Muutke küpsiste eelistusi

PHTLS: Prehospital Trauma Life Support, Military Edition: Prehospital Trauma Life Support, Military Edition 9th edition [Pehme köide]

  • Formaat: Paperback / softback, 1032 pages, kaal: 1871 g
  • Ilmumisaeg: 15-Oct-2019
  • Kirjastus: Jones and Bartlett Publishers, Inc
  • ISBN-10: 1284180581
  • ISBN-13: 9781284180589
Teised raamatud teemal:
  • Formaat: Paperback / softback, 1032 pages, kaal: 1871 g
  • Ilmumisaeg: 15-Oct-2019
  • Kirjastus: Jones and Bartlett Publishers, Inc
  • ISBN-10: 1284180581
  • ISBN-13: 9781284180589
Teised raamatud teemal:
On the battlefield, seconds count. PHTLS: Prehospital Trauma Life Support, Military Ninth Edition teaches and reinforces the principles of rapidly assessing a trauma patient using an orderly approach, immediately treating life-threatening problems as they are identified, and minimizing any delays in initiating transport to an appropriate destination. Developed by the National Association of Emergency Medical Technicians (NAEMT) in cooperation with the American College of Surgeons Committee on Trauma (ASC-COT), PHTLS, the Military Ninth Edition reflects current, evidence-based knowledge and practice, and promotes critical-thinking as the foundation for providing quality care.

Since 1996, Tactical Combat Casualty Care (TCCC) has improved the care rendered in combat prehospital environments. TCCC is the battlefield prehospital component of the Joint Trauma System, an organization within the Department of Defense that projects combat trauma care out to the point of injury and continues that care seamlessly while bringing the casualty home for recuperation and rehabilitation. TCCC guidelines are continuously revised and updated by the Committee on Tactical Combat Casualty Care (Co-TCCC), an all-volunteer group of military medicine and trauma care specialists. The membership of Co-TECC includes combat medics, corpsmen, and pararescuemen as well as physicians and physician assistants.

PHTLS: Prehospital Trauma Life Support, Military Ninth Edition is the next step in the evolution of the premier global prehospital trauma education program, a partnership between PHTLS and TCCC that goes back to the fourth edition of this manual. Military Ninth Edition continues the shared mission to promote excellence in trauma care by all providers and in all environments. In addition to the PHTLS core content, it features thirteen chapters written by military prehospital trauma care experts for practitioners in the military environment.

Military Ninth Edition includes:

Scenario - An opening case study that presents the key concepts of the chapter in a realistic patient or casualty care situation that encourages the participant to ask, "What would I do?"
Key Terms - All key terms that appear in the Glossary are highlighted within the chapters.
Engaging Art Program - The Military Ninth Edition features photos and illustrations that depict the realities of battlefield prehospital care.
Summary - A list of the key concepts of the chapter.
Scenario Solution - A discussion on how the patient or casualty in the opening scenario is assessed and treated in the field or on the battlefield and during transport.
Division 1 Introduction 1(44)
Chapter 1 PHTLS: Past, Present, and Future
3(18)
Introduction
3(1)
History of Trauma Care in Emergency Medical Services (EMS)
3(4)
Ancient Period
3(1)
Larrey Period (Late 1700s to Approximately 1950)
4(1)
Farrington Era (Approximately 1950 to 1970)
5(1)
Modern Era of Prehospital Care (Approximately 1970 to Today)
5(2)
Philosophy of PHTLS
7(2)
Epidemiology and Financial Burden
8(1)
The Phases of Trauma Care
9(5)
Pre-event Phase
10(1)
Event Phase
11(1)
Postevent Phase
12(2)
PHTLS-Past, Present, Future
14(3)
Advanced Trauma Life Support
14(1)
PHTLS
15(1)
PHTLS in the Military
16(1)
International PHTLS
16(1)
Vision for the Future
16(1)
Summary
17(1)
References
17(2)
Suggested Reading
19(2)
Chapter 2 Golden Principles, Preferences, and Critical Thinking
21(24)
Introduction
22(1)
Principles and Preferences
23(3)
Situation
24(1)
Condition of the Patient
24(1)
Fund of Knowledge of the Prehospital Care Provider
25(1)
Local Protocols
25(1)
Equipment Available
25(1)
Critical Thinking
26(2)
Using Critical Thinking to Control Biases
27(1)
Using Critical Thinking in Rapid Decision Making
