Fundamentals of Paramedic Practice A Systems Approach

Description

Title Page Copyright Page Contents List of contributors Preface Acknowledgements About the companion website Chapter 1 Professionalism in paramedic practice Introduction Professionalism in paramedic practice Defining professionalism Professionalism as ethical practice Professional identity, socialisation, and culture Identity Socialisation Professional culture How do students learn professionalism? Assessment and standards of professionalism Regulatory areas, fitness to practise processes, and outcomes Conclusion Activities Glossary References Chapter 2 Professional health regulation for paramedicine and ambulance prehospital emergency care Introduction Principles for paramedic professional health regulation Health professional regulation for paramedic professionalism The UK experience Paramedics behaving badly The Australian experience Conclusion Activities Glossary References Chapter 3 Human factors in paramedicine Introduction What are human factors? Human error in paramedicine Tasks Organisation Tools and technology Environment Interactions Human factors in paramedic practice Crew/team working Situational awareness Conclusion Activities Glossary References Chapter 4 Mental capacity and prehospital care Introduction What is mental capacity? How do we make decisions? Assessing mental capacity Diagnostic test Functional test Providing information The five principles Relevance of the five principles to prehospital care Deprivation of liberty safeguards Additional mental capacity safeguards Mental capacity act: Sections 5 and 6 Legal aspects of mental capacity Conclusion Activities Glossary References Chapter 5 Mental health and prehospital care Introduction What is ‘mental health’? What are ‘mental disorder’ and ‘mental illness’? Organic Functional Emotions (mood) and behaviour ABC model of emotion Brief outline of common mental illnesses Anxiety Depression Bipolar disorder Schizophrenia Dementia General strategies to help with all mental health conditions in the prehospital environment Mental health act Conclusion Activities Glossary References Chapter 6 Communication skills for the prehospital professional Introduction Background The importance of effective communication A model of communication Sender Message Receiver Feedback Nonverbal communication Body language Negative body language Eye contact Touch (tactile communication) Proximity Facial expressions Verbal communication Language Language registers Mood Effective listening Empathy Barriers to effective communication in the prehospital setting Environmental Noise Medical conditions Individual personal beliefs Relatives and bystanders Conclusion Activities Glossary References Chapter 7 Sociological aspects of paramedic practice Introduction The sociological imagination Three sociological paradigms Functionalism Conflict theory Symbolic interactionism and microsociology The sociocultural context of health Medicalisation and demedicalisation Conclusion Activities Glossary References Chapter 8 Legal and ethical aspects of paramedic practice Introduction Legal aspects of paramedic practice Consent to treatment Informed consent Implied consent Best interest Battery Negligence Capacity to make decisions Mental capacity in children Ethical aspects of paramedic practice Ethics and morality Utilitarianism and deontology Ethical principles: An ethical framework Conclusion Activities References Chapter 9 Leadership and mentorship in paramedic practice Introduction Theories of leadership: a brief overview Definitions of leadership From leaders to leadership behaviours Leadership styles and approaches Leadership and the mentoring or supervisory role Leadership and team work Ongoing leadership development Conclusion Activities Glossary References Chapter 10 Safeguarding adults at risk of abuse and neglect Introduction Legislation and policy Types of abuse and neglect Recognising abuse and neglect Physical abuse Sexual abuse Financial abuse Organisational abuse Recognising neglect Radicalisation and extremism Practice principles of safeguarding Paramedic responsibilities Conclusion Activities Glossary References Chapter 11 Essential toxicology for prehospital clinicians Introduction What is toxicology and why is it important? What makes a toxin? Pharmacokinetics in toxicology Absorption Distribution Biotransformation Excretion The importance of clinical context and vulnerability The initial resuscitative approach in toxicology Resuscitation Risk assessment and disposition Toxicology sequelae Toxidromes Physiology Pharmacology Cholinergic toxidrome Anticholinergic toxidrome Opioid toxidrome Sedative toxidrome Sympathomimetic toxidrome Serotonin syndrome Malignant hyperthermia Neuroleptic malignant syndrome Activities Glossary References Chapter 12 Medical terminology Introduction A brief history (Hx) of medical terminology Greek influence Latin influence Arabic influence Contemporary english dominance Medical terminology and word structure Prefixes and suffixes The building blocks of medical terms Pronunciation of medical terms Forming plurals Eponyms Anatomical positions Anatomical directional terms Anatomical planes Movement terminology Medical abbreviations and acronyms Common similarities in terminology Spelling – British versus American English Conclusion Activities Glossary References Chapter 13 Research methods and paramedic practice Introduction Qualitative and quantitative research Ethics Practice insight Case reports Case control studies Questionnaire studies Interview studies Focus group studies Observational and participatory studies Before-and-after studies and routinely collected data Randomised controlled trials Longitudinal cohort and panel studies Critical literature reviews Step 1: The topic of the literature review Step 2: Searching for the literature Step 3: Critical appraisal of the literature Step 4: Thematic analysis and discussion of the findings Step 5: Reaching conclusions and recommendations Conclusion Activities Glossary References Chapter 14 Trauma Introduction Head injuries Minor head injuries Major head injuries Skull fracture Base-of-skull fracture Subdural haemorrhage Subarachnoid haemorrhage Facial injuries Laceration Nasal injury Facial fracture Neck and back injuries Spinal immobilisation C-spine fractures Cervical collars and immobilisation Muscular injuries Chest injuries Rib fractures Flail segment Pneumothorax Haemothorax Ruptured blood vessel Abdominal injuries Blood loss in the abdomen Open abdominal injury Pelvic injuries Open-book pelvic fracture Hip