Nancy Caroline's Emergency Care in the Streets with Advantage Access

Nancy Caroline’s Emergency Care in the Streets, Ninth Edition is the newest evolution of the premier paramedic education training program. This legendary paramedic textbook was first developed by Dr. Nancy Caroline in the early 1970s and transformed paramedic education. Today, lead editors Bob Elling and Barb Aehlert, along with the American Academy of Orthopaedic Surgeons, are proud to continue this legacy and set the new gold standard for the paramedics of tomorrow. The Ninth Edition offers cutting-edge, evidence-based content that meets or exceeds the most current scientific recommendations developed by the International Liaison Committee on Resuscitation (ILCOR) and the ECC Guidelines established by the American Heart Association and other resuscitation councils around the world. Clear chapter objectives align with the 2019 National EMS Scope of Practice Model and 2021 EMS Education Standards. Thoroughly reviewed by medical doctors and subject-matter experts, the Ninth Edition teaches students the technical skills required of today’s paramedic while emphasizing other important professional attributes, including critical thinking, empathy, teamwork, communication, problem solving, and personal well-being. Taking a systemic approach to the assessment and management of traumatic and medical emergencies, and devoting entire chapters to special topics, such as mass-casualty incidents, the Ninth Edition covers the full scope of paramedic practice. Some of the key high-level updates to the Ninth Edition include the following: Language carefully reviewed throughout text to ensure gender neutrality, racial inclusivity, and nonstigmatizing descriptions of patient conditions NEW Street Smarts boxes throughout the text to emphasize the “soft skills” expected of today’s paramedics Images updated to reflect appropriate PPE in the current COVID-19 setting Added emphasis on current spinal motion restriction guidelines Thoroughly reviewed and updated references, statistics, and case studies CPR and ACLS algorithms updated throughout text to reflect the current AHA guidelines Title Page Copyright Page Brief Contents Contents Skill Drills Acknowledgments SECTION 1 Preparatory Chapter 1 EMS Systems Introduction EMS System Development The History of EMS The 20th Century and Modern Technology Licensure, Certification, Registration, and Credentialing Reciprocity Traditional EMS Employment The EMS System Levels of Education The Dispatcher Emergency Medical Responder EMT Advanced EMT Paramedic Paramedic Education Initial Education Continuing Education Additional Types of Transports Transport to Specialty Centers Interfacility Transports Working With Other Professionals Working With Hospital Staff Working With Public Safety Agencies Community Expectations National EMS Group Involvement Professionalism Roles and Responsibilities Medical Direction Improving System Quality Continuous Quality Improvement and Quality Control Minimizing Errors EMS Research The Research Process Funding Types of Research Research Methods Ethical Considerations Evaluating Medical Research Evidence-Based Practice Chapter 2 Workforce Safety and Wellness Introduction Components of Well-Being Physical Well-Being Mental Well-Being Emotional Well-Being Spiritual Well-Being Disease Transmission Management of an Exposure Protecting Yourself Immunizations Personal Protective Equipment and Practices Hostile Situations Traffic Incidents Power Lines and Lightning Hazards Stress What Triggers Stress Physiology of Acute Stress How People React to Stressful Situations Coping With Your Own Stress Burnout Coping With Death and Dying Stages of the Grieving Process Dealing With a Dying Patient Dealing With a Grieving Family Dealing With a Grieving Child After the Call Is Over Peer Support and Suicide Prevention Chapter 3 Public Health Introduction Role of Public Health Public Health Threats Injuries Chronic Illness Acute Illness The Cost of