28(1)
Using Critical Thinking in Data Analysis
28(1)
Using Critical Thinking Throughout the Phases of Patient Care
28(1)
Ethics
28(3)
Ethical Principles
29(1)
Autonomy
29(2)
Nonmaleficence
31(1)
Beneficence
31(1)
Justice
31(1)
The Golden Hour or Period
31(1)
Why Trauma Patients Die
32(1)
The Golden Principles of Prehospital Trauma Care
33(5)
1 Ensure the Safety of the Prehospital Care Providers and the Patient
33(1)
2 Assess the Scene Situation to Determine the Need for Additional Resources
34(1)
3 Recognize the Physics of Trauma That Produced the Injuries
35(1)
4 Use the Primary Survey to Identify Life-Threatening Conditions
35(1)
5 Provide Appropriate Airway Management While Maintaining Cervical Spine Stabilization as Indicated
36(1)
6 Support Ventilation and Deliver Oxygen to Maintain an Spot 94%
36(1)
7 Control Any Significant External Hemorrhage
36(1)
8 Provide Basic Shock Therapy, Including Appropriately Splinting Musculoskeletal Injuries and Restoring and Maintaining Normal Body Temperature
36(1)
9 Maintain Manual Spinal Stabilization Until the Patient Is Immobilized
36(1)
10 For Critically Injured Trauma Patients, Initiate Transport to the Closest Appropriate Facility as Soon as Possible After EMS Arrival on Scene
37(1)
11 Initiate Warmed Intravenous Fluid Replacement en Route to the Receiving Facility
37(1)
12 Ascertain the Patient's Medical History and Perform a Secondary Survey When Life-Threatening Problems Have Been Satisfactorily Managed or Have Been Ruled Out
37(1)
13 Provide Adequate Pain Relief
38(1)
14 Provide Thorough and Accurate Communication Regarding the Patient and the Circumstances of the Injury to the Receiving Facility
38(1)
Research
38(3)
Reading the EMS Literature
38(1)
Types of Evidence
38(1)
Steps in Evaluation
39(2)
Summary
41(2)
References
43(1)
Suggested Reading
43(2)
Division 2 Assessment and Management 45(210)
Chapter 3 Shock: Pathophysiology of Life and Death
47(52)
Introduction
48(1)
Physiology of Shock
48(1)
Metabolism
48(1)
Definition of Shock
49(1)
Physiology of Shock
49(2)
Metabolism: The Human Motor
49(1)
The Fick Principle
50(1)
Cellular Perfusion and Shock
51(1)
Anatomy and Pathophysiology of Shock
51(4)
Cardiovascular Response
51(2)
Hemodynamic Response
53(1)
Endocrine Response
54(1)
Classification of Traumatic Shock
55(1)
Types of Traumatic Shock
55(5)
Hypovolemic Shock
55(3)
Distributive (Vasogenic) Shock
58(2)
Cardiogenic Shock
60(1)
Assessment
60(9)
Primary Survey
61(5)
Secondary Survey
66(1)
Musculoskeletal Injuries
67(1)
Confounding Factors
68(1)
Management
69(13)
Exsanguinating Hemorrhage
69(4)
Airway
73(1)
Breathing
73(1)
Disability
74(1)
Expose/Environment
74(1)
Patient Transport
75(1)
Vascular Access
75(2)
Volume Resuscitation
77(5)
Complications of Shock
82(2)
Acute Renal Failure
83(1)
Acute Respiratory Distress Syndrome
83(1)
Hematologic Failure
83(1)
Hepatic Failure
83(1)
Overwhelming Infection
83(1)
Multiple Organ Failure
84(1)
Prolonged Transport
84(1)
Summary
85(1)
References
86(2)
Suggested Reading
88(11)
Chapter 4 The Physics of Trauma
99(46)
Introduction
100(1)
General Principles
100(1)
Pre-event
101(1)
Event
101(1)
Postevent
101(1)
Energy
101(6)
Laws of Energy and Motion
101(3)
Energy Exchange Between a Solid Object and the Human Body
104(3)
Blunt Trauma
107(20)
Motor Vehicle Crashes
108(10)
Motorcycle Crashes
118(1)
Pedestrian Injuries
119(3)
Falls
122(1)
Sports Injuries
122(1)
Regional Effects of Blunt Trauma
123(4)
Penetrating Trauma
127(10)
Physics of Penetrating Trauma
127(1)
Damage and Energy Levels
128(4)
Anatomy
132(1)
Regional Effects of Penetrating Trauma
133(2)
Shotgun Wounds
135(2)
Blast Injuries
137(2)
Injury From Explosions
137(1)
Physics of Blast
137(1)
Interaction of Blast Waves With the Body
138(1)
Explosion Related Injuries
138(1)
Injury From Fragments
139(1)
Multi etiology Injury
139(1)
Using the Physics of Trauma in Assessment
139(1)
Summary
140(1)
References
141(2)
Suggested Reading
143(2)
Chapter 5 Scene Management
145(22)
Introduction
146(1)
Scene Assessment
146(1)
Safety
146(1)
Situation
147(1)
Safety Issues
147(4)
Traffic Safety
147(2)
Violence
149(1)
Hazardous Materials
150(1)
Situation Issues
151(14)
Crime Scenes
152(1)
Weapons of Mass Destruction
153(1)
Scene Control Zones
153(1)
Decontamination
153(2)
Secondary Devices
155(1)
Command Structure
