues this tradition of excellence, reflecting the latest techniques and innovations in emergency patient care and including the latest advances in instructional technology.

The authors have based Emergency Care on the U.S. DOT 1994 EMT-Basic National Standard Curriculum; everything in the 1994 curriculum is addressed in the text. In addition, the text and the accompanying CD-ROM were developed taking into account the years of experience that the authors, with the input of countless instructors and students, have had with the DOT curriculum since its publication. The result is a proven text with outstanding readability and a level of detail that more instructors have found appropriate for their classrooms than any other.

The content of the Ninth Edition is summarized below:

Module 1, PREPARATORY: CHAPTERS 1-5
This first module sets a framework for all the modules that follow by introducing some essential concepts, information, and skills. The EMS system and the role of the EMT-B within the system are introduced. Issues of EMT-B safety and well-being and legal and ethical issues are covered. Basic anatomy and physiology and techniques of safe lifting and moving are also included in this first module.

Module 2, AIRWAY MANAGEMENT: CHAPTER 6
There is only one chapter in Module2, but it may be considered the most important module in the text, because no patient will survive without an open airway. Basic airway management techniques are covered in detail.

Module 3, ASSESSMENT: CHAPTERS 7-15
The ability to perform a rapid but accurate assessment, treat for life-threatening conditions, and initiate transport to the hospital within optimum time limits are the essence of the EMT-B's job. In this module, all of the steps of the assessment and their application to different types of trauma and medical patients, plus the skills of measuring vital signs, taking a patient history, communication, and documentation, are explained and illustrated.

Module 4, MEDICAL EMERGENCIES: CHAPTERS 16-25
The Medical Emergencies module begins with a chapter on pharmacology in which the medications the EMT-B can administer or assist with under the 1994 curriculum are introduced. The module continues with chapters on respiratory, cardiac, diabetic, allergy, poisoning and overdose, environmental, behavioral, and obstetric/gynecological emergencies. It ends with a new chapter on caring for patients with multiple medical complaints.

Module 5, TRAUMA: CHAPTERS 26-30
The Trauma module begins with a chapter on bleeding and shock; continues with chapters on soft-tissue injuries, musculoskeletal injuries, and injuries to the head and spine; and ends with a new chapter on caring for multiple-trauma patients.

Module 6, INFANTS AND CHILDREN: CHAPTER 31
The difference between treating adult and pediatric patients often lies in understanding the physical and psychological differences in infants and children compared to adults. This module explores these special aspects of pediatric care as well as medical conditions and injury patterns that are especially common to or critical for infants and children.

Module 7, OPERATIONS: CHAPTERS 32-34
This module deals with nonmedical operations and special situations, including ambulance operations, motor-vehicle collision rescues, and multiple-casualty and hazardous materials incidents.

Module 8, ADVANCED AIRWAY MANAGEMENT (ELECTIVE): CHAPTER 35
In some states and regions, EMT-Bs will be trained to perform invasive airway management procedures, including orotracheal intubation and, in children, nasogastric intubation. Module 8 is included as an elective to cover these advanced airway management skills.

APPENDICES AND BCLS REVIEW
There are four appendices to this textbook, covering advanced life support assist skills, stress, and the National Registry of Emergency Medical Technicians skill sheets. There is also a review of the basic cardiac life support course, which is a prerequisite to the EMT-Basic course.

INNOVATIONS STUDENTS NEED—
FEATURES Of THE BOOK AND THE
COMPANION CD-ROM

The features of the Ninth Edition of Emergency Care and its accompanying Electronic Extras CD have been designed to address the needs of students training to become EMT-Bs. Some features—like the "Patient Assessment" and "Patient Care" sections and Scans—are hallmarks of Emergency Care and have been used successfully in several editions. Other new or revised features—like the Street Scenes and Topic Overview—have been added based on the comments of instructors and students who have used the book in the past and were kind enough to provide us with their suggestions.

Here's what we have found about what students need most in their studies-and here's how this latest revision of Emergency Care meets those needs:

Students want material to be relevant to real life. Only work in the field provides real life experience, but case-based learning is an effective way of integrating concepts with practice in the classroom.

• New! Word on the Street. Each chapter opens with a brief anecdote, where experienced EMTs share their insights, wisdom, and experiences.
• New! Street Scenes. Each chapter concludes with a case study that applies information from the chapter to a life-like scenario. The Street Scenes case study begins, then stops to ask students questions; to make decisions; to figure out what to do next. As the case study continues, the story answers the questions by explaining what the EMTs would really do.
• An Electronic Edge. More case studies, plus on-the-scene action video footage and photos of trauma injuries, are found on the Electronic Extras CD.

Students prefer material in easy-to-read, easy-to-locate "chunks." So do we! Whether it's a mnemonic device like SAMPLE or a quick-reference Scan page that summarizes a skill, Emergency Care is designed to make important information accessible.