Public Health Threats The Teachable Moment Prevention The 4 Es of Prevention: Education, Enforcement, Engineering/Environment, and Economic Incentives The Value of Passive Interventions Why EMS Should Be Involved How EMS Can Get Involved Injury and Illness Surveillance The Haddon Matrix Getting Started in Your Community Recognizing Injury and Illness Patterns in Your Community Prevention Programs for Children The Steps to Developing a Prevention Program Community Organizing Funding a Prevention Program Summary Chapter 4 Medical, Legal, and Ethical Issues Introduction Medical Ethics Ethics and EMS Research The Legal System in the United States Types of Law The Legal Process Legal Accountability of the Paramedic The Paramedic and the Medical Director EMS-Enabling Legislation Administrative Regulations Medical Practice Act Scope of Practice Health Insurance Portability and Accountability Act Emergency Medical Treatment and Active Labor Act Emergency Vehicle Laws Transportation Crime Scene and Emergency Scene Responsibilities Mandatory Reporting Coroner and Medical Examiner Cases Paramedic–Patient Relationships Consent and Refusal Decision-Making Capacity Documenting Informed Refusal Minors Violent Patients and Restraints Negligence and Protection Against Negligence Claims Elements of Negligence Abandonment Patient Autonomy Advance Directives End-of-Life Decisions Defenses to Litigation Good Samaritan Legislation Governmental Immunity Qualified Immunity Employment Law and the Paramedic Americans With Disabilities Act Title VII of the Civil Rights Act Sexual Harassment Additional Federal Laws Dealing With Discrimination State Laws Family and Medical Leave Act Occupational Safety and Health Administration Ryan White Act National Labor Relations Act Chapter 5 Communications Introduction Communication Theory Barriers to Effective Communication Response to the Call for Emergency Medical Services Crew Resource Management Phases of EMS Dispatch EMS Communications Systems Basic Radio Communications Theory Communications Systems Components Interoperability Cellular Technology Satellite Communications Backup Communications Systems Biotelemetry Communicating by Radio FCC Regulations Clarity of Transmission Content of Transmissions Communications Formats Used During the Different Phases of the Response Relaying Information to Medical Control Therapeutic Communication Developing Rapport Conducting the Interview Strategies to Elicit Useful Responses to Questions Common Interviewing Errors Nonverbal Skills Special Interview Situations Cross-Cultural Communication Cultural Competence Cultural Awareness Traditional Folk Medicine and Understanding of Illness Language Interpretation Chapter 6 Documentation Introduction Legal Implications of a PCR Purposes of Documentation Continuity of Care Minimum Requirements and Billing EMS Research Incident Review and Quality Assurance Types of PCRs Documentation for Every EMS Call Transfer of Care Care Before Arrival Situations Requiring Additional Documentation Refusal of Care Workplace Injuries and Illnesses Special Circumstances Completing a PCR PCR Narrative Elements of a Properly Written PCR Consequences of Poor Documentation Errors and Falsification Documenting Incident Times Chapter 7 Medical Terminology Introduction Origins of Medical Words Eponyms Medical Term Components Word Roots Prefixes Suffixes Combining Forms and Vowels Plural Endings Compound Words Homonyms Antonyms Synonyms Topographic Anatomy Anatomic Planes and Axes of the Body Specific Structures of the Body Body Cavities Directional Terms Movement and Positional Terms Other Directional Terms Position of the Patient Abbreviations, Acronyms, and Symbols Medical Abbreviations Error-Prone Abbreviations Symbols Medical Terminology Related to Pharmacology Master Tables SECTION 2 The Human Body and Human Systems Chapter 8 Anatomy and Physiology Introduction Characteristics of Life Organizational Structure Chemical Level Matter, Elements, and Atoms Chemical Bonds