155(1)
Incident Action Plans
156(2)
Blood borne Pathogens
158(3)
Patient Assessment and Triage
161(4)
Summary
165(1)
References
166(1)
Suggested Reading
166(1)
Chapter 6 Patient Assessment and Management
167(32)
Introduction
168(1)
Establishing Priorities
168(1)
Primary Survey
169(9)
General Impression
169(1)
Sequence of Primary Survey
170(7)
Simultaneous Evaluation and Management
177(1)
Adjuncts to Primary Survey
178(1)
Resuscitation
178(3)
Transport
178(1)
Fluid Therapy
178(2)
Basic Versus Advanced Prehospital Care Provider Levels
180(1)
Secondary Survey
181(4)
Vital Signs
182(1)
SAMPLE History
182(1)
Assessing Anatomic Regions
182(3)
Neurologic Examination
185(1)
Definitive Care in the Field
185(4)
Preparation for Transport
186(1)
Transport
186(1)
Field Triage of Injured Patients
186(3)
Duration of Transport
189(1)
Method of Transport
189(1)
Monitoring and Reassessment (Ongoing Assessment)
189(1)
Communication
190(1)
Special Considerations
191(3)
Traumatic Cardiopulmonary Arrest
191(1)
Pain Management
192(1)
Injury Due to Interpersonal Abuse
192(2)
Prolonged Transport and Interfacility Transfers
194(2)
Patient Issues
194(1)
Crew Issues
195(1)
Equipment Issues
195(1)
Summary
196(1)
References
197(1)
Suggested Reading
198(1)
Chapter 7 Airway and Ventilation
199(56)
Introduction
200(1)
Anatomy
200(1)
Upper Airway
200(1)
Lower Airway
200(1)
Physiology
200(5)
Oxygenation and Ventilation of the Trauma Patient
204(1)
Pathophysiology
205(1)
Causes and Sites of Airway Obstruction in the Trauma Patient
205(1)
Assessment of the Airway and Ventilation
206(1)
Position of the Airway and Patient
206(1)
Upper Airway Sounds
207(1)
Examine the Airway for Obstructions
207(1)
Look for Chest Rise
207(1)
Management
207(2)
Airway Control
207(1)
Essential Skills
207(2)
Manual Clearing of the Airway
209(2)
Manual Maneuvers
209(1)
Suctioning
209(2)
Selection of Adjunctive Device
211(1)
Simple Adjuncts
212(1)
Oropharyngeal Airway
212(1)
Nasopharyngeal Airway
213(1)
Complex Airways
213(14)
Supraglottic Airways
213(1)
Endotracheal Intubation
214(13)
Ventilatory Devices
227(2)
Pocket Masks
227(1)
Bag-Mask Device
227(1)
Positive-Pressure Ventilators
227(2)
Evaluation
229(1)
Pulse Oximetry
229(1)
Capnography
229(1)
Continuous Quality Improvement in Intubation
230(1)
Prolonged Transport
230(1)
Summary
231(2)
References
233(1)
Suggested Reading
234(21)
Division 3 Specific Injuries 255(238)
Chapter 8 Head Trauma
257(36)
Introduction
258(1)
Anatomy
258(3)
Physiology
261(2)
Cerebral Blood Flow
261(1)
Cerebral Venous Drainage
262(1)
Oxygen and Cerebral Blood Flow
263(1)
Carbon Dioxide and Cerebral Blood Flow
263(1)
Pathophysiology
263(7)
Primary Brain Injury
263(1)
Secondary Brain Injury
263(7)
Assessment
270(2)
Physics of Trauma
270(1)
Primary Survey
270(2)
Secondary Survey
272(1)
Specific Head and Neck Injuries
272(9)
Scalp Injuries
273(1)
Skull Fractures
273(1)
Facial Injuries
273(3)
Laryngeal Injuries
276(1)
Injuries to Cervical Vessels
276(1)
Brain Injuries
276(5)
Management
281(6)
Exsanguinating Hemorrhage
281(1)
Airway
282(1)
Breathing
283(1)
Circulation
284(1)
Disability
284(1)
Transport
285(2)
Summary
287(1)
References
288(3)
Suggested Reading
291(2)
Chapter 9 Spinal Trauma
293(52)
Introduction
294(1)
Anatomy and Physiology
295(6)
Vertebral Anatomy
295(4)
Spinal Cord Anatomy
299(2)
Pathophysiology
301(3)
Skeletal Injuries
301(1)
Specific Mechanisms of Injury That Cause Spinal Trauma
301(1)
Spinal Cord Injuries
302(2)
Assessment
304(2)
Neurologic Examination
304(1)
Using Mechanism of Injury to Assess SCI
304(2)
Indications for Spinal Motion Restriction
306(14)
Management
308(2)
General Method
310(1)
Manual In-Line Stabilization of the Head
310(1)
Rigid Cervical Collars
311(1)
Immobilization of Torso to the Board Device
312(1)
The Backboard Debate
313(1)
Maintenance of Neutral In-Line Position of the Head
314(1)
Completing Immobilization
315(3)
Rapid Extrication Versus Short Device for the Seated Patient
318(1)
Most Common Immobilization Mistakes
318(1)
Obese Patients
318(1)
Pregnant Patients
319(1)
Use of Steroids
319(1)
Prolonged Transport
320(1)
Summary
321(1)
References
322(3)
Suggested Reading
325(20)
Chapter 10 Thoracic Trauma
345(32)
Introduction
346(1)
Anatomy
346(1)
Physiology
347(3)
Ventilation
347(2)
Circulation
349(1)
Pathophysiology
350(1)
Penetrating Injury