• Scans. Key information and step-by-step procedures are summarized and presented for easy reference in illustrated Scans.
  
  Medication Scans give you all the information you need in order to administer or help administer medications. Procedure Scans list and describe the steps in performing particular procedures.
• Study Guides. Sprinkled throughout the text, these summarize key points or mnemonic devices.
• Special Notes. "Pediatric Notes" and "Geriatric Notes" in many chapters describe what is unique in dealing with infants, children, or older adults and how you should deal with those differences. "Safety Notes" appear throughout the book as needed to point out situations where you need to take special care.

Patient assessment practice is essential. Because today's EMTs must assess patients accurately in order to perform their jobs well, training must contain a strong focus on this important skill.

• Patient Care and Patient Assessment sections. These segments describe the assessment and treatment you should provide for particular types of patients, disorders, or injuries. Patient Assessment typically lists the important signs and symptoms. Patient Care lists the key steps of EMT-B emergency care.
• An Electronic Edge. Video Activities on the Electronic Extras CD emphasize patient assessment with actual video footage and interactive exercises.

Good documentation skills require practice, practice, practice. One of the most common problems students encounter when they begin work on the street is documentation of calls.

• Documentation Tips. The Ninth Edition continues the use of the popular Documentation Tips throughout the text, with new examples added to the end of every medical, trauma, and pediatric chapter.
• New! Sample Documentation. After the chapter on documentation (Chapter 15), each Street Scenes case study concludes with a filled-out run sheet for the call.
• An Electronic Edge. The video activities on the Electronic Extras CD include documentation practice.

Retention improves when students have a broader framework in which to place newly learned information. When students first grasp a general overview, they are better prepared to synthesize details.

• New! Topic Overview. The chapter opens with a list of the key topics to be covered in the chapter.
• DOT Objectives. This list of cognitive, affective, and skills objectives opens each chapter and represents what is required by the U.S. DOT's National Standard. Includes page references to the chapter for quick review.

Sometimes students want to know more than what's in the DOT.

• FYIs. These popular "For Your Information" sections include material that is intended to broaden your knowledge of a chapter topic but it is not essential to an understanding of your job as an EMT-B.
• New! How and Why. This feature, posted throughout the text, brings to your attention extra information related to the topic at hand. In-depth expansions on these notes can be found on your Electronic Extras CD.
• New! Web Medic. The internet can be a large, confusing place for students. We will show them the right places to go for the best information. Each chapter has recommended web sites for your students to check out, located on the Emergency Care Companion Website so that URLs can be updated as needed.
• An Electronic Edge. Spanish phrases are included in audio format on the Electronic Extras CD!

Quality review material means better grades. Most students believe there is never too much opportunity for review and practice. We agree.

• In-text Chapter Review. Each chapter concludes with a Summary, a list of Key Terms (and definitions), Review Questions, and an Application Question.
• An Electronic Edge. Chapter Quizzes, Puzzles, Case Studies, and Patient Assessment activities are included on the CD for further practice.
• On the Companion Website. Even more chapter questions, anatomy review material, and interactive case studies can be found here.
• National Registry Skill Sheets. The practical skill sheets used at the EMT-Basic level by the National Registry of Emergency Medical Technicians are included in Appendix C as a tool to aid skill practice. The skill sheets also allow the instructor the opportunity to use a formal evaluation instrument when evaluating student performance. Preceding the skill sheets are instructions provided to the candidate prior to practical testing. This information should allay student fears and uncertainties about what criteria will be tested on the practical examination.

OUR GOAL: IMPROVING FUTURE TRAINING AND EDUCATION

Some of the best ideas for better training and education methods come from instructors who can tell us what areas of study caused their students the most trouble. Other sound ideas come from practicing EMT-Bs who let us know what problems they faced in the field. We welcome any of your suggestions. If you are an EMS instructor who has an idea on how to improve this book, the companion CD, or EMT-Basic training in general, please write to us at:

Brady/Prentice Hall Health
c/o EMS Editor
Pearson Education
One Lake Street
Upper Saddle River, NJ 07458

If you have access to a computer with a modem, you can also reach us through the following addresses:

[e-mail]
[e-mail]

Visit Brady's Web Site
...