Compounds Chemical Reactions Electrolytes Acids, Bases, and the pH Scale Cellular Level Cell Structure Life Cycle of the Cell Cellular Signaling Cellular Respiration Body Fluid Composition Cellular Transport Mechanisms Tissue Level Epithelial Tissues Connective Tissues Muscle Tissues Nervous Tissues Types of Membranes Homeostasis Organ Systems The Integumentary System Skin Accessory Structures The Skeletal System Characteristics and Composition of Bones Joints Axial Skeleton Appendicular Skeleton The Musculoskeletal System Components of Connective Tissue Muscle Attachments Muscle Function Muscle Contraction Muscle Tone Muscle Relaxation Energy Sources The Nervous System Neurons and Impulse Transmission Central Nervous System Peripheral Nervous System Sensory Function The Endocrine System Intercellular Communication Hormones Hypothalamus Pituitary Gland Thyroid Gland Parathyroid Glands Thymus Gland Adrenal Glands Gonads Pineal Gland The Circulatory System Blood Heart Blood Vessels and Circulation The Lymphatic System The Respiratory System Upper Airway Lower Airway Lung Volumes Ventilation Oxygenation Respiration Control of Breathing The Digestive System Abdomen Oral Cavity Esophagus Stomach Small Intestine Large Intestine Accessory Organs Digestion and Absorption of Nutrients The Urinary System Kidneys Ureters Urinary Bladder Urethra Fluid Balance The Reproductive System Male Reproductive Anatomy Female Reproductive Anatomy Chapter 9 Pathophysiology Introduction Adaptations in Cells and Tissues Disturbances in Fluid Balance Edema Isotonic Fluid Deficit Electrolyte Imbalances Sodium Potassium Calcium Phosphate Magnesium Disturbances of Acid–Base Balance Types of Acid–Base Imbalance Cellular Injury Hypoxic Injury Chemical Injury Infectious Injury Immunologic and Inflammatory Injury Injurious Genetic Factors Injurious Nutritional Imbalances Injurious Physical Agents or Conditions Apoptosis Abnormal Cell Death Hypoperfusion Types of Shock Central Shock Peripheral Shock Management of Shock Multiple Organ Dysfunction Syndrome The Body’s Self-Defense Mechanisms Anatomic Barriers Immune Response Inflammatory Response Variances in Immunity and Inflammation Hypersensitivity Immune Deficiencies Factors That Cause Disease Controllable Versus Uncontrollable Risk Factors Analysis of Disease Risk Common Familial Diseases and Associated Risk Factors Stress and Disease General Adaptation Syndrome Effects of Chronic Stress Chapter 10 Life Span Development Introduction Infants Physical Changes Psychosocial Changes Toddlers and Preschoolers Physical Changes Psychosocial Changes School-Age Children Physical Changes Psychosocial Changes Adolescents (Teenagers) Physical Changes Psychosocial Changes Early Adults Physical Changes Psychosocial Changes Middle Adults Physical Changes Psychosocial Changes Late Adults Physical Changes Psychosocial Changes SECTION 3 Patient Assessment Chapter 11 Patient Assessment Introduction Sick Versus Not Sick Establishing a Field Impression Is This a Medical Emergency or Trauma? Scene Size-up Scene Safety: A Dynamic Process Mechanism of Injury or Nature of Illness Standard Precautions Primary Survey Examination Techniques Form a General Impression Assess the Airway Assess Breathing Assess Circulation Restoring Circulation Assess the Patient for Disability Expose, Then Cover Make a Transport Decision History Taking Purpose Patient Information Techniques for History Taking Ensuring Confidentiality Protecting the Patient’s Privacy Gathering Information From Third Parties Cultural Competence Special Challenges in History Taking Managing Age-Related Considerations Responsive Medical Patients Unresponsive Patients Trauma Patients Review of Body Systems Critical Thinking Clinical Reasoning Secondary Assessment Physical Exam of Priority Patients Assessment Techniques Vital Signs Equipment Used in the Secondary Assessment The Physical Exam The Full-Body Exam Secondary Assessment of Unresponsive Patients Secondary Assessment of Trauma Patients Recording