Paramedic Principles and Practice in the UK

1st Edition - April 13, 2023
Editor: Aidan Ward
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 8 7 3 9 1 - 8
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 7 3 9 2 - 5

Paramedic Principles and Practice in the UK is a key textbook designed to support paramedicine students in this country throughout their studies. The volume takes a practica… Read more

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Paramedic Principles and Practice in the UK is a key textbook designed to support paramedicine students in this country throughout their studies.

The volume takes a practical approach, with case histories covering a broad range of clinical presentations and treatments, all incorporating a patient-centric perspective that acknowledges the longer patient journey.

This must-have textbook will not only arm readers with technical knowledge and expertise, but also with the non-technical principles of the profession, developing future paramedics who are able to provide a safe and effective management plan in the out-of-hospital environment.

Cover image
Title page
Table of Contents
Copyright
Foreword
Preface to the UK edition
Preface to the second ANZ edition
Contributing authors
Acknowledgements
About the ANZ editors
About the UK adaptation editor
The key to improving your clinical practice
Paramedic Principles
Section 1. Introduction to Paramedic Principles and Practice
Chapter 1. Introduction
Professionalism
Paramedic Principles and Practice 2nd edition
Summary
Section 2. Foundation Knowledge
Section 2. Foundation Knowledge
Chapter 2. Perfusion
Introduction
What is perfusion?
Factors leading to normal perfusion
Disturbances of perfusion
Assessment of perfusion
Principles of medical management of perfusion
Summary
Chapter 3. The Autonomic Response
Introduction
The autonomic nervous system
Assessment of autonomic nervous system function
Principles of management
Summary
Chapter 4. The Inflammatory Response
Introduction
What is inflammation?
Abnormal inflammation
Summary
Chapter 5. Pharmacodynamics and Pharmacokinetics
Introduction
Definitions
Pharmacodynamics (what the drug does to the body)
Pharmacokinetics (what the body does to the drug)
The effects of population variance on pharmacokinetics
Summary
Section 3. Foundation Concepts
Section 3. Foundation Concepts
Chapter 6. Paramedic Education
Introduction
Experience versus education
The history of ambulance and paramedic education in the UK
International educational standards
Programme endorsement/approval and professional regulation
Continuing professional development and postgraduate education
Educational challenges and future directions
Summary
Chapter 7. Evidence-Based Practice in Paramedicine
Introduction
Introduction to evidence-based practice
Strengths of evidence-based practice
Barriers and weaknesses of evidence-based practice
So what does this all mean for paramedics?
Chapter 8. Developing a Philosophy of Practice
Introduction
Models of practice
Building a philosophy of practice
Summary
Chapter 9. The Clinical Reasoning Process
Introduction
How do paramedics make decisions?
Theoretical and conceptual foundations of clinical reasoning
Dual-process theory—a framework for reasoning
Approaches to decision-making ‘on the ground’
Factors affecting the clinical reasoning process
Strategies to enhance quality of clinical reasoning
A step-by-step guide to clinical decision-making
Step 1: Assess
Step 2: Confirm
Step 3: Treat
Step 4: Evaluate
Summary
Section 4. Communication and Non-Technical Skills
Section 4. Communication and Non-technical Skills
Chapter 10. Interpersonal Communication and Patient-Focused Care
Introduction
Fundamental concepts of communication
Verbal and non-verbal communication
The science and art of patient communication
Effective listening
Patient-centred communication
Emotional and behavioural components of effective communication
Summary
Section 5. The UK Healthcare System
Section 5. The UK Healthcare System
Chapter 11. The Paramedic Role in Healthcare
Introduction
The roles of ambulance services and paramedics in the United Kingdom
Professionalism, regulation and professional standards
The future paramedic role
Summary
Chapter 12. Characteristics of Ambulance Patients
Introduction
Who is using ambulance services?
What factors can lead to people calling for an ambulance?
From problem onset to the decision to call for an ambulance
The process of calling for an ambulance
Summary
Section 6. Patient and Paramedic Safety
Section 6. Patient and Paramedic Safety
Chapter 13. Patient Safety and Paramedicine
Introduction
The harm caused by healthcare errors
Types of medical error
Models of error
Reducing diagnostic errors
Error defence
Error management
Risk management controls
Evidence-based practice and patient safety
Evidence-based practice, individual patients and clinical reasoning
Summary
Chapter 14. Paramedic Health and Wellbeing
Introduction
Paramedic health and safety
Definitions
Stress
Managing emotion
Fatigue
Shiftwork
Occupational violence
Getting help
Physical injury, physical employment standards and physical activity
Nutrition
Alcohol and other drugs
Summary
Section 7. Legal, Ethical and Professional Considerations
Section 7. Legal, Ethical and Professional Considerations
Chapter 15. Legal and Ethical Considerations in Clinical Decision-Making
Introduction
Ethics and the law
Consent
Refusal of treatment
