Paramedic Principles and Practice

A Clinical Reasoning Approach

2nd Edition - October 1, 2020
Imprint: Elsevier
Authors: Brett Williams, Linda Ross
Language: English
Paperback ISBN:
9 7 8 - 0 - 7 2 9 5 - 4 3 0 6 - 4
eBook ISBN:
9 7 8 - 0 - 7 2 9 5 - 8 7 3 7 - 2
eBook ISBN:
9 7 8 - 0 - 7 2 9 5 - 8 7 3 6 - 5

Edited by expert academics and educators, Brett Williams and Linda Ross, and written by content specialists and experienced clinicians, this essential resource encourages re… Read more

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Edited by expert academics and educators, Brett Williams and Linda Ross, and written by content specialists and experienced clinicians, this essential resource encourages readers to see the links between the pathophysiology of a disease, how this creates the signs and symptoms and how these should to be managed in the out-of-hospital environment. Additionally, Paramedic Principles and Practice 2e will arm readers with not only technical knowledge and expertise, but also the non-technical components of providing emergency care, including professional attitudes and behaviours, decision-making, teamwork and communication skills.

Case studies are strategically used to contextualise the principles, step readers through possible scenarios that may be encountered and, importantly, reveal the process of reaching a safe and effective management plan. The case studies initially describe the pathology and typical presentation of a particular condition and progress to more-complex and less-typical scenarios where the practitioner faces increasing uncertainty.

