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Tables of Contents for Emergency Care
Chapter/Section Title
Page #
Page Count
MODULE Preparatory
Introduction to Emergency Medical Care
4
16
The Emergency Medical Services System
6
2
How It Began
6
1
EMS Today
7
1
Components of the EMS System
8
9
Accessing the EMS System
9
1
Levels of EMS Training
10
1
Roles and Responsibilities of the EMT-B
10
1
Traits of a Good EMT-B
11
2
Where Will You Become a Provider?
13
1
National Registry of Emergency Medical Technicians
14
1
Quality Improvement
14
1
Medical Direction
15
1
Special Issues
16
1
Chapter Review
17
1
Street Scenes
18
2
The Well-Being of the EMT-Basic
20
23
Personal Protection
22
3
Body Substance Isolation (BSI) Precautions
22
1
Personal Protective Equipment
23
2
FYI Diseases of Concern
25
5
Immunizations
30
1
Emotion and Stress
30
5
Physiologic Aspects of Stress
30
1
Types of Stress Reactions
31
2
Causes of Stress
33
1
Signs and Symptoms of Stress
33
1
Dealing with Stress
33
2
Scene Safety
35
6
Hazardous Materials Incidents
35
2
Rescue Operations
37
1
Violence
37
4
Chapter Review
41
1
Street Scenes
42
1
Medical/Legal and Ethical Issues
43
16
Scope of Practice
45
1
Patient Consent and Refusal
45
5
Consent
45
1
When a Patient Refuses Care
46
3
Do Not Resuscitate Orders
49
1
Other Legal Aspects
50
6
Negligence
50
1
Duty to Act
51
1
Good Samaritan Laws
51
1
Confidentiality
51
1
Special Situations
52
1
Crime Scenes
53
2
Special Crimes and Reporting
55
1
Chapter Review
56
1
Street Scenes
57
2
The Human Body
59
40
Anatomical Terms
61
4
Directional Terms
61
2
Positional Terms
63
2
Body Systems
65
16
Musculoskeletal System
65
4
Respiratory System
69
2
Cardiovascular System
71
5
Nervous System
76
2
Digestive System
78
1
Skin
79
1
Endocrine System
80
1
FYI Locating Body Organs and Structures
81
12
Chapter Review
93
4
Street Scenes
97
2
Lifting and Moving Patients
99
27
Protecting Yourself: Body Mechanics
101
2
Protecting Your Patient: Emergency, Urgent, and Non-Urgent Moves
103
18
Emergency Moves
103
3
Urgent Moves
106
1
Non-Urgent Moves
107
14
Chapter Review
121
1
Street Scenes
122
4
MODULE Airway
Airway Management
126
50
Respiration
128
5
Adequate and Inadequate Breathing
129
4
Opening the Airway
133
4
Head-Tilt, Chin-Lift Maneuver
135
1
Jaw-Thrust Maneuver
136
1
Techniques of Artificial Ventilation
137
7
Mouth-to-Mask Ventilation
138
2
Bag-Valve Mask
140
4
Flow-Restricted, Oxygen-Powered Ventilation Device
144
1
Airway Adjuncts
144
7
Rules for Using Airway Adjuncts
146
1
Oropharyngeal Airways
146
1
Nasopharyngeal Airways
147
4
Suctioning
151
4
Suctioning Devices
151
2
Techniques of Suctioning
153
2
Oxygen Therapy
155
13
Importance of Supplemental Oxygen
155
1
Oxygen Therapy Equipment
156
4
Hazards of Oxygen Therapy
160
1
Administering Oxygen
161
7
Special Considerations
168
2
Chapter Review
170
6
MODULE Patient Assessment
Scene Size-up
176
18
Scene Size-up
178
14
Scene Safety
178
6
Nature of the Call
184
7
Number of Patients and Adequacy of Resources
191
1
Chapter Review
192
2
The Initial Assessment
194
16
The Initial Assessment
196
1
Form a General Impression
196
1
Cultural Considerations
197
6
Assess Mental Status
200
1
Assess the ABCs
200
1
Determine Priority
201
2
Patient Characteristics and Initial Assessment
203
5
Comparing the Initial Assessments
206
2
Chapter Review
208
1
Street Scenes
209
1
Vital Signs and Sample History
210
20
Gathering the Vital Signs and History
212
1
Vital Signs
212
12
Pulse
213
2
Respiration
215
1
Skin
216
2
Pupils
218
1
Blood Pressure
218
4
Oxygen Saturation
222
2
Sample History
224
1
Cultural Considerations
224
2
Chapter Review
226
3
Street Scenes
229
1
Assessment of the Trauma Patient
230
39
Focused History and Physical Exam for the Trauma Patient
232
15
Trauma Patient with No Significant Mechanism of Injury
233
3
Applying a Cervical Collar
236
1
Trauma Patient with a Significant Mechanism of Injury
237
10
Cultural Considerations
247
7
Some General Principles
253
1
Detailed Physical Exam
254
7
Trauma Patient with a Significant Mechanism of Injury
254
7
Trauma Patient with No Significant Mechanism of Injury
261
1
Comparing Assessments