Elements of consent from a paramedic perspective
Case study evaluation
Documentation
Summary
Paramedic Practice
Section 8. The Paramedic Clinical Approach
Section 8. The Paramedic Clinical Approach
Chapter 16. The Structured Clinical Approach
Introduction
The structured clinical approach
Chapter 17. The Patient-Centred Interview
Introduction
The structured patient-centred interview
Paramedic–patient interview structure
Summary
Section 9. The Paramedic Approach to the Patient with a Respiratory Condition
Section 9. The Paramedic Approach to the Patient with a Respiratory Condition
Chapter 18. Airway Obstruction
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Hospital admission
Follow-up
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Chapter 19. Asthma
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Chapter 20. Acute Pulmonary Oedema
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Chapter 21. Chronic Obstructive Pulmonary Disease
Introduction
Pathophysiology
Definitions
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Chapter 22. Pneumothorax
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Hospital admission
Long-term impact
Assess
Confirm
Treat
Evaluate
Summary
Chapter 23. Pleural Effusion
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Investigations
Hospital admission
Follow-up
Assess
Confirm
Treat
Evaluate
Summary
Chapter 24. Pulmonary Embolism
Introduction
Pathophysiology
Risk factors
Assess
Confirm
Treat
Evaluate
Ongoing management
Investigations
Hospital admission
Follow-up
Assess
Confirm
Treat
Evaluate
Research
Summary
Section 10. The Paramedic Approach to the Patient with a Cardiac Condition
Section 10. The Paramedic Approach to the Patient with a Cardiac Condition
Chapter 25. Chest Pain
Introduction
Pathophysiology
Myocardial perfusion and myocardial workload
Assess
Confirm
Treat
Evaluate
Investigations
Ongoing management
Hospital admission
Follow-up
Acute coronary syndrome across the lifespan
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research
Summary
Chapter 26. Arrhythmias
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Hospital admission
Arrhythmias across the lifespan
Wolff-Parkinson-White
Long QT syndrome
Commotio cordis
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Summary
Chapter 27. Cardiac Arrest
Introduction
Chain of survival
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Long-term outcomes
Assess
Confirm
Treat
Evaluate
Future research
Summary
Section 11. The Paramedic Approach to the Patient with a Medical Condition
Section 11. The Paramedic Approach to the Patient with a Medical Condition
Chapter 28. Haematological Presentations
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Chapter 29. Hypoglycaemia and Hyperglycaemia
Introduction
Hypoglycaemia
Hyperglycaemia
Diabetic ketoacidosis
Euglycaemic diabetic ketoacidosis
Hyperglycaemic hyperosmolar states
Assess
Confirm
What else could it be?
Treat
Evaluate
Summary
Chapter 30. Stroke
Introduction
Pathophysiology
Clinical manifestations
Assess
Confirm
Treat
Evaluate
Ongoing management
Investigations
Hospital admission
Stroke across the lifespan
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research
Summary
Chapter 31. Overdose
Introduction
Pathophysiology
Other drugs
Assess
Confirm
Treat
Evaluate
Ongoing treatment
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research
Summary
Chapter 32. Anaphylaxis
Introduction
Assess
Confirm
Treat
Evaluate
Investigations
Ongoing management
Hospital admission
Post-discharge management
Anaphylaxis variations between adults and children
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research
Summary
Chapter 33. Seizures
Introduction
Pathophysiology
Seizure classification
Management
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research and trends
Summary
Chapter 34. Pain
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research
Summary
Chapter 35. Acute Abdominal Pain
Introduction
Pathophysiology
Specific conditions
Pressure
Assess
Confirm
Treat
Evaluate
Ongoing management in hospital
Hospital admission
Assess
Initial assessment summary
Confirm
What else could it be?
Treat
Evaluate
Assess
Initial assessment summary
Confirm
Treat
Evaluate
Assess
Initial assessment summary
Confirm
Treat
Evaluate
Ongoing management
Assess
Initial assessment summary
Confirm
What else could be the cause?
Treat
Evaluate
Ongoing management
Bowel obstruction across the lifespan
Summary
Chapter 36. Sepsis
Introduction
Definitions
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Sepsis across the lifespan
Assess
Confirm
Treat
Evaluate
Future Research
Summary
Chapter 37. Bleeding From the Gastrointestinal and Urinary Tract
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Hospital management
Summary
Chapter 38. Renal Colic
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Investigations
Ongoing management
Hospital admission
Long-term role
Renal stones across the lifespan
Summary
Chapter 39. The Patient on Out-of-Hospital Dialysis
Introduction
Pathophysiology
Neurological
Dialysis
Assess
Confirm
Treat
Evaluate
Ongoing management
Follow-up
Long-term role
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research
Summary
Section 12. The Paramedic Approach to the Trauma Patient
Section 12. The Paramedic Approach to the Trauma Patient
Chapter 40. Head Injuries
Introduction
Anatomy
Pathophysiology
Assess
Confirm
Treat
Ongoing management
Investigations
Hospital admission
Hospital discharge