Secondary Assessment Findings Limits of the Secondary Assessment Monitoring Devices Reassessment Reassessment of the Primary Survey Reassessment of Patient Care and Transport Priorities Chapter 12 Critical Thinking and Clinical Decision Making Introduction Cornerstones of Effective Paramedic Practice Gathering, Evaluating, and Synthesizing Information Developing and Implementing a Treatment Plan Using Judgment and Independent Decision Making The Range of Patient Conditions Critical Thinking and Clinical Decision Making Concept Formation Data Interpretation Application of Principle Reflection in Action Reflection on Action From Theory to Practical Application Taking It to the Streets 1. Read the Scene 2. Read the Patient 3. React 4. Reevaluate 5. Revise the Treatment Plan 6. Review Performance SECTION 4 Pharmacology Chapter 13 Principles of Pharmacology Introduction Historical Perspective on Medication Administration Medication and Drug Regulation Sources of Medication Forms of Medication Medication Management for Paramedics Medication Names Medication Reference Sources AHA Classification of Recommendations and Level of Evidence Medication Storage Medication Security The Physiology of Pharmacology Principles of Pharmacodynamics Types of Medication Responses Principles of Pharmacokinetics Routes of Medication Administration Distribution of Medication Volume of Distribution Medication Metabolism Medication Elimination Reducing Medication Errors Drugs That Act on the Sympathetic Nervous System Important Medications in the Prehospital Setting Medications Used in Airway Management Medications Used in Respiratory Management Medications Affecting the Cardiovascular System Additional Cardiovascular Medications Blood Products and Medications Affecting the Blood Medications Used for Neurologic Conditions Medications Affecting the GI System Miscellaneous Medications Used in the Prehospital Setting Chapter 14 Medication Administration Introduction Medical Direction Ensuring Correct and Safe Medication Administration Local Drug Distribution System Medical Asepsis Clean Technique Versus Sterile Technique Antiseptics and Disinfectants Standard Precautions and Contaminated Equipment Disposal Disposal of Contaminated Equipment Cellular Fluid Composition and Status Body Fluid Composition IV Fluid Composition Types of IV Solutions IV Techniques and Administration Assembling Your Equipment Choosing an IV Solution Choosing an Administration Set Choosing an IV Site Choosing an IV Catheter Inserting the IV Catheter Vein Identification Assistive Devices Securing the Line Changing an IV Bag Discontinuing the IV Line Alternative IV Sites and Techniques Pediatric IV Therapy Considerations Older Adult IV Therapy Considerations Factors Affecting IV Flow Rates Potential Complications of IV Therapy Local Complications Systemic Complications Obtaining Blood Samples Blood Transfusions Intraosseous Infusion IO Sites Equipment for IO Infusion Performing IO Infusion Potential Complications of IO Infusion Contraindications to IO Infusion Medication Administration Mathematic Principles Used in Pharmacology Calculating Medication Doses Weight-Based Drug Doses Calculating Fluid Infusion Rates Calculating the Dose and Rate for a Medication Infusion Non–Weight-Based Medication Infusions Weight-Based Medication Infusions Pediatric Drug Doses Enteral Medication Administration Oral Medication Administration Orogastric and Nasogastric Tube Medication Administration Rectal Medication Administration Parenteral Medication Administration Syringes and Needles Packaging of Parenteral Medications Intradermal Medication Administration Subcutaneous Medication Administration IM Medication Administration IV Bolus Medication Administration Adding Medication to an IV Bag IO Medication Administration Percutaneous Medication Administration Medications Administered by the Inhalation Route Nebulizer and Metered-Dose Inhaler Long-Term Vascular Access Devices Nontunneling VADs Implanted VADs Rates of