350(1)
Blunt Force Injury
351(1)
Assessment
351(1)
Assessment and Management of Specific Injuries
352(17)
Rib Fractures
352(1)
Flail Chest
353(1)
Pulmonary Contusion
354(1)
Pneumothorax
354(5)
Hemothorax
359(2)
Blunt Cardiac Injury
361(1)
Cardiac Tamponade
362(2)
Commotio Cord is
364(1)
Traumatic Aortic Disruption
364(2)
Tracheobronchial Disruption
366(1)
Traumatic Asphyxia
367(1)
Diaphragmatic Rupture
368(1)
Prolonged Transport
369(1)
Summary
369(2)
References
371(1)
Suggested Reading
372(5)
Chapter 11 Abdominal Trauma
377(18)
Introduction
378(1)
Anatomy
378(3)
Pathophysiology
381(1)
Assessment
381(5)
Kinematics
382(1)
History
383(1)
Physical Examination
383(1)
Special Examinations and Key Indicators
384(2)
Management
386(2)
Special Considerations
388(4)
Impaled Objects
388(1)
Evisceration
388(1)
Trauma in the Obstetric Patient
389(2)
Genitourinary Injuries
391(1)
Summary
392(1)
References
393(1)
Suggested Reading
393(2)
Chapter 12 Musculoskeletal Trauma
395(24)
Introduction
396(1)
Anatomy and Physiology
396(2)
Assessment
398(3)
Mechanism of Injury
398(1)
Primary and Secondary Surveys
399(2)
Associated Injuries
401(1)
Specific Musculoskeletal Injuries
401(7)
Hemorrhage
401(2)
Pulseless Extremity
403(1)
Instability (Fractures and Dislocations)
404(4)
Special Considerations
408(5)
Critical Multisystem Trauma Patient
408(1)
Compartment Syndrome
408(1)
Mangled Extremity
409(1)
Amputations
409(2)
Crush Syndrome
411(2)
Sprains
413(1)
Prolonged Transport
413(1)
Summary
414(1)
References
415(1)
Suggested Reading
415(4)
Chapter 13 Burn Injuries
419(26)
Introduction
420(1)
Etiology of Burn Injury
420(1)
Pathophysiology of Burn Injury
420(1)
Systemic Effects of Burn Injury
421(1)
Anatomy of the Skin
421(1)
Burn Characteristics
422(2)
Burn Depth
422(2)
Burn Assessment
424(5)
Primary Survey and Resuscitation
424(2)
Secondary Survey
426(3)
Management
429(3)
Initial Burn Care
429(1)
Fluid Resuscitation
429(3)
Analgesia
432(1)
Special Considerations
432(9)
Electrical Burns
432(1)
Circumferential Burns
433(1)
Smoke Inhalation Injuries
434(2)
Cold Temperature Injury
436(1)
Child Abuse
436(2)
Radiation Burns
438(1)
Chemical Burns
438(3)
Summary
441(2)
References
443(2)
Chapter 14 Pediatric Trauma
445(28)
Introduction
446(1)
The Child as Trauma Patient
446(2)
Demographics of Pediatric Trauma
446(1)
The Physics of Trauma and the Pediatric Trauma
446(1)
Common Patterns of Injury
446(1)
Thermal Homeostasis
446(1)
Psychosocial Issues
447(1)
Recovery and Rehabilitation
448(1)
Pathophysiology
448(2)
Hypoxia
448(1)
Hemorrhage
448(1)
Central Nervous System Injury
449(1)
Assessment
450(7)
Primary Survey
450(1)
Airway
451(1)
Breathing
452(2)
Circulation
454(2)
Disability
456(1)
Expose/Environment
456(1)
Secondary Survey
457(1)
Management
457(4)
Control of Severe External Hemorrhage
457(1)
Airway
457(1)
Breathing
458(1)
Circulation
459(2)
Pain Management
461(1)
Transport
461(1)
Specific Injuries
461(5)
Traumatic Brain Injury
461(2)
Spinal Trauma
463(1)
Thoracic Injuries
463(1)
Abdominal Injuries
464(1)
Extremity Trauma
464(1)
Burn Injuries
464(2)
Motor Vehicle Injury Prevention
466(1)
Child Abuse and Neglect
467(1)
Prolonged Transport
467(2)
Summary
469(1)
References
470(2)
Suggested Reading
472(1)
Chapter 15 Geriatric Trauma
473(20)
Introduction
474(1)
Anatomy and Physiology of Aging
474(6)
Influence of Chronic Medical Problems
475(1)
Ears, Nose, and Throat
475(1)
Respiratory System
476(1)
Cardiovascular System
476(1)
Nervous System
477(1)
Sensory Changes
478(1)
Renal System
478(1)
Musculoskeletal System
478(1)
Skin
479(1)
Nutrition and the Immune System
480(1)
Assessment
480(5)
Physics of Trauma
480(1)
Primary Survey
481(1)
Secondary Survey
482(3)
Management
485(2)
Exsanguinating Hemorrhage
485(1)
Airway
485(1)
Breathing
485(1)
Circulation
486(1)
Immobilization
486(1)
Temperature Control
486(1)
Legal Considerations
487(1)
Reporting Elder Abuse
487(1)
Elder Maltreatment
487(1)
Profile of the Abused
487(1)
Profile of the Abuser
487(1)
Categories of Maltreatment
488(1)
Important Points
488(1)
Disposition
488(1)
Prolonged Transport
489(1)
Prevention
489(1)
Summary
489(1)
References
490(2)
Suggested Reading
492(1)
Division 4 Prevention 493(24)
Chapter 16 Injury Prevention
495(22)
Introduction
496(1)
Concepts of Injury
496(5)
Definition of Injury
496(1)
Injury as a Disease
497(1)