261
5
Chapter Review
266
2
Street Scenes
268
1
Assessment of the Medical Patient
269
17
Focused History and Physical Exam for a Medical Patient
271
9
Responsive Medical Patient
271
6
Unresponsive Medical Patient
277
3
Comparing Assessments
280
4
Chapter Review
284
1
Street Scenes
285
1
Ongoing Assessment
286
10
Ongoing Assessment
288
3
Components of the Ongoing Assessment
289
1
Observing Trends
290
1
Ongoing Assessment for Stable and Unstable Patients
291
1
Comparing Assessments
291
3
Chapter Review
294
1
Street Scenes
294
2
Communications
296
12
Communications Systems and Radio Communication
298
5
Communications Systems
298
1
Radio Communication
299
4
The Verbal Report
303
1
Interpersonal Communication
303
3
Chapter Review
306
2
Documentation
308
22
Prehospital Care Report
310
7
Functions of the Prehospital Care Report
310
4
Elements of the Prehospital Care Report
314
3
Cultural Considerations
317
1
Special Documentation Issues
318
8
Legal Issues
318
4
Special Situations
322
4
Chapter Review
326
4
MODULE Medical Emergencies
General Pharmacology
330
12
Medications EMT-Basics Can Administer
332
3
Medications on the Ambulance
332
1
Prescribed Medications
333
2
General Information About Medications
335
2
Drug Names
335
1
What You Need to Know When Giving a Medication
336
1
FYI Medications Patients Often Take
337
2
Chapter Review
339
3
Respiratory Emergencies
342
22
Respiration
344
5
Respiratory Anatomy and Physiology
344
1
Adequate Breathing
345
1
Inadequate Breathing
345
3
Adequate and Inadequate Artificial Ventilation
348
1
Breathing Difficulty
349
2
FYI Respiratory Assessment and Conditions
351
3
The Prescribed Inhaler
354
2
FYI Small-Volume Nebulizer
356
4
Chapter Review
360
3
Cultural Considerations
363
1
Cardiac Emergencies
364
41
Cardiac Anatomy and Physiology
367
1
Cardiac Compromise
367
2
Cultural Considerations
369
6
Management of Cardiac Compromise
369
6
FYI Causes of Cardiac Compromise
375
3
Cardiac Arrest
378
3
Chain of Survival
378
3
FYI Controlled Hypothermia
381
14
Management of Cardiac Arrest
381
1
Automated External Defibrillator (AED)
381
10
Special Considerations for AED Use
391
4
FYI Implants and Surgeries
395
6
Chapter Review
401
1
Street Scenes
402
3
Acute Abdominal Emergencies
405
15
Abdominal Anatomy and Physiology
406
2
Abdominal Pain and Distress
408
3
Assessment and Care of Abdominal Distress
408
3
Cultural Considerations
411
4
General Abdominal Distress
415
1
FYI Abdominal Conditions
415
2
Chapter Review
417
1
Street Scenes
418
2
Diabetic Emergencies and Altered Mental Status
420
23
Diabetes
422
4
Diabetic Emergencies
422
3
Blood Glucose Meters
425
1
Cultural Considerations
426
3
FYI Additional Information on Diabetes
429
1
Other Causes of Altered Mental Status
430
2
Seizure Disorders
430
2
FYI Types of Seizures
432
8
Stroke
433
3
Dizziness and Syncope
436
4
Chapter Review
440
1
Street Scenes
441
2
Allergic Reactions
443
14
Allergic Reactions
445
6
Distinguishing Anaphylaxis from Mild Allergic Reaction
447
4
Self-Administered Epinephrine
451
3
Chapter Review
454
1
Street Scenes
455
2
Poisoning and Overdose Emergencies
457
24
Poisoning
459
2
Ingested Poisons
460
1
FYI Food Poisoning
461
3
FYI Antidotes
464
4
Inhaled Poisons
465
3
FYI Smoke Inhalation
468
1
Absorbed Poisons
468
1
Injected Poisons
469
1
Alcohol and Substance Abuse
469
2
Alcohol Abuse
469
2
FYI Poison Control Centers
471
7
Substance Abuse
473
5
Chapter Review
478
1
Street Scenes
479
2
Environmental Emergencies
481
29
Exposure to Cold
483
7
How the Body Loses Heat
483
1
Generalized Hypothermia
484
4
Localized Cold Injuries
488
2
Exposure to Heat
490
3
Effects of Heat on the Body
490
1
Patient with Moist, Pale, Normal-to-Cool Skin
491
1
Patient with Hot, Dry or Moist Skin
492
1
Water-Related Emergencies
493
5
Water-Related Accidents
493
1
Drowning and Near-Drowning
494
4
Diving Accidents
498
1
FYI Scuba Diving Accidents
498
2
FYI Water Rescues; Ice Rescues
500
1
Bites and Stings
500
7
Insect Bites and Stings
500
3
Snakebites
503
2
Poisoning from Marine Life
505
2
Chapter Review
507
3
Behavioral Emergencies
510
14
Behavioral Emergencies
512
2
What Is a Behavioral Emergency?