Medication Absorption Chapter 15 Emergency Medications Pharmacology Formulary Drug Profiles Acetaminophen (Tylenol) AcetaZOLAMIDE (Diamox, Diamox Sequels) Acetic Acid (vinegar) Acetylcysteine (Mucomyst, Acetadote) Activated Charcoal (Insta-Char, Actidose-Aqua, Liqui-Char) Adenosine (Adenocard) Alprazolam (Xanax) Albuterol (Proventil, Ventolin, Proair, Accuneb) Amiodarone (Cordarone, Pacerone) Antibiotics Anticoagulants Antidepressant Agents Antiplatelet Agents Aspirin (Acetylsalicylic Acid) Atropine Sulfate Benzocaine Spray (Hurricane) Beta Blocking Agents Bumetanide (Bumex) Calcium Chloride Calcium Gluconate Cimetidine (Tagamet) Dexamethasone Sodium Phosphate (Decadron) Dextrose Diazepam (Valium, Diastat AcuDial) Digoxin (Lanoxin) Diltiazem (Cardizem, Dilacor, Diltiaz) DiphenhydrAMINE (Benadryl) DOBUTamine Hydrochloride (Dobutrex) DOPamine Hydrochloride (Intropin) Droperidol (Inapsine) Epinephrine (Adrenalin, EpiPen, AsthmaNefrin) Etomidate (Amidate) Famotidine (Pepcid) Fentanyl Citrate (Sublimaze) Fibrinolytic Agents Furosemide (Lasix) Glucagon (GlucaGen) Glucose, Oral (Insta-Glucose) Glycoprotein IIb/IIIa Inhibitors Haloperidol (Haldol) Helium Gas Mixture (Heliox) HydrALAZINE (Apresoline) Hydrocortisone Sodium Succinate (Solu-Cortef) HYDROmorphone (Dilaudid) Hydroxocobalamin (Cyanokit) Ibuprofen (Advil, Motrin) Insulin Ipratropium Bromide (Atrovent) Isopropyl Alcohol Ketamine (Ketalar) Ketorolac Tromethamine (Toradol) Levalbuterol (Xopenex) Lidocaine Hydrochloride (Xylocaine) Lorazepam (Ativan) Magnesium Sulfate Mannitol (Osmitrol) Meperidine Hydrochloride (Demerol) MethylPREDNISolone Sodium Succinate (Solu-Medrol) Metoclopramide (Reglan) Midazolam Hydrochloride (Versed) Milrinone (Primacor) Morphine Sulfate (Roxanol, MS Contin) Naloxone Hydrochloride (Narcan, EVZIO) NIFEdipine (Procardia, Adalat, Nifedical) Nitroglycerin (Nitrostat, Nitrolingual Pumpspray, NitroQuick, Nitro-Bid, Tridil) Nitroprusside (Nitropress) Nitrous Oxide 50:50 (Nitronox) Norepinephrine Bitartrate (Levophed, Levarterenol) Octreotide (Sandostatin) Olanzapine (Zyprexa) Ondansetron Hydrochloride (Zofran, Zofran ODT, Zuplenz) Oral Antidiabetic (Hypoglycemic) Drugs Oxygen Oxymetazoline (Afrin, Dristan 12-Hour, Vicks Sinus-12 Hour) Oxytocin (Pitocin) Pancuronium Bromide (Pavulon) Phenylephrine (Neo-Synephrine) Phenytoin (Dilantin) Potassium Iodide (Pima Syrup, SSKI, ThyroSafe, ThyroShield) Pralidoxime (2-PAM, Protopam) PredniSONE (Rayos) Procainamide Hydrochloride (Pronestyl) Prochlorperazine (Compazine) Promethazine Hydrochloride (Phenergan) Proparacaine Ophthalmic (Alcaine, Ophthaine) Propofol (Diprivan) Proton Pump Inhibitors Rocuronium Bromide (Zemuron) Sildenafil (Revatio, Viagra) Sodium Bicarbonate Sodium Thiosulfate (Nithiodote) Statins Succinylcholine Chloride (Anectine) Tadalafil (Cialis, Adcirca) Tetracaine Ophthalmic Solution (Pontocaine) Thiamine Hydrochloride (Vitamin B1) Tranexamic Acid (Cyklokapron, Lysteda) Vecuronium Bromide (Norcuron) Verapamil Hydrochloride (Isoptin, Calan) Ziprasidone (Geodon) IV Solutions (Colloids and Crystalloids) Albumin (Albumarc, Albutein, Flexbumin) Bacteriostatic Water Dextran Hetastarch (Hespan) Lactated Ringer (Hartmann) Solution Plasma Protein Fraction (Plasmanate) Total Parenteral Nutrition (TPN; varies based on mixture) 5% Dextrose in Water 10% Dextrose in Water 0.9% Sodium Chloride (Normal Saline) 0.45% Sodium Chloride 3% Sodium Chloride (Hypertonic Saline) 5% Dextrose in 0.45% Sodium Chloride 5% Dextrose in 0.9% Sodium Chloride 5% Dextrose in Lactated Ringer Solution SECTION 5 Airway Management Chapter 16 Airway Management Introduction Review of Airway Anatomy Upper Airway Ventilation, Oxygenation, and Respiration Pathophysiology of Respiration Hypoxia Ventilation–Perfusion Ratio and Mismatch Factors Affecting Ventilation Factors Affecting Oxygenation and Respiration Acid–Base Balance Patient Assessment: Airway Evaluation Assessing Airway Patency Recognizing Adequate Breathing Recognizing Inadequate Breathing Assessment of Breath