Haddon Matrix
498(2)
Swiss Cheese Model
500(1)
Classification of Injury
500(1)
Scope of the Problem
501(4)
Intimate Partner Violence
504(1)
Injury to EMS Personnel
504(1)
Prevention as the Solution
505(1)
Concepts of Injury Prevention
505(5)
Goal
505(1)
Opportunities for Intervention
505(1)
Potential Strategies
506(2)
Strategy Implementation
508(1)
Public Health Approach
509(1)
Evolving Role of EMS in Injury Prevention
510(2)
One-on-One Interventions
510(1)
Communitywide Interventions
511(1)
Injury Prevention for EMS Providers
511(1)
Summary
512(2)
References
514(2)
Suggested Reading
516(1)
Division 5 Mass Casualties and Terrorism 517(62)
Chapter 17 Disaster Management
519(24)
Introduction
520(1)
The Disaster Cycle
520(4)
Comprehensive Emergency Management
521(1)
Personal Preparedness
522(2)
Mass-Casualty Incident Management
524(5)
The National Incident Management System
525(1)
Incident Command System
525(2)
Organization of the Incident Command System
527(2)
Medical Response to Disasters
529(6)
Initial Response
530(1)
Search and Rescue
530(1)
Triage
531(2)
Treatment
533(1)
Transport
533(1)
Medical Assistance Teams
533(1)
Threat of Terrorism and Weapons of Mass Destruction
534(1)
Decontamination
534(1)
Treatment Area
535(1)
Psychological Response to Disasters
535(1)
Characteristics of Disasters That Affect Mental Health
535(1)
Factors Impacting Psychological Response
535(1)
Psychological Sequelae of Disasters
535(1)
Interventions
535(1)
Emergency Responder Stress
536(1)
Disaster Education and Training
536(1)
Common Pitfalls of Disaster Response
537(3)
Preparedness
537(1)
Communications
538(1)
Scene Security
538(1)
Self-Dispatched Assistance
538(1)
Supply and Equipment Resources
538(1)
Failure to Notify Hospitals
539(1)
Media
539(1)
Summary
540(1)
References
541(1)
Suggested Reading
542(1)
Chapter 18 Explosions and Weapons of Mass Destruction
543(36)
Introduction
544(1)
General Considerations
544(5)
Scene Assessment
544(1)
Incident Command System
545(1)
Personal Protective Equipment
545(1)
Control Zones
546(2)
Patient Triage
548(1)
Principles of Decontamination
548(1)
Explosions, Explosives, and Incendiary Agents
549(7)
Categories of Explosives
549(1)
Mechanisms of Injury
550(4)
Injury Patterns
554(1)
Evaluation and Management
554(1)
Transport Considerations
555(1)
Incendiary Agents
555(1)
Chemical Agents
556(5)
Physical Properties of Chemical Agents
556(1)
Personal Protective Equipment
556(1)
Evaluation and Management
557(1)
Transport Considerations
557(1)
Selected Specific Chemical Agents
557(4)
Biologic Agents
561(7)
Concentrated Biohazard Agent Versus Infected Patient
561(2)
Selected Agents
563(5)
Radiologic Disasters
568(6)
Medical Effects of Radiation Catastrophes
569(4)
Personal Protective Equipment
573(1)
Assessment and Management
573(1)
Transport Considerations
574(1)
Summary
574(1)
References
575(2)
Suggested Reading
577(2)
Division 6 Special Considerations 579(148)
Chapter 19 Environmental Trauma I: Heat and Cold
581(48)
Introduction
582(1)
Epidemiology
582(1)
Heat-Related Illness
582(1)
Cold-Related Illness
582(1)
Anatomy
582(1)
The Skin
582(1)
Physiology
583(2)
Thermoregulation and Temperature Balance
583(2)
Homeostasis
585(1)
Risk Factors in Heat Illness
585(2)
Obesity, Fitness, and Body Mass Index
586(1)
Age
586(1)
Medical Conditions
586(1)
Medications
586(1)
Dehydration
586(1)
Injuries Caused by Heat
587(9)
Minor Heat-Related Disorders
589(1)
Major Heat-Related Disorders
590(6)
Prevention of Heat-Related Illness
596(7)
Environment
598(1)
Hydration
599(1)
Fitness
600(1)
Heat Acclimatization
600(2)
Emergency Incident Rehabilitation
602(1)
Injuries Produced by Cold
603(13)
Dehydration
603(1)
Minor Cold-Related Disorders
603(1)
Major Cold-Related Disorders
604(12)
2015 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science
616(2)
Cardiac Arrest in Special Situations-Accidental Hypothermia
616(1)
Basic Life Support Guidelines for Treatment of Mild to Severe Hypothermia
616(2)
Advanced Cardiac Life Support Guidelines for Treatment of Hypothermia
618(1)
Prevention of Cold-Related Injuries
618(4)
Prolonged Transport
620(1)
Heat-Related Illness
620(1)
Cold-Related Illness
621(1)
Summary
622(2)
References
624(4)
Suggested Reading
628(1)
Chapter 20 Environmental Trauma II: Lightning, Drowning, Diving, and Altitude
629(46)
Introduction