Cover image
Title page
Table of Contents
Copyright
Foreword
Preface
About the editors
Contributing authors
Reviewers
The key to improving your clinical practice
Acknowledgements
PART ONE: PARAMEDIC PRINCIPLES
SECTION 1: INTRODUCTION TO PARAMEDIC PRINCIPLES AND PRACTICE
Chapter 1: Introduction
Professionalism
Summary
SECTION 2: FOUNDATION KNOWLEDGE
Chapter 2: Introduction to: Foundation Knowledge
Chapter 3: Perfusion
Introduction
What is perfusion?
Factors leading to normal perfusion
Disturbances of perfusion
Assessment of perfusion
Principles of medical management of perfusion
Summary
Chapter 4: The Autonomic Response
Introduction
The autonomic nervous system
Assessment of ANS function
Principles of management
Summary
Chapter 5: The Inflammatory Response
Introduction
What is inflammation?
The basics of normal inflammation
Abnormal inflammation
Summary
Chapter 6: Pharmacokinetics and Pharmacodynamics
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
Chapter 7: Introduction to: Foundation Concepts
Chapter 8: Evidence-Based Practice in Paramedicine
Case 1
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 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
Summary
Chapter 10: Introduction to: Communication and Non-technical Skills
SECTION 4: COMMUNICATION AND NON-TECHNICAL SKILLS
Chapter 11: 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 AUSTRALIAN AND NEW ZEALAND HEALTHCARE SYSTEMS
Chapter 12: Introduction to: The Australian and New Zealand Healthcare Systems
Chapter 13: The Paramedic Role in Healthcare
Introduction
The roles of ambulance services and paramedics in Australia and New Zealand
Professionalism, regulation and professional standards
The future paramedic role
Summary
Chapter 14: 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
Chapter 15: Introduction to: Patient and Paramedic Safety
Chapter 16: 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
Evidence-based practice and patient safety
EBP, individual patients and clinical reasoning
Summary
Chapter 17: 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
Chapter 18: Introduction to: Legal, Ethical and Professional Considerations
Chapter 19: 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
Chapter 20: Introduction to: The Paramedic Clinical Approach
PART TWO: PARAMEDIC PRACTICE
SECTION 8: THE PARAMEDIC CLINICAL APPROACH
Chapter 21: The Structured Clinical Approach
Introduction
The structured clinical approach
Chapter 22: The Patient-Centred Interview
Introduction
The structured patient-centred interview
Paramedic-patient interview structure
Summary
Chapter 23: Introduction to: The Paramedic Approach to the Patient With a Respiratory Condition
SECTION 9: THE PARAMEDIC APPROACH TO THE PATIENT WITH A RESPIRATORY CONDITION
Chapter 24: Airway Obstruction
Introduction
Pathophysiology
ASSESS
TREAT
EVALUATE
Ongoing management
Hospital admission
Follow-up
ASSESS
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TREAT
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Summary
Chapter 25: Asthma
Introduction
Pathophysiology
Gas trapping
Airway remodelling
ASSESS
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TREAT
EVALUATE
Ongoing management
Follow-up
ASSESS
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TREAT
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Future directions
Summary
Chapter 26: Acute Pulmonary Oedema
Introduction
EVALUATE
Hospital admission
Long-term impact
Acute pulmonary oedema across the lifespan
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TREAT
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Ongoing management
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Ongoing management
Future research
Summary
Chapter 27: Chronic Obstructive Pulmonary Disease
Introduction
Pathophysiology
Definitions
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TREAT
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Hospital admission
Investigations
Follow-up
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TREAT
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Future research and trends
Summary
Chapter 28: Pneumothorax
Introduction
Pathophysiology
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TREAT
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Ongoing management
Hospital admission
Long-term impact
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Summary
Chapter 29: Pulmonary Embolism
Introduction
Pathophysiology
Risk factors
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Research
Summary
SECTION 10: THE PARAMEDIC APPROACH TO THE PATIENT WITH A CARDIAC CONDITION
Chapter 30: Introduction to: The Paramedic Approach to the Patient With a Cardiac Condition
Chapter 31: Chest Pain
Introduction
Pathophysiology
Myocardial perfusion and myocardial workload
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Investigations
Ongoing management
Hospital admission
Follow-up
ACS across the lifespan
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Future research
Summary
Chapter 32: Arrhythmias
Introduction
Pathophysiology
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TREAT
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Ongoing management
Hospital admission
Arrhythmias across the lifespan
Wolff-Parkinson-White
Long QT syndrome
Commotio cordis
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Summary
Chapter 33: Cardiac Arrest
Introduction
Chain of survival
Pathophysiology
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Ongoing management
Long-term outcomes
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Future research
Summary
SECTION 11: THE PARAMEDIC APPROACH TO THE PATIENT WITH A MEDICAL CONDITION
Chapter 34: Introduction to: The Paramedic Approach to the Patient With a Medical Condition
Chapter 35: Hypoglycaemia and Hyperglycaemia
Introduction
Hypoglycaemia
Hyperglycaemia
Diabetic ketoacidosis
Euglycaemic DKA
Hyperglycaemic hyperosmolar states
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What else could it be?
TREAT
EVALUATE
Summary
Chapter 36: Stroke
Introduction
Pathophysiology
Clinical manifestations
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Ongoing management
Investigations
Hospital admission
Stroke across the lifespan
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Future research
Summary
Chapter 37: Overdose
Introduction
Pathophysiology
Methamphetamine
Opioids
Quetiapine
Tricyclic antidepressants
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Ongoing treatment
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Future research
Summary
Chapter 38: Anaphylaxis
Introduction
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TREAT
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Investigations
Ongoing management
Hospital admission
Post-discharge management
Anaphylaxis across the lifespan
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Future research
Summary
Chapter 39: Seizures
Introduction
Pathophysiology
Seizure classification
Management
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Ongoing management
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Future research and trends
Summary
Chapter 40: Pain
Introduction
Pathophysiology
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Ongoing management
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Future research
Summary
Chapter 41: Acute Abdominal Pain
Introduction
Pathophysiology
Specific conditions
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Ongoing management in hospital