Sounds Quantifying Ventilation and Oxygenation Pulse Oximetry Peak Expiratory Flow Measurement Arterial Blood Gas Analysis End-Tidal Carbon Dioxide Assessment Airway Management Positioning the Patient Manual Airway Maneuvers Suctioning Suctioning Equipment Suctioning Techniques Airway Adjuncts Oropharyngeal Airway Nasopharyngeal Airway Airway Obstructions Causes of Airway Obstruction Recognition of an Airway Obstruction Emergency Medical Care for Foreign Body Airway Obstruction Supplemental Oxygen Therapy Oxygen Sources Safety Reminders Oxygen Regulators and Flowmeters Preparing an Oxygen Cylinder for Use Supplemental Oxygen-Delivery Devices Nonrebreathing Mask Nasal Cannula Partial Rebreathing Mask Venturi Mask Tracheostomy Masks Oxygen Humidifier Ventilatory Support Normal Ventilation Versus Positive-Pressure Ventilation Assisted Ventilation Artificial Ventilation Mouth-to-Mask Ventilation Mouth-to-Mask Ventilation Technique The Bag-Mask Device Automatic Transport Ventilators Continuous Positive Airway Pressure Indications for CPAP Contraindications for CPAP Application of CPAP Complications of CPAP Gastric Distention Gastric Decompression Special Patient Considerations Laryngectomy, Tracheostomy, Stoma, and Tracheostomy Tubes Dental Appliances Facial Trauma Advanced Airway Management Predicting the Difficult Airway ET Intubation Orotracheal Intubation by Direct Laryngoscopy Orotracheal Intubation by Video Laryngoscopy Nasotracheal Intubation Technique for Nasotracheal Intubation Face-to-Face Intubation Failed Intubation Field Extubation Pharmacologic Adjuncts to Airway Management and Ventilation Sedation in Emergency Intubation Neuromuscular Blockade in Emergency Intubation Pharmacology of Neuromuscular Blocking Agents Rapid Sequence Intubation Alternative Advanced Airway Devices Supraglottic Airway Devices Cricothyrotomy Surgical Cricothyrotomy Needle Cricothyrotomy SECTION 6 Medical Chapter 17 Respiratory Emergencies Introduction Anatomy and Physiology Review Tracheobronchial Tree Mediastinum Pulmonary Blood Flow Perfusion Mechanisms of Respiratory Control Hypoventilation Hyperventilation Patient Assessment Scene Size-up Primary Survey History Taking Secondary Assessment Reassessment Emergency Medical Care Perform Standard Interventions Decrease the Work of Breathing Provide Supplemental Oxygen Administer a Bronchodilator Administer a Vasodilator Restore Fluid Balance Administer a Diuretic Support or Assist Ventilation Intubating the Adult Patient Inject a Beta Agonist Subcutaneously Pathophysiology, Assessment, and Management of Obstructive Upper Airway Diseases Anatomic Obstruction Inflammation Caused by Infection Aspiration Pathophysiology, Assessment, and Management of Obstructive Lower Airway Diseases Asthma COPD: Emphysema and Chronic Bronchitis Pathophysiology, Assessment, and Management of Common Respiratory Conditions Pulmonary Infections Atelectasis Cancer Toxic Inhalations Pulmonary Edema Acute Respiratory Distress Syndrome Pathophysiology, Assessment, and Management of Conditions Outside the Lung Parenchyma Pneumothorax Pleural Effusion Pulmonary Embolism Chapter 18 Cardiovascular Emergencies Introduction Anatomy and Physiology Review Patient Assessment Scene Size-up Primary Survey History Taking Secondary Assessment Reassessment Electrophysiology Depolarization and Repolarization Cardiac Action Potential Refractory Periods The Conduction System The Autonomic Nervous System and the Heart Causes of Cardiac Dysrhythmia The Electrocardiogram Approach to Dysrhythmia Interpretation Specific Cardiac Dysrhythmias Rhythms Originating in the SA Node Rhythms Originating in the Atria Rhythms Originating at the AV Junction Rhythms Originating in the Ventricles Management of Adult Cardiac Arrest AV Blocks Artificial Pacemaker Rhythms 12-Lead ECGs Acquisition Modes Lead Placement Approach to 12-Lead ECG Interpretation Pathophysiology, Assessment, and Management of Specific Cardiovascular Conditions Epidemiology of CVD Acute Coronary Syndromes