630(1)
Lightning-Related Injuries
630(7)
Epidemiology
630(1)
Mechanism of Injury
631(1)
Injuries From Lightning
631(2)
Assessment
633(1)
Management
634(1)
Prevention
635(2)
Drowning
637(11)
Epidemiology
638(1)
Risk Factors for Drowning
638(2)
Mechanism of Injury
640(2)
Water Rescue
642(1)
Predictors of Survival
642(1)
Assessment
643(1)
Management
644(2)
Prevention of Drowning Injuries
646(2)
Recreational Scuba-Related Injuries
648(12)
Epidemiology
648(1)
Mechanical Effects of Pressure
648(1)
Barotrau ma
649(4)
Assessment of AGE and DCS
653(1)
Management
654(1)
Prevention of Scuba-Related Diving Injuries
654(6)
High-Altitude Illness
660(7)
Epidemiology
660(1)
Hypobaric Hypoxia
661(1)
Factors Related to High-Altitude Illness
661(2)
Acute Mountain Sickness
663(1)
High-Altitude Cerebral Edema
663(2)
High-Altitude Pulmonary Edema
665(1)
Prevention
666(1)
Prolonged Transport
667(1)
Drowning
667(1)
Lightning Injury
667(1)
Recreational Scuba-Related Diving Injuries
668(1)
High-Altitude Illness
668(1)
Summary
668(2)
References
670(4)
Suggested Reading
674(1)
Chapter 21 Wilderness Trauma Care
675(36)
Wilderness EMS Defined
676(2)
Wilderness EMS Versus Traditional Street EMS
677(1)
Wilderness EMS System
678(1)
Training for Wilderness EMS Providers
678(1)
Wilderness EMS Medical Oversight
679(1)
Wilderness EMS Agencies
679(1)
The Wilderness EMS Context
679(3)
Key Wilderness EMS/SAR Principles: Locate, Access, Treat, Extricate (LATE)
679(1)
Technical Rescue Interface
680(1)
Wilderness EMS Realms
680(1)
Wilderness Injury Patterns
680(1)
Safety
681(1)
Proper Care Depends on Context
681(1)
Ideal to Real Care
681(1)
Wilderness EMS Decision Making: Balancing Risks and Benefits
682(4)
TCCC and TECC Principles Applied in Wilderness Trauma Care
683(1)
Principles of Basic Patient Packaging
683(1)
Physiologic Splinting
683(1)
Airway Considerations
684(1)
Spinal Injuries and Spinal Motion Restriction
685(1)
Wilderness Extrication Options
686(1)
Other Wilderness EMS Patient Care Considerations
686(7)
Principles of Patient Assessment
686(1)
MARCH PAWS
687(1)
Prolonged Patient Care Considerations
688(1)
Elimination (Urination/Defecation) Needs
688(2)
Food and Water Needs
690(1)
Suspension Syndrome
691(1)
Eye/Head Protection
692(1)
Sun Protection
692(1)
Specifics of Wilderness EMS
693(10)
Wound Management
693(1)
Improvised Tourniquets
694(2)
Pain Management
696(1)
Dislocations
697(1)
Cardiopulmonary Resuscitation in the Wilderness
697(1)
Bites and Stings
698(5)
The Wilderness EMS Context Revisited
703(1)
Summary
704(1)
References
705(4)
Suggested Reading
709(2)
Chapter 22 Civilian Tactical Emergency Medical Support (TEMS)
711(16)
Introduction
712(1)
History and Evolution of Tactical Emergency Medical Support
712(1)
TEMS Practice Components
712(1)
Barriers to Traditional EMS Access
713(1)
Zones of Operation
713(1)
Phases of Care
714(7)
Care Under Fire (Direct Threat Care)
714(1)
Tactical Field Care (Indirect Threat Care)
715(5)
Tactical Evacuation Care (Evacuation Care)
720(1)
Mass-Casualty Incidents
721(1)
Medical Intelligence
721(1)
Summary
722(1)
References
723(1)
Suggested Reading
724(3)
Division 7 Military Medicine 727(266)
Chapter 23 Introduction to Tactical Combat Casualty Care (TCCC)
729(20)
Introduction
730(1)
Tourniquets Reconsidered and the Need for TCCC
731(1)
The Committee on Tactical Combat Casualty Care and the TCCC Working Group
731(1)
CoTCCC Membership
732(1)
CoTCCC Alignment
732(1)
TCCC Guideline Updates
732(1)
Battlefield Trauma Care in 2018
732(1)
Battlefield Experience with TCCC in Iraq and Afghanistan
733(2)
Changing the Culture in Battlefield Trauma Care
735(2)
TCCC in the U.S. Department of Defense-2019
737(3)
From the Battlefields of Iraq and Afghanistan to Worldwide Use
740(4)
TCCC in Allied Militaries
740(1)
PHTLS and the American College of Surgeons Committee on Trauma
740(1)
Hartford Consensus and Stop the Bleed
740(1)
TCCC and Wilderness Medicine
741(1)
The American College of Emergency Physicians (ACEP)
741(1)
Lessons Learned Are Not Really Lessons Learned-Unless We Actually Learn Them
741(3)
Summary
744(1)
References
745(4)
Chapter 24 Care Under Fire
749(14)
Introduction
750(1)
Moving Casualties in Tactical Settings
750(3)
Casualty Movement and Spinal Immobilization
752(1)
Hemorrhage Control
753(4)
Tourniquets
753(4)
Hemostatic Agents
757(1)