dislocation Neck-of-femur fracture Mid-shaft femur fractures Limb injuries Limb lacerations De-gloving Crush injuries Amputations Upper limb injuries Fractured/dislocated clavicle Fractured/dislocated shoulder Shock Conclusion Activities Glossary References Chapter 15 Prehospital electrocardiography Introduction What is an ECG? P, Q, R, S, and T waves Evaluating the ECG Heart rate Heart rhythm P wave QRS complex T wave PR interval Atrioventricular heart blocks First-degree AV block Second-degree AV block Third-degree AV block Heart blocks and the QRS width Performing and reviewing a 12lead ECG P wave QRS complex aVR negative R wave progress ST segment elevation Acute coronary syndromes and the ECG Idioventricular rhythm Bundle branch blocks Left bundle branch block Right bundle branch block Incomplete bundle branch block Conclusion Activities Glossary References Chapter 16 Assessing the cardiac system Introduction Cardiac anatomy and physiology Common cardiac conditions Ischaemic heart disease Heart failure Atrial fibrillation Chronic cor pulmonale Valvular heart disease Patient assessment History taking Clinical examination Chest examination Blood pressure measurement Mean arterial pressure End-tidal carbon dioxide monitoring (Capnography) Conclusion Activities Glossary References Chapter 17 Assessing the nervous system Introduction Nervous system: Structure and function Central nervous system Cerebrum Cerebellum Brain stem Spinal cord Peripheral nervous system Upper and lower motor neurones History and physical examination Physical examination/assessment of the neurological system Detecting increases in intracranial pressure Conclusion Test your knowledge Activities Glossary References Chapter 18 Assessing the abdomen Introduction Abdominal anatomy and physiology Genitourinary causes of abdominal pain The nature of abdominal pain The acute abdomen Important abdominal pathologies Biliary colic, acute cholecystitis, and pancreatitis Ruptured abdominal aortic aneurysm Patient assessment History taking Presenting complaint and history of presenting complaint Past/previous medical history Drug history Allergies Social history Family history Clinical examination Hand assessment Head and neck assessment Abdominal examination Conclusion Activities Glossary References Chapter 19 Respiratory assessment Introduction Respiratory anatomy and physiology Lungs and pleural membranes Mechanism of breathing Pathophysiology of respiratory conditions Patient assessment History taking Presenting complaint and previous medical history Medication history Allergies Social history Clinical examination Hand assessment Head and neck assessment Chest examination Inspection Palpation Percussion Auscultation End-tidal CO2 Conclusion Activities Glossary References Chapter 20 Paramedic assessment skills Introduction Part 1: The conscious patient Case study 1: Using the primary survey Case study 2: Implementing the secondary survey Signs and symptoms Patient history Last ins and outs Events leading up VSS HTT Pain management Managing nausea and/or vomiting Managing presenting condition(s) and establishing your provisional diagnosis Packing and transporting your patient Hospital handover Case study 3: Completing the systematic approach Part 2: The unconscious patient Reversible causes of cardiac arrest Secondary survey in an unconscious patient Case study 4: The unconscious patient systematic approach Primary survey Secondary survey Cardiopulmonary resuscitation Professional development and ongoing maintenance of clinical skills Conclusion Picture glossary Activities Glossary References Chapter 21 Birth and the paramedic Introduction Physiological birth Birth phases Latent phase Active phase Preparing for the birth Paramedic intervention following normal childbirth Birth complications Shoulder dystocia Breech birth Postpartum haemorrhage Transverse/shoulder presentation Cord prolapse Conclusion Activities Glossary References Chapter 22 Paediatrics Introduction Paediatric anatomy and physiology Paediatric vital signs Paediatric examination Patient assessment triangle Appearance Effort of breathing Circulation Application of the patient assessment triangle Paediatric emergencies The unconscious child Abdominal pain Poisoning Anaphylaxis Infection Breathing difficulties Conclusion Activities Glossary References Chapter 23 Medical emergencies Introduction Neurological emergencies Seizures Stroke (Cerebrovascular event) Metabolic emergencies Hyperglycaemia Hypoglycaemia End-of-life care Ambulance callouts for end‐of‐life care Barriers to care Legal considerations, dignity, and choice Infection Cellulitis Sepsis Immunological emergencies Anaphylaxis Conclusion Activities Glossary References Chapter 24 Caring for older adults Introduction The elderly population Assessing older adults Physiology of ageing Changes to the cardiovascular system due to ageing Changes to the respiratory system due to ageing Changes to the musculoskeletal system due to ageing Skin Special senses Immune function Thermoregulation Dementia Multimorbidity Frailty Recognition of frailty Implications of frailty Trauma Falls Change in level of consciousness Pain suggestive of fracture Head trauma Long lie Additional assessments in the elderly Pain assessment End-of-life care Conclusion Activities Glossary References Chapter 25 Managing minor injuries in the prehospital setting Introduction Background The importance of history taking Consent to treatment Clinical examination Examination of limbs Clinical documentation Minor head injuries Nasal injuries Wound assessment and care Special considerations Wound care Ankle injuries Minor burns Transporting minor injury patients Conclusion Activities Glossary References Chapter 26 Major incident management Introduction Managing the incident site: first ambulance on scene Declaring a major incident: METHANE and SAM Casualty management Triage Sort Paediatric patients Triage tags Treatment Transport Incident management system Emergency management Conclusion Activities Glossary References Chapter 27 Low acuity Introduction What is low acuity care? Frequent user management Post-discharge management Integration with medical centres How to approach low acuity care patient assessment S – Subjective O – Objective Performing a systems review Other physical assessment clues to assist the diagnosis Fingers Face and mouth Other areas of the body Gathering further clinical information from patients Ultrasound Point-of-care testing Suturing and wound management Telemedicine Conclusion Activities Glossary References Answers to activities Index EULA