Head injuries across the lifespan
Assess
Confirm
Treat
Evaluate
Future research
Summary
Chapter 41. Chest Injuries
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Investigations
Hospital admission
Long-term role
Chest trauma across the lifespan
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future Research
Summary
Chapter 42. Burns
Introduction
Anatomy of the skin
Pathophysiology of burn injury
Burn injury severity
The inflammatory response to burn injury
Assess
Confirm
Treat and Evaluate
Assess
Treat
Assess
Confirm
What else needs to be considered?
Treat
Evaluate
Other types of burns
Future research
Summary
Chapter 43. Musculoskeletal Injuries
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Investigations
Ongoing management of uncomplicated injuries
Torn muscle repair
Management of specific fractures
Complications of musculoskeletal injuries
Rehabilitation
Long-term impact
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research
Summary
Chapter 44. Traumatic Spinal Injuries
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Long-term issues and care
Life expectancy for spinal cord injury survivors
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Future research
Summary
Chapter 45. Lower Back Pain
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Hospital admission
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Summary
Chapter 46. Major Incidents
Introduction
The ‘all-hazard’ response to major incidents
Managing the scene at a major incident
Summary
Section 13. The Paramedic Approach to the Patient with an Environmental Condition
Section 13. The Paramedic Approach to the Patient with an Environmental Condition
Chapter 47. Hypothermia and Hyperthermia
Introduction
Hypothermia
Assess
Confirm
Treat
Evaluate
Hyperthermia
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Chapter 48. Decompression Injuries
Introduction
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Assess
Confirm
Treat
Evaluate
Summary
Chapter 49. Tropical Medicine
Introduction
General approach
Guidelines
Assess
Confirm
Treat
Evaluate
Malaria and other vector-borne diseases
Tuberculosis
Human immunodeficiency virus
Other tropical and emerging diseases
Future research
Summary
Section 14. The Paramedic Approach to Complex Cases: Specific Challenges to Paramedic Reasoning and Management
Section 14. The Paramedic Approach to Complex Cases: Specific Challenges to Paramedic Reasoning and Management
Chapter 50. The Socially Isolated Patient
Introduction
Background
Assess
Confirm
Treat
Evaluate
Ongoing management
Hospital admission
Assess
Confirm
Treat
Evaluate
Summary
Chapter 51. The Dying Patient
Introduction
Death and dying across the lifespan
Pathophysiology
Assess
Confirm
Treat
Evaluate
Ongoing management
Hospital admission
Assess
Confirm
Treat
Evaluate
Summary
Chapter 52. Older Patients
Introduction
Pathophysiology
Approach to assessment
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Summary
Chapter 53. Cultural Competence
Introduction
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Summary
Chapter 54. Family Violence and Safeguarding
Introduction
Background to abuse and neglect
The role of paramedics and ambulance services
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Summary
Section 15. The Paramedic Approach to the Patient Displaying Changes in Behaviour: Mental Health and Mental Illness
Section 15. The Paramedic Approach to the Patient Displaying Changes in Behaviour: Mental Health and Mental Illness
Chapter 55. Mental Health Conditions
Introduction
Prevalence of out-of-hospital and emergency department mental health presentations
The mental health system: why the increase in the out-of-hospital attendance to those with mental health concerns?
Concepts of recovery and the biopsychosocial model of care
Pathophysiology
Law and mental health
The Mental State Assessment
Assess
Confirm
Treat
Evaluate
Specific treatment guidelines
Investigations
Hospital admission
Long-term treatment and its impact
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Summary
Chapter 56. De-Escalation Strategies
Introduction
Aggression
De-Escalation
Summary
Section 16. The Paramedic Approach to Obstetric (Maternity), Neonatal and Paediatric Patients
Section 16. The Paramedic Approach to Obstetric (Maternity), Neonatal and Paediatric Patients
Chapter 57. Imminent Birth
Introduction
Physiology
Assess
Confirm
Treat
Hospital admission
Investigations
Follow-up
Assess
Treat
Assess
Treat
Assess
Treat
Assess
Treat
Further research
Summary
Chapter 58. Neonatal Resuscitation
Introduction
Pathophysiology
Identifying the newborn at risk of disorders during transition
Failure to breathe effectively at birth
Failure to establish effective ventilation after birth
Preparing for the birth of a baby
Assess
Confirm
Treat
Evaluate
Newborn airway management
Ongoing management
Documentation
Birth during transport
Discontinuing resuscitation
Hospital admission
Investigations
Follow-up
The preterm baby
Assess
Confirm
Treat
Evaluate
Long-term role
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Hospital management
Future research
Summary
Chapter 59. Paediatric Patients
Introduction
Important differences in children
Respiratory distress
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Assess
Confirm
Treat
Evaluate
Summary
Appendix 1. Medications Commonly Encountered in Community Emergency Health
Index

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Aidan Ward