Airway
757(1)
Summary
758(1)
References
759(4)
Chapter 25 Tactical Field Care
763(94)
Introduction
765(1)
Establishing a Security Perimeter
765(7)
Disarming Casualties With Altered Mental Status and Securing Their Communications Equipment
772(1)
The MARCH Mnemonic
772(1)
Massive Hemorrhage
772(4)
Extremity Hemorrhage
774(1)
Hemostatic Dressings
774(1)
Junctional Hemorrhage
774(1)
XStat
775(1)
Airway
776(6)
Overview
776(2)
Airway Procedures
778(4)
Respiration/Breathing
782(13)
Tension Pneumothorax
782(10)
Open Pneumothorax
792(1)
Pulse Oximetry
793(2)
Oxygen Administration
795(1)
Circulation
795(19)
Bleeding
795(7)
Intravenous Access
802(3)
Tranexamic Acid
805(2)
Fluid Resuscitation
807(7)
Hypothermia Prevention
814(1)
Hypothermia and Coagulopathy on the Battlefield
814(1)
Penetrating Eye Trauma
815(5)
Analgesia
820(6)
The TCCC Triple-Option Analgesia Plan
820(6)
Antibiotics
826(2)
Communication
828(2)
Cardiopulmonary Resuscitation
830(1)
Cardiopulmonary Resuscitation in Tactical Settings
830(1)
Documentation of Care
830(2)
Documenting Care on the Battlefield
830(2)
Preparing the Casualty for Evacuation
832(2)
Casualty Movement
834(1)
Wounded Hostile Combatants
835(1)
Calling for Tactical Evacuation (TACEVAC)
836(1)
CAT A-Urgent (Denotes a Critical, Life-Threatening Injury)
836(1)
CAT B-Priority (Serious Injury)
836(1)
CAT C-Routine (Mild to Moderate Injury)
836(1)
Opportunities to Improve in TCCC
836(2)
References
838(19)
Chapter 26 Tactical Evacuation Care
857(20)
Introduction
858(1)
Tactical Evacuation Care Versus Tactical Field Care
858(7)
2012 Defense Health Board TACEVAC Care Recommendations
865(1)
Specific Aspects of Care in TACEVAC
866(5)
Massive Hemorrhage
866(1)
Airway
866(1)
Respirations/Breathing
867(1)
Circulation-Bleeding
867(1)
Circulation-Tranexamic Acid
868(1)
Circulation-Fluid Resuscitation
868(1)
Prevention of Hypothermia
869(1)
Traumatic Brain Injury in TACEVAC Care
869(1)
Electronic Monitoring
870(1)
Analgesia
870(1)
Casualty Movement
870(1)
Cardiopulmonary Resuscitation (CPR) During TACEVAC
870(1)
Care for Wounded Hostile Combatants
870(1)
Summary
871(2)
References
873(4)
Chapter 27 Scenarios
877(10)
Introduction
877(1)
Scenario 1: Gunshot Wound on a Night Patrol
878(1)
Scenario 2: Rocket-Propelled Grenade Attack in an Urban Environment
879(1)
Scenario 3: Rocket-Propelled Grenade Attack on a Convoy
880(2)
Scenario 4: Dismounted Improvised Explosive Device Attack
882(1)
Scenario 5: Fast-Roping Casualty in an Urban Environment
883(1)
References
884(3)
Chapter 28 Aeromedical Evacuation in a Combat Theater
887(12)
Introduction
888(1)
History of Aeromedical Casualty Movement
888(1)
En Route Care
888(1)
Tactical Evacuation (TACEVAC) Care
889(2)
Principles
889(1)
Medical-Care
890(1)
Preparation of the Casualty
890(1)
MTF to MTF MEDEVAC
891(1)
Aeromedical Evacuation
892(4)
Doctrine and Principles
892(1)
Role of Critical Care Air Transport Team
892(1)
Stressors of Aeromedical Evacuation
893(2)
Electronic Equipment Considerations
895(1)
Patient Movement Regulation
895(1)
Summary
896(1)
References
897(2)
Chapter 29 Joint Trauma System and Military Roles of Care
899(10)
Introduction
900(1)
The Joint Trauma System and the Department of Defense Trauma Registry
900(1)
Prevention
901(1)
Battlefield Injury Care Capabilities
902(3)
Role 1 (First Responder Care)
903(1)
Role 2 (Forward Resuscitative Care)
903(1)
Role 3 (Theater Hospitalization)
903(1)
Role 4 (Definitive Care)
904(1)
En Route Care
905(1)
Continuum of Care
905(1)
Summary
905(2)
References
907(2)
Chapter 30 Triage in Tactical Combat Casualty Care
909(8)
Introduction
910(1)
Triage in Tactical Combat Casualty Care
911(1)
Combat Triage Decision Algorithm
912(2)
Cursory Evaluation
912(1)
Physiologic Status
912(2)
Anatomic Criteria
914(1)
Planning and Protection
914(1)
Summary
915(1)
References
916(1)
Chapter 31 Injuries from Explosives
917(34)
Introduction
918(1)
Overview
919(1)
Explosive Agents
919(5)
Categories
919(2)
Types
921(3)
Factors That Worsen Outcomes
924(1)
Patterns of Injury
925(2)
Triage
927(1)
Taxonomy
928(1)
Assessment and Management by Blast Injury Category
928(14)
Primary Blast Injury
930(6)
Secondary Injury
936(2)
Tertiary Injury
938(2)
Quaternary Injury
940(1)
Quinary Injury
940(1)
Combination Injuries
941(1)
Special Considerations
942(1)
Personal Protection
942(1)