Heart Failure Cardiac Tamponade Cardiogenic Shock Hypertensive Emergencies Infectious Diseases of the Heart Vascular Disorders Chapter 19 Neurologic Emergencies Introduction Anatomy and Physiology Review Patient Assessment Scene Size-up Primary Survey History Taking Secondary Assessment Reassessment Standard Care Guideline for the Neurologic Patient Administration of Dextrose Administration of Naloxone Interventions for Increased ICP Pathophysiology, Assessment, and Management of Common Neurologic Emergencies Stroke Transient Ischemic Attacks Coma Seizures Status Epilepticus Syncope Headache Dementia Neoplasms Pathophysiology, Assessment, and Management of Demyelinating, Degenerating, and Motor Neuron Disorders Multiple Sclerosis Guillain-Barré Syndrome Parkinson Disease Amyotrophic Lateral Sclerosis Cranial Nerve Disorders Dystonia Central Nervous System Infections and Inflammation Abscesses Poliomyelitis and Postpolio Syndrome Peripheral Neuropathy Chapter 20 Diseases of the Eyes, Ears, Nose, and Throat Introduction The Eye Anatomy and Physiology Review Patient Assessment Patients Wearing Contact Lenses Patients With an Eye Prosthesis Pathophysiology, Assessment, and Management of Specific Eye Conditions The Ear Anatomy and Physiology Review Patient Assessment Pathophysiology, Assessment, and Management of Specific Ear Conditions The Nose Anatomy and Physiology Review Patient Assessment Pathophysiology, Assessment, and Management of Specific Nose Conditions The Throat Anatomy and Physiology Review Patient Assessment Pathophysiology, Assessment, and Management of Specific Throat Conditions Chapter 21 Abdominal and Gastrointestinal Emergencies Introduction Anatomy and Physiology Review Patient Assessment Scene Size-Up Primary Survey History Taking Secondary Assessment Reassessment Emergency Medical Care Management of Pain, Nausea, and Vomiting Fluid Resuscitation Pathophysiology, Assessment, and Management of Specific Abdominal and GI Emergencies Pathophysiology, Assessment, and Management of GI Bleeding Upper GI Bleeding: Esophagogastric Varices Upper GI Bleeding: Mallory-Weiss Syndrome and Boerhaave Syndrome Upper GI Bleeding: Peptic Ulcer Disease and Gastritis Upper GI Bleeding: Gastroesophageal Reflux Disease and Hiatal Hernia Lower GI Bleeding: Hemorrhoids Lower GI Bleeding: Anal Fissures Pathophysiology, Assessment, and Management of Esophageal Pathologies Esophagitis Tracheoesophageal Fistula Esophageal Stricture or Stenosis Pathophysiology, Assessment, and Management of Acute Inflammatory Conditions Peritonitis Cholecystitis and Biliary Tract Disorders Appendicitis Diverticulitis Pancreatitis Pathophysiology, Assessment, and Management of Chronic Inflammatory Conditions Ulcerative Colitis Crohn Disease Irritable Bowel Syndrome Pathophysiology, Assessment, and Management of Acute Infectious Conditions Acute Gastroenteritis Rectal Abscess Liver Disease: Cirrhosis Liver Disease: Hepatic Encephalopathy Pathophysiology, Assessment, and Management of Obstructive Conditions Esophageal Obstruction Small-Bowel Obstruction Large-Bowel Obstruction Abdominal Wall Hernia Rectal Foreign Body Obstruction Pathophysiology, Assessment, and Management of Ischemic and Neoplastic Disorders Mesenteric Ischemia Neoplasms Tumors of the Colon Pancreatic Tumors Hepatic Tumors Prevention Strategies Chapter 22 Genitourinary and Renal Emergencies Introduction Anatomy and Physiology Review Patient Assessment Scene Size-up Primary Survey History Taking Secondary Assessment Reassessment Emergency Medical Care Pain Management Pathophysiology, Assessment, and Management of Specific Emergencies Urinary Tract Infections Urinary Catheters Urinary Obstruction and Incontinence Kidney Stones (Renal Calculi) Acute Kidney Injury Chronic Kidney Disease End-Stage Renal Disease Renal Dialysis Male Genital Tract Conditions Chapter 23 Gynecologic Emergencies Introduction Anatomy and Physiology Review Menstruation Patient Assessment Scene Size-up Primary Survey History Taking