512
1
Physical Causes of Altered Behavior
512
1
Situational Stress Reactions
513
1
Emergency Care for Behavioral Emergencies
514
7
Psychiatric Emergencies
514
1
Suicide
515
2
Aggressive or Hostile Patients
517
1
Reasonable Force and Restraint
517
1
Transport to an Appropriate Facility
518
2
Medical/Legal Considerations
520
1
Chapter Review
521
3
Obstetrics and Gynecological Emergencies
524
31
Anatomy and Physiology of Childbirth
526
3
Pregnancy and Delivery
526
1
Labor
527
1
Labor Pains
528
1
Normal Childbirth
529
6
Role of the EMT-Basic
529
1
Normal Delivery
530
5
Cultural Considerations
535
5
The Newborn
535
1
Assessing the Newborn
535
3
Caring for the Mother
538
2
Childbirth Complications
540
9
Complications of Delivery
540
5
Emergencies in Pregnancy
545
4
FYI Childbirth and Death; Stillbirths; Accidental Death of a Pregnant Woman
549
1
Gynecological Emergencies
549
2
Chapter Review
551
4
Putting It All Together for the Medical Patient
555
11
Multiple Medical Complaints
556
1
Managing the Patient with Multiple Medical Complaints
556
1
Typical Calls
556
1
Cultural Consisderations
557
3
Analysis of the Calls
560
1
Patient Conditions Not Covered in the EMT-B Course
560
2
Chapter Review
562
4
MODULE Trauma
Bleeding and Shock
566
25
Circulatory System
568
1
Main Components
568
1
FYI Functions of the Blood
569
1
Bleeding
569
11
External Bleeding
569
9
Internal Bleeding
578
2
Shock (Hypoperfusion)
580
1
Causes of Shock
580
1
FYI Types of Shock
581
1
Severity of Shock
581
1
Cultural Considerations
582
6
Emergency Care
583
5
Chapter Review
588
1
Street Scenes
589
2
Soft-Tissue Injuries
591
42
Soft Tissues
593
1
Closed Wounds
594
2
Types of Closed Wounds
594
2
Open Wounds
596
5
Types of Open Wounds
596
4
Emergency Care for Open Wounds
600
1
Treating Specific Types of Open Wounds
601
9
Treating Abrasions and Lacerations
601
1
Treating Puncture Wounds
601
1
Treating Impaled Objects
602
3
Treating Avulsions
605
1
Treating Amputations
605
1
Wounds to the Neck
605
1
Chest Injuries
606
4
FYI Chest Injury Complications
610
3
Abdominal Injuries
611
2
Burns
613
6
Classifying Burns by Agent and Source
613
2
Classifying Burns by Depth
615
1
Determining the Severity of Burns
616
2
Classifying Burns by Severity
618
1
Treating Specific Types of Burns and Electrical Injuries
619
4
Electrical Injuries
622
1
FYI Specific Chemical Burns
623
2
Dressing and Bandaging
625
4
Chapter Review
629
2
Street Scenes
631
2
Musculoskeletal Injuries
633
49
Musculoskeletal System
635
5
Anatomy of Bone
636
2
Self-Healing Nature of Bone
638
1
Muscles, Cartilage, Ligaments, and Tendons
639
1
General Guidelines for Emergency Care
640
12
Mechanisms of Musculoskeletal Injury
640
1
Painful, Swollen, or Deformed Extremity
640
3
Assessment of Musculoskeletal Injuries
643
1
Splinting
644
8
Emergency Care of Specific Injuries
652
27
Upper Extremity Injuries
653
1
Lower Extremity Injuries
653
26
Chapter Review
679
1
Street Scenes
680
2
Injuries to the Head and Spine
682
41
Nervous and Skeletal Systems
684
2
Nervous System
684
1
Anatomy of the Head
685
1
Anatomy of the Spine
686
1
Injuries to the Skull and Brain
686
2
Scalp Injuries
686
1
Skull Injuries
686
1
Brain Injuries
687
1
FYI Types of Brain Injuries
688
2
FYI Glasgow Coma Scale
690
3
Cranial Injuries with Impaled Objects
692
1
Injuries to the Face and Jaw
692
1
Nontraumatic Brain Injuries
693
1
Injuries to the Spine
693
5
Mechanisms of Injury
693
5
Immobilization Issues
698
20