Psychological Considerations
943(1)
Evidence
943(1)
Summary
943(2)
References
945(6)
Chapter 32 Treatment of Burn Casualties in Tactical Combat Casualty Care
951(14)
Introduction
952(1)
Initial Assessment
952(2)
Care Under Fire
952(1)
Tactical Field Care
952(1)
Additional Burn Assessments and Interventions
953(1)
Physical Characteristics of the Burn Wound
954(2)
Types of Burns
954(1)
Burn Depth
954(2)
Burn Size
956(1)
Fluid Resuscitation for Burn Injury
956(2)
Pediatric Casualties
958(1)
Special Circumstances
958(1)
Wound Care
958(2)
Evacuation of Burn Patients
960(1)
U.S. Army Institute of Surgical Research Burn Flight Team
961(1)
Summary
961(2)
References
963(2)
Chapter 33 Casualty Response Planning in Tactical Combat Casualty Care
965(14)
Introduction
965(1)
Casualty Response System
965(1)
Training
966(1)
Focus on the Possible
966(1)
Medical Planning
966(1)
Predeployment Requirements
966(1)
Medical Threat Assessment
967(1)
Identify the Area of Operations (AO)
967(1)
Identify Medical Intelligence and Health Threats
967(1)
Higher Headquarters Orders and Guidelines
967(1)
Higher Headquarters Medical Guidelines and Requirements
967(1)
Requests for Information (RFI)
968(1)
Determine Medical Assets
968(2)
Evacuation Assets
968(1)
Requesting Evacuation
968(1)
Familiarization With Evacuation Assets
968(1)
Rehearsals With External Assets
968(1)
Surgical and Area Medical Support Assets
968(2)
Primary and Alternate Planning
970(1)
Tactical Medical Support Plan Development
970(2)
Understand the Tactical Commander's Plan
970(1)
Casualty Estimation
970(1)
Issue Initial Medical Planning Guidance to Subordinates
970(1)
Determine Casualty Flow From Target to Hospitalization
971(1)
Determine Key Locations
971(1)
Establish the Tactical Medical Support Plan
971(1)
Air Tactical Evacuation Plan
971(1)
Ground Tactical Evacuation Plan
972(1)
Medical Communications
972(1)
Medical Resupply Requirements and Methods
972(1)
Briefs, Rehearsals, and Pre-combat Inspections
972(1)
Briefs
972(1)
Rehearsals
972(1)
Pre-combat Inspections
973(1)
Casualty Collection Point Operations
973(5)
CCP Site Selection
974(1)
CCP Operational Guidelines
974(1)
Guidelines for Establishing CCP Inside a Building
974(1)
CCP Duties and Responsibilities
974(1)
Unit Leadership and Medical Planners
974(1)
General Guidelines for CCP Personnel
974(1)
General CCP Layout Templates
974(4)
After-Action Review
978(1)
Summary
978(1)
Suggested Reading
978(1)
Chapter 34 Medical Support of Urban Operations
979(10)
Introduction
980(1)
Urban Terrain
980(1)
Characteristics of Urban Combat
981(1)
Restrictive Rules of Engagement
982(1)
Casualties
982(2)
Penetrating Injury
983(1)
Blunt Trauma
983(1)
Psychological Injury
983(1)
Civilian Casualties
984(1)
Medical Preparation for Urban Combat
984(1)
Evacuation
984(1)
Infectious Disease
985(1)
Portable Water
985(1)
The Future
985(1)
Summary
986(2)
References
988(1)
Chapter 35 Ethical Considerations for the Combat Medic
989(4)
Introduction
989(1)
Ethics in Conflict
989(1)
Ethics and Prisoners of War
990(1)
Management of Wounded Hostile Combatants
990(1)
Summary
991(1)
References
991(2)
Glossary 993(16)
Index 1009
Formed in 1975 and more than 32,000 members strong, the National Association of Emergency Medical Technicians (NAEMT) is the nations only organization solely dedicated to representing the professional interests of all EMS practitioners, including paramedics, emergency medical technicians, emergency medical responders and other professionals working in prehospital emergency medicine. NAEMT members work in all sectors of EMS, including government service agencies, fire departments, hospital-based ambulance services, private companies, industrial and special operations settings, and in the military. NAEMT represents all EMS practitioners in promoting: Greater understanding and appreciation by government agencies at the local, state and national levels of the role that EMS plays in our nation's health care, public safety, and disaster response systems. Pay and benefits that reflects their professional training, responsibilities and dedication. Leadership at the federal level that fosters and supports the delivery of quality EMS nationwide. Adequate and sustainable funding for EMS in all locations. Public policy that supports EMS practitioners and the patients they serve.