Table of Contents

1. Introduction to Emergency Medical Care
2. Well-Being of the EMT
3. Lifting and Moving Patients
4. Medical, Legal, and Ethical Issues
5. Medical Terminology
6. Anatomy and Physiology
7. Principles of Pathophysiology
8. Life Span Development

1. Airway Management
2. Respiration and Artificial Ventilation

1. Scene Size-Up
2. Primary Assessment
3. Vital Signs and Monitoring Devices
4. Principles of Assessment
5. Secondary Assessment
6. Reassessment
7. Communication and Documentation

1. General Pharmacology
2. Respiratory Emergencies
3. Cardiac Emergencies
4. Resuscitation
5. Diabetic Emergencies and Altered Mental Status
6. Allergic Reaction
7. Infectious Diseases and Sepsis
8. Poisoning and Overdose Emergencies
9. Abdominal Emergencies
10. Behavioral and Psychiatric Emergencies and Suicide
11. Hematologic and Renal Emergencies

1. Bleeding and Shock
2. Soft-Tissue Trauma
3. Chest and Abdominal Trauma
4. Musculoskeletal Trauma
5. Trauma to the Head, Neck, and Spine
6. Multisystem Trauma
7. Environmental Emergencies

1. Obstetric and Gynecologic Emergencies
2. Emergencies for Patients with Special Challenges

1. EMS Operations
2. Hazardous Materials, Multiple-Casualty Incidents, and Incident Management
3. Highway Safety and Vehicle Extrication
4. EMS Response to Terrorism

Preface

Emergency Care has set the standard for EMT-B training texts for over 30 years. The famous "yellow book" has been used by over 1.6 million students to pass the National Registry and state exams. More than any other text, this book has defined the field. The thoroughly revised Ninth Edition continues this tradition of excellence, reflecting the latest techniques and innovations in emergency patient care and including the latest advances in instructional technology.

The authors have based Emergency Care on the U.S. DOT 1994 EMT-Basic National Standard Curriculum; everything in the 1994 curriculum is addressed in the text. In addition, the text and the accompanying CD-ROM were developed taking into account the years of experience that the authors, with the input of countless instructors and students, have had with the DOT curriculum since its publication. The result is a proven text with outstanding readability and a level of detail that more instructors have found appropriate for their classrooms than any other.

The content of the Ninth Edition is summarized below:

Module 1, PREPARATORY: CHAPTERS 1-5
This first module sets a framework for all the modules that follow by introducing some essential concepts, information, and skills. The EMS system and the role of the EMT-B within the system are introduced. Issues of EMT-B safety and well-being and legal and ethical issues are covered. Basic anatomy and physiology and techniques of safe lifting and moving are also included in this first module.

Module 2, AIRWAY MANAGEMENT: CHAPTER 6
There is only one chapter in Module 2, but it may be considered the most importantmodule in the text, because no patient will survive without an open airway. Basic airway management techniques are covered in detail.

Module 3, ASSESSMENT: CHAPTERS 7-15
The ability to perform a rapid but accurate assessment, treat for life-threatening conditions, and initiate transport to the hospital within optimum time limits are the essence of the EMT-B's job. In this module, all of the steps of the assessment and their application to different types of trauma and medical patients, plus the skills of measuring vital signs, taking a patient history, communication, and documentation, are explained and illustrated.

Module 4, MEDICAL EMERGENCIES: CHAPTERS 16-25
The Medical Emergencies module begins with a chapter on pharmacology in which the medications the EMT-B can administer or assist with under the 1994 curriculum are introduced. The module continues with chapters on respiratory, cardiac, diabetic, allergy, poisoning and overdose, environmental, behavioral, and obstetric/gynecological emergencies. It ends with a new chapter on caring for patients with multiple medical complaints.

Module 5, TRAUMA: CHAPTERS 26-30
The Trauma module begins with a chapter on bleeding and shock; continues with chapters on soft-tissue injuries, musculoskeletal injuries, and injuries to the head and spine; and ends with a new chapter on caring for multiple-trauma patients.

Module 6, INFANTS AND CHILDREN: CHAPTER 31
The difference between treating adult and pediatric patients often lies in understanding the physical and psychological differences in infants and children compared to adults. This module explores these special aspects of pediatric care as well as medical conditions and injury patterns that are especially common to or critical for infants and children.

Module 7, OPERATIONS: CHAPTERS 32-34
This module deals with nonmedical operations and special situations, including ambulance operations, motor-vehicle collision rescues, and multiple-casualty and hazardous materials incidents.

Module 8, ADVANCED AIRWAY MANAGEMENT (ELECTIVE): CHAPTER 35
In some states and regions, EMT-Bs will be trained to perform invasive airway management procedures, including orotracheal intubation and, in children, nasogastric intubation. Module 8 is included as an elective to cover these advanced airway management skills.

APPENDICES AND BCLS REVIEW
There are four appendices to this textbook, covering advanced life support assist skills, stress, and the National Registry of Emergency Medical Technicians skill sheets. There is also a review of the basic cardiac life support course, which is a prerequisite to the EMT-Basic course.

INNOVATIONS STUDENTS NEED—
FEATURES Of THE BOOK AND THE
COMPANION CD-ROM

The features of the Ninth Edition of Emergency Care and its accompanying Electronic Extras CD have been designed to address the needs of students training to become EMT-Bs. Some features—like the "Patient Assessment" and "Patient Care" sections and Scans—are hallmarks of Emergency Care and have been used successfully in several editions. Other new or revised features—like the Street Scenes and Topic Overview—have been added based on the comments of instructors and students who have used the book in the past and were kind enough to provide us with their suggestions.