Tips for Applying a Cervical Collar
698
1
Tips for Immobilizing a Seated Patient
698
5
Tips for Applying a Long Backboard
703
5
Tips for Dealing with a Standing Patient
708
4
Patient Found Wearing a Helmet
712
6
FYI Selective Spine Immobilization
718
2
Chapter Review
720
3
Putting It All Together for the Trauma Patient
723
13
Multiple Trauma
724
1
Cultural Considerations
724
1
Managing the Multiple-Trauma Patient
725
4
A Typical Call
725
2
Analysis of the Call
727
1
General Principles of Multiple-Trauma Management
728
1
FYI Trauma Scoring
729
2
Chapter Review
731
5
MODULE Younger and Older Patients
Infants and Children
736
52
Developmental Characteristics of Infants and Children
738
7
Psychological and Personality Characteristics
741
1
Anatomical and Physiological Differences
741
2
Interacting with the Pediatric Patient
743
1
The Adolescent Patient
744
1
Supporting the Parents or Other Care Providers
745
1
Assessing the Pediatric Patient
746
11
Pediatric Assessment Triangle (PAT)
746
1
Scene Size-up and Safety---Pediatric
747
1
Initial Assessment---Pediatric
747
2
Focused History and Physical Exam---Pediatric
749
1
Detailed Physical Exam---Pediatric
750
5
Ongoing Assessment---Pediatric
755
1
Comparing Assessments
755
2
Special Concerns in Pediatric Care
757
9
Maintaining an Open Airway
757
2
Clearing an Airway Obstruction
759
3
Infant and Child BCLS Review
762
1
Providing Supplemental Oxygen and Ventilations
762
2
Caring for Shock (Hypoperfusion)
764
1
Protecting Against Hypothermia
765
1
Medical Emergencies
766
1
Respiratory Disorders
766
1
Respiratory Distress
766
1
FYI Respiratory Diseases
767
2
FYI Meningitis
769
6
Fever
770
1
Diarrhea and Vomiting
771
1
Seizures
771
1
Altered Mental Status
772
1
Poisoning
773
1
Near-Drowning
773
1
Sudden Infant Death Syndrome
774
1
Trauma
775
3
Injury Patterns
775
2
Pneumatic Anti-Shock Garments
777
1
Burns
777
1
Child Abuse and Neglect
778
3
Physical and Sexual Abuse
778
3
Role of the EMT-B in Cases of Suspected Abuse or Neglect
781
1
Cultural Considerations
781
1
Infants and Children with Special Needs
782
2
Tracheostomy Tubes
782
1
Home Artificial Ventilators
783
1
Central Intravenous Lines
783
1
Gastrostomy Tubes and Gastric Feeding
783
1
Shunts
784
1
The EMT-B and Pediatric Emergencies
784
1
Chapter Review
785
1
Street Scenes
786
2
Geriatric Patients
788
16
The Geriatric Patient
789
3
Communicating with the Geriatric Patient
790
1
Assessing the Geriatric Patient
791
1
Cultural Considerations
792
8
Reasons the Elderly Encounter EMS
795
5
Chapter Review
800
1
Street Scenes
800
4
MODULE Operations
Ambulance Operations
804
36
Preparing for the Ambulance Call
806
8
Ambulance Supplies and Equipment
807
4
Ensuring Ambulance Readiness for Service
811
3
Receiving and Responding to a Call
814
8
Role of the Emergency Medical Dispatcher
814
2
Operating the Ambulance
816
6
Transferring the Patient to the Ambulance
822
1
Transporting the Patient to the Hospital
823
3
Preparing the Patient for Transport
823
2
Caring for the Patient en Route
825
1
Transferring the Patient to the Emergency Department Staff
826
1
Terminating the Call
826
8
At the Hospital
828
2
En Route to Quarters
830
1
In Quarters
831
3
Air Rescue
834
3
When to Call for Air Rescue
834
1
How to Call for Air Rescue
835
1
How to Set Up a Landing Zone
835
1
How to Approach a Helicopter
836
1
Chapter Review
837
1
Street Scenes
838
2
Gaining Access and Rescue Operations
840
24
Vehicle Rescue
842
19