Hospital admission
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Ongoing management
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Ongoing management
Bowel obstruction across the lifespan
Summary
Chapter 42: Sepsis
Introduction
Definitions
Pathophysiology
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TREAT
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Ongoing management
Sepsis across the lifespan
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Future research
Summary
Chapter 43: Bleeding From the Gastrointestinal and Urinary Tract
Introduction
Pathophysiology
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Hospital management
Summary
SECTION 12: THE PARAMEDIC APPROACH TO THE TRAUMA PATIENT
Chapter 44: Introduction to: The Paramedic Approach to the Trauma Patient
Chapter 45: Head Injuries
Introduction
Anatomy
Pathophysiology
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TREAT
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Ongoing management
Investigations
Hospital admission
Hospital discharge
Head injuries across the lifespan
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Future research
Summary
Chapter 46: Chest Injuries
Introduction
Pathophysiology
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TREAT
EVALUATE
Ongoing management
Investigations
Hospital admission
Long-term role
Chest trauma across the lifespan
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Future research
Summary
Chapter 47: Musculoskeletal Injuries
Introduction
Pathophysiology
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TREAT
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Ongoing management
Investigations
Ongoing management of uncomplicated injuries
Torn muscle repair
Management of specific fractures
Complications of MSIs
Rehabilitation
Long-term impact
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Summary
Chapter 48: Traumatic Spinal Injuries
Introduction
Pathophysiology
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Long-term issues and care
Life expectancy for SCI survivors
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Future research
Summary
Chapter 49: Burns
Introduction
Anatomy of the skin
Pathophysiology of burn injury
Burn injury severity
The inflammatory response to burn injury
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TREAT AND EVALUATE
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Other types of burns
Future research
Summary
Chapter 50: Mass-Casualty Incidents
Introduction
The 'all-hazard’ response to MCIs
Managing the scene at an MCI
Summary
SECTION 13: THE PARAMEDIC APPROACH TO THE PATIENT WITH AN ENVIRONMENTAL CONDITION
Chapter 51: Introduction to: The Paramedic Approach to the Patient With an Environmental Condition
Chapter 52: Hypothermia and Hyperthermia
Introduction
Hypothermia
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Chapter 53: Decompression Injuries
Introduction
Pathophysiology
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Ongoing management
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Summary
Chapter 54: Snakebite Envenoming
Introduction
Pathophysiology
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TREAT
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Ongoing management
Hospital management
Investigations
Hospital admission
Long-term impact
Snake bites across the lifespan
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Future research
Summary
Chapter 55: Spider Bites
Introduction
Pathophysiology
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TREAT
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Ongoing hospital management
Hospital admission
Long-term impact
Spider bites across the lifespan
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TREAT
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Summary
Chapter 56: Marine Envenoming
Introduction
Pathophysiology
ASSESS
CONFIRM
TREAT
EVALUATE
Hospital management
Long-term impact
Envenoming across the lifespan
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Hospital management
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Future research
Summary
Chapter 57: Tropical Medicine
Introduction
General approach
Guidelines
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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
Chapter 58: Introduction to: The Paramedic Approach to Complex Cases: Specific Challenges to Paramedic Reasoning and Management
Chapter 59: The Socially Isolated Patient
Introduction
Background
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Ongoing management
Hospital admission
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Summary
Chapter 60: The Dying Patient
Introduction
Death and dying across the lifespan
Pathophysiology
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Ongoing management
Hospital admission
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Summary
Chapter 61: Older Patients
Introduction
Pathophysiology
Approach to assessment
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Summary
Chapter 62: Indigenous Australian Patients
Introduction
Kinship
Culture
Distribution
Epidemiological profile
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Summary
Chapter 63: Māori Patients
Introduction
Specific aspects of healthcare for Mori
Epidemiological profile
Mental health
Delayed access to healthcare
Death among Mori populations
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Summary
Chapter 64: Family Violence
Introduction
Background to family violence
The role of paramedics and ambulance services
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Summary
SECTION 15: THE PARAMEDIC APPROACH TO THE PATIENT DISPLAYING CHANGES IN BEHAVIOUR: MENTAL HEALTH AND MENTAL ILLNESS
Chapter 65: Introduction to: The Paramedic Approach to the Patient Displaying Changes in Behaviour: Mental Health and Mental Illness
Chapter 66: 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
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Summary
Chapter 67: De-Escalation Strategies
Introduction
Aggression
De-escalation
Summary
SECTION 16: THE PARAMEDIC APPROACH TO OBSTETRIC, NEONATAL AND PAEDIATRIC PATIENTS
Chapter 68: Introduction to: The Paramedic Approach to Obstetric, Neonatal and Paediatric Patients
Chapter 69: Imminent Birth
Introduction
Physiology
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TREAT
Hospital admission
Investigations
Follow-up
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Further research
Summary
Chapter 70: 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
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Newborn airway management
Ongoing management
Documentation
Birth during transport
Discontinuing resuscitation
Hospital admission
Investigations
Follow-up
The preterm baby
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Long-term role
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Hospital management
Future research
Summary
Chapter 71: Paediatric Patients
Introduction
Important differences in children
Respiratory distress
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Summary
Medications Commonly Encountered in Community Emergency Health
Glossary
Index

Life Sciences

Physical Sciences & Engineering

Social Sciences & Humanities

Health

Paramedic Principles and Practice

A Clinical Reasoning Approach

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Brett Williams

Linda Ross

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