Secondary Assessment Reassessment Emergency Medical Care Management of Gynecologic Trauma Pathophysiology, Assessment, and Management of Specific Emergencies Infections Ovarian Disorders Uterine Disorders Vaginal Bleeding Sexual Assault Sexual Practices and Vaginal Foreign Bodies Chapter 24 Endocrine Emergencies Introduction Anatomy and Physiology Review Components of the Endocrine System Patient Assessment Scene Size-up Primary Survey History Taking Secondary Assessment Reassessment Emergency Medical Care Pathophysiology, Assessment, and Management of Glucose Metabolic Derangements Diabetes Mellitus Gestational Diabetes Hypoglycemia Hyperglycemia and Diabetic Ketoacidosis Hyperosmolar Hyperglycemic Nonketotic Syndrome Pathophysiology, Assessment, and Management of Other Disorders of the Pancreas Pancreatitis Pathophysiology, Assessment, and Management of Adrenal Insufficiency Primary Adrenal Insufficiency Secondary Adrenal Insufficiency Pathophysiology, Assessment, and Management of Other Adrenal Emergencies Cushing Syndrome Adrenal Gland Tumor Pathophysiology, Assessment, and Management of Thyroid, Parathyroid, and Pituitary Gland Disorders Growth Hormone Pathologies Hypothyroidism and Hyperthyroidism Graves Disease Hashimoto Disease Myxedema Coma Thyrotoxicosis Hyperparathyroidism Panhypopituitarism Diabetes Insipidus and SIADH Chapter 25 Hematologic Emergencies Introduction Anatomy and Physiology Review Blood and Plasma Blood-Forming Organs and RBC Production Patient Assessment Scene Size-up Primary Survey History Taking Secondary Assessment Reassessment Emergency Medical Care Pathophysiology, Assessment, and Management of Specific Emergencies Sickle Cell Crisis Anemia Leukemia Lymphomas Assessment Management Polycythemia Disseminated Intravascular Coagulation Assessment Hemophilia Multiple Myeloma Transfusion Reactions Chapter 26 Immunologic Emergencies Introduction Anatomy and Physiology Review Immune Response Routes of Entry for Allergens Physiology of Immune Response Patient Assessment Scene Size-up Primary Survey History Taking Secondary Assessment Reassessment Emergency Medical Care Pathophysiology, Assessment, and Management of Specific Emergencies Anaphylactic Reactions Autoimmune Disorders and Collagen Vascular Diseases Organ Transplantation Disorders Chapter 27 Infectious Diseases Introduction Protecting Public Health Responsibilities of Public Health Agencies Responsibilities of Paramedics Protecting Health Care Providers Communicable Disease Transmission Transmission-Based Precautions Personal Protective Equipment and Practices: Task Based Removal of PPE Postexposure Medical Follow-up Patient Assessment General Management Principles Chain of Infection Exposure and the Risk of Infection Infection and Sepsis Pathophysiology Assessment Management Pathophysiology, Assessment, and Management of Droplet-Transmitted Diseases Meningitis Respiratory Conditions Seasonal Influenza Pertussis (Whooping Cough) Mumps Rubella (German Measles) COVID-19 Pathophysiology, Assessment, and Management of Airborne-Transmitted Diseases Tuberculosis Varicella Zoster (Chickenpox) Measles Other Infections of the Respiratory Tract Mononucleosis Pathophysiology, Assessment, and Management of STIs Gonorrhea Syphilis Genital Herpes Chlamydia Scabies Lice Other STIs and Related Conditions Pathophysiology, Assessment, and Management of Common Bloodborne Diseases Types of Viral Hepatitis Hepatitis B Virus Infection Hepatitis C Virus Infection Hepatitis D Virus Infection Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome Fungal Skin Infections Dermatophyte Infections Helminths Hookworm Pinworm Ebola Pathophysiology Assessment Management Pathophysiology, Assessment, and Management of Enteric (Intestinal) Diseases Norovirus Infection Pathophysiology, Assessment, and Management of Non-Bloodborne Hepatitis Viruses Hepatitis A Virus Infection Hepatitis E Virus Infection Pathophysiology, Assessment, and Management of Vector-Borne and Zoonotic (Animal-Borne) Diseases M