Preparing for the Rescue
842
1
Sizing Up the Situation
843
1
Recognizing and Managing Hazards
844
9
Stabilizing a Vehicle
853
3
Gaining Access
856
5
Chapter Review
861
1
Street Scenes
862
2
Special Operations
864
30
Hazardous Materials
866
11
Training Required by Law
866
2
Responsibilities of the EMT-B
868
4
Establish a Treatment Sector
872
5
Multiple-Casualty Incidents
877
13
Multiple-Casualty Incident Operations
877
1
Incident Command System
878
4
Scene Management
882
5
Transportation and Staging Logistics
887
3
FYI Psychological Aspects of MCIs
890
1
Chapter Review
891
3
EMS Response to Terrorism
894
34
Defining Terrorism
895
1
Domestic Terrorism
895
1
International Terrorism
895
1
Types of Terrorism Incidents
896
1
Terrorism and EMS
896
2
First Responders as Targets
896
1
Identify the Threat Posed by the Event
896
2
Cultural Considerations
898
2
Recognize the Harms Posed by the Threat
899
1
Time/Distance/Shielding
900
1
Responses to Terrorism
900
5
Responses to a Chemical Incident
900
1
Responses to a Biological Incident
901
2
Responses to a Radiological/Nuclear Incident
903
1
Responses to an Explosive Incident
904
1
Dissemination and Weaponization
905
1
The Respiratory Route
905
1
Other Routes
905
1
Weaponization
906
1
Characteristics of CBRNE Agents
906
11
Chemical Agents
906
1
Biological Agents
907
9
Radioactive/Nuclear Devices
916
1
Incendiary Devices
917
1
Strategy and Tactics
917
4
Isolation
918
1
Notification
919
1
Identification
919
1
Protection
920
1
Chapter Review
921
3
Study Guide: Self-Protection in a Terrorist Incident
924
4
MODULE Advanced Airway Management
Advanced Airway Management
928
2
Anatomy and Physiology
930
3
Anatomy
930
1
Physiology
931
1
Pediatric Airway
932
1
Management of the Airway
933
23
Oropharyngeal Suctioning
933
1
Orotracheal Intubation
933
15
Nasogastric Intubation of an Infant or Child
948
2
Orotracheal Suctioning
950
1
Multilumen Airways
950
4
Laryngeal Mask Airway
954
1
Automatic Transport Ventilators
955
1
Chapter Review
956
Appendix A ALS-Assist Skills
1
8
Assisting with Endotracheal Intubation
1
3
Preparing the Patient for Intubation
1
1
Ventilating the Tubed Patient
2
1
Assisting with a Trauma Intubation
3
1
Applying ECG Electrodes
4
1
Assisting in IV Therapy
5
2
Setting Up an IV Fluid Administration Set
5
2
Maintaining an IV
7
1
Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP)
7
2
Assisting with CPAP Devices
8
1
Appendix B National Registry Skill Sheets
9
13
Appendix C Basic Cardiac Life Support Review
22
1
Before Beginning Resuscitation
22
4
Assessing the Patient
22
1
Activating EMS
23
1
Positioning the Patient
24
1
Opening the Airway
24
2
Initial Ventilations and Pulse Check
26
1
Rescue Breathing
26
2
Mouth-to-Mask Ventilation
28
1
Gastric Distention
28
1
Recovery Position
28
1
CPR
28
6
Checking for Circulation
28
1
How to Perform CPR
29
1
One-Rescuer and Two-Rescuer CPR
29
3
CPR Techniques for Children and Infants
32
1
Special Considerations in CPR
32
2
When Not to Begin or to Terminate CPR
34
1
Clearing Airway Obstructions
34
1
Partial Airway Obstruction
35
1
Complete Airway Obstruction
35
Reference Section
1
13
Anatomy and Physiology Illustrations
2
12
Musculoskeletal System
2
2
Nervous System
4
2
Cardiovascular System
6
1
Circulatory System
7
1
Respiratory System
8
1
Digestive System
9
1
Urinary System
10
1
Reproductive System
11
1
Integumentary System
12
1
Senses
13
1
Atlas of Injuries
14
4
Medical Terminology
18
Glossary
1
1
Index
1