Here's what we have found about what students need most in their studies-and here's how this latest revision of Emergency Care meets those needs:

Students want material to be relevant to real life. Only work in the field provides real life experience, but case-based learning is an effective way of integrating concepts with practice in the classroom.

• New! Word on the Street. Each chapter opens with a brief anecdote, where experienced EMTs share their insights, wisdom, and experiences.
• New! Street Scenes. Each chapter concludes with a case study that applies information from the chapter to a life-like scenario. The Street Scenes case study begins, then stops to ask students questions; to make decisions; to figure out what to do next. As the case study continues, the story answers the questions by explaining what the EMTs would really do.
• An Electronic Edge. More case studies, plus on-the-scene action video footage and photos of trauma injuries, are found on the Electronic Extras CD.

Students prefer material in easy-to-read, easy-to-locate "chunks." So do we! Whether it's a mnemonic device like SAMPLE or a quick-reference Scan page that summarizes a skill, Emergency Care is designed to make important information accessible.

• Scans. Key information and step-by-step procedures are summarized and presented for easy reference in illustrated Scans.
  
• Study Guides. Sprinkled throughout the text, these summarize key points or mnemonic devices.
• Special Notes. "Pediatric Notes" and "Geriatric Notes" in many chapters describe what is unique in dealing with infants, children, or older adults and how you should deal with those differences. "Safety Notes" appear throughout the book as needed to point out situations where you need to take special care.

Patient assessment practice is essential. Because today's EMTs must assess patients accurately in order to perform their jobs well, training must contain a strong focus on this important skill.

• Patient Care and Patient Assessment sections. These segments describe the assessment and treatment you should provide for particular types of patients, disorders, or injuries. Patient Assessment typically lists the important signs and symptoms. Patient Care lists the key steps of EMT-B emergency care.
• An Electronic Edge. Video Activities on the Electronic Extras CD emphasize patient assessment with actual video footage and interactive exercises.

Good documentation skills require practice, practice, practice. One of the most common problems students encounter when they begin work on the street is documentation of calls.

• Documentation Tips. The Ninth Edition continues the use of the popular Documentation Tips throughout the text, with new examples added to the end of every medical, trauma, and pediatric chapter.
• New! Sample Documentation. After the chapter on documentation (Chapter 15), each Street Scenes case study concludes with a filled-out run sheet for the call.
• An Electronic Edge. The video activities on the Electronic Extras CD include documentation practice.

Retention improves when students have a broader framework in which to place newly learned information. When students first grasp a general overview, they are better prepared to synthesize details.

• New! Topic Overview. The chapter opens with a list of the key topics to be covered in the chapter.
• DOT Objectives. This list of cognitive, affective, and skills objectives opens each chapter and represents what is required by the U.S. DOT's National Standard. Includes page references to the chapter for quick review.

Sometimes students want to know more than what's in the DOT.

• FYIs. These popular "For Your Information" sections include material that is intended to broaden your knowledge of a chapter topic but it is not essential to an understanding of your job as an EMT-B.
• New! How and Why. This feature, posted throughout the text, brings to your attention extra information related to the topic at hand. In-depth expansions on these notes can be found on your Electronic Extras CD.
• New! Web Medic. The internet can be a large, confusing place for students. We will show them the right places to go for the best information. Each chapter has recommended web sites for your students to check out, located on the Emergency Care Companion Website so that URLs can be updated as needed.
• An Electronic Edge. Spanish phrases are included in audio format on the Electronic Extras CD!

Quality review material means better grades. Most students believe there is never too much opportunity for review and practice. We agree.

• In-text Chapter Review. Each chapter concludes with a Summary, a list of Key Terms (and definitions), Review Questions, and an Application Question.
• An Electronic Edge. Chapter Quizzes, Puzzles, Case Studies, and Patient Assessment activities are included on the CD for further practice.
• On the Companion Website. Even more chapter questions, anatomy review material, and interactive case studies can be found here.
• National Registry Skill Sheets. The practical skill sheets used at the EMT-Basic level by the National Registry of Emergency Medical Technicians are included in Appendix C as a tool to aid skill practice. The skill sheets also allow the instructor the opportunity to use a formal evaluation instrument when evaluating student performance. Preceding the skill sheets are instructions provided to the candidate prior to practical testing. This information should allay student fears and uncertainties about what criteria will be tested on the practical examination.

OUR GOAL: IMPROVING FUTURE TRAINING AND EDUCATION

Some of the best ideas for better training and education methods come from instructors who can tell us what areas of study caused their students the most trouble.