ABC of Prehospital Emergency Medicine (eBook)

Tim Nutbeam, Matthew Boylan (Herausgeber)

eBook Download: PDF

2013
John Wiley & Sons (Verlag)
978-1-118-59228-1 (ISBN)

Infos

Prehospital Emergency Medicine (PHEM) is a new and evolving field within Prehospital Care and involves the delivery of safe prehospital critical care to seriously ill or injured patients, and safe transfer to or between hospitals. It covers a broad range of medical and traumatic conditions, interventions, clinical providers and physical environments.

ABC of Prehospital Emergency Medicine is the first text to provide a comprehensive overview of this field and with an international team of expert authors is essential reading to anyone involved in the delivery of Prehospital Emergency Medicine and Prehospital Care.

This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from iTunes, Google Play or the MedHand Store.

 

Tim Nutbeam, Consultant in Emergency Medicine, Derriford Hospital, Plymouth Hospitals NHS Trust, UK

Matt Boylan, Consultant in Military Emergency Medicine and Prehospital Care, University Hospitals Birmingham NHS Foundation Trust, UK

Inhalt

Cover???????????????????????? 1
Title Page?????????????????????????????????? 5
Copyright???????????????????????????????? 6
Contents?????????????????????????????? 7
Contributor list?????????????????????????????????????????????? 9
Foreword?????????????????????????????? 13
Preface???????????????????????????? 15
Chapter 1 Prehospital Emergency Medicine?????????????????????????????????????????????????????????????????????????????????????????????? 17
Introduction 17
Prehospital emergency medicine 17
Training in PHEM 17
Summary 18
Further reading 18
Chapter 2 Activation and Deployment???????????????????????????????????????????????????????????????????????????????????? 19
Introduction 19
Activation of prehospital services 19
Call handling 19
Call prioritization 19
Dispatch 20
Deployment of prehospital services 20
Further reading 22
Chapter 3 Personal Protective Equipment???????????????????????????????????????????????????????????????????????????????????????????? 23
Introduction 23
Legislation 23
The role of PPE 24
Essential personal protective equipment for prehospital practitioners 24
Helmet 24
Eye protection 24
Ear protection 24
Face masks 24
Clinical gloves 24
Extrication gloves 25
High-visibility clothing 25
Boots 25
Additional items 25
Specialist personal protective equipment 25
Helicopter Emergency Medical Services operations 25
Urban search and rescue 26
Tactical operations 26
Water operations 26
CBRN/HAZMAT incidents 26
Further reading 28
Chapter 4 Scene Safety and Assessment???????????????????????????????????????????????????????????????????????????????????????? 29
Introduction 29
Safety 29
Where is the danger? 29
Communicate 30
Read the wreckage 30
Fall from height 30
Motor vehicle collisions 31
Everyone found? 32
Assessment of the patients 32
Method of extrication 32
Evacuation 32
Right hospital 32
Further reading 33
Chapter 5 The Primary Survey?????????????????????????????????????????????????????????????????????? 34
Introduction 34
Further reading 35
Chapter 6 Airway Assessment and Management?????????????????????????????????????????????????????????????????????????????????????????????????? 36
Introduction 36
Airway assessment 36
Look 36
Listen 36
Feel 36
Difficult airway assessment 37
Airway management 37
Patient positioning 37
Suction 37
Foreign body removal 37
Facial fracture reduction 37
Manual airway manoeuvres 38
Basic airway adjuncts 39
Supraglottic airway devices 39
Endotracheal intubation 40
Cricothyroidotomy 41
Further reading 42
Chapter 7 Breathing Assessment and Management???????????????????????????????????????????????????????????????????????????????????????????????????????? 43
Introduction 43
Respiratory failure 43
Assessment of breathing 43
Look 43
Feel 44
Listen 44
Monitor 44
Management of respiratory failure 45
Oxygen administration 45
Ventilation 45
Patient positioning 47
Life-threatening breathing problems: trauma 47
Tension pneumothorax 47
Open pneumothorax 48
Massive haemothorax 48
Flail chest 49
Other chest injuries 49
Life-threatening breathing problems: medical 49
Further reading 50
Chapter 8 Circulation Assessment and Management???????????????????????????????????????????????????????????????????????????????????????????????????????????? 51
Introduction 51
Hypovolaemic shock 51
Hypovolaemia in trauma 51
Cardiogenic shock 52
Distributive shock 52
Obstructive shock 52
Assessment of the circulation 52
Compensated shock 53
Decompensated shock 53
Aids to identifying shock 53
Management of the shocked trauma patient 53
Control of external haemorrhage 54
Control of non-compressible torso haemorrhage 55
Control of skeletal haemorrhage 55
Control of maxillofacial haemorrhage 55
Circulatory access 56
Fluid resuscitation 57
Minimal handling techniques 58
Tranexamic acid 58
Hypothermia mitigation 59
Triage 59
Management of the shocked medical patient 59
Further reading 59
Chapter 9 Prehospital Anaesthesia???????????????????????????????????????????????????????????????????????????????? 60
Introduction 60
Evidence base 60
The team approach 61
Training and skills required 61
Minimum monitoring standards 61
Current recommended minimum standards for practice 61
Drugs 61
Procedural summary 62
General principles 62
Preparation 62
Pre-induction 63
Induction and intubation 63
Post intubation 64
Transfer 64
Paediatrics 65
Further reading 66
Chapter 10 Prehospital Analgesia and Sedation???????????????????????????????????????????????????????????????????????????????????????????????????????? 67
Analgesia 67
The problem with pain 67
Physiology of pain 67
Principles of management of acute pain 68
Assessment of pain 68
Treatment of pain 68
Procedural sedation 70
What is it? 70
How much is the patient sedated? 70
What is required for procedural sedation? 71
Further reading 71
Chapter 11 Prehospital Monitoring???????????????????????????????????????????????????????????????????????????????? 73
Introduction 73
Prehospital monitoring 73
The human–equipment interface 73
The structured approach to monitoring 74
Airway 74
Breathing 74
Circulation 75
Disability 76
Environment 76
Monitoring in aircraft 77
Future monitoring techniques 78
Summary 78
Further reading 78
Chapter 12 Prehospital Ultrasound???????????????????????????????????????????????????????????????????????????????? 79
Introduction 79
What is ultrasound? 79
Prehospital uses of ultrasound 80
A – the role of ultrasound in airway management 80
B – The role of ultrasound in the assessment of breathing 80
C – The role of ultrasound in the assessment of circulation 82
D – The role of ultrasound in the assessment of disability? 84
E – The role of ultrasound in the evaluation of other injuries 84
Further reading 85
Glossary 85
Chapter 13 Trauma: Head Injury?????????????????????????????????????????????????????????????????????????? 86
Introduction 86
Pathophysiology 86
Assessment 87
Minor head injury 87
Severe head injury 88
Assessment and management 88
Airway and ventilatory management 88
Circulatory management 88
Management of raised intracranial pressure 89
Immobilization 89
Transfer 89
Further reading 90
Chapter 14 Trauma: Spinal Injuries?????????????????????????????????????????????????????????????????????????????????? 91
Introduction 91
Spinal anatomy 91
Pathophysiology 91
Primary cord Injury 91
Secondary cord injury 92
Spinal shock 92
Neurogenic shock 92
Mechanism of injury 92
Blunt Injury 92
Penetrating Injury 92
Clinical assessment 92
Identification of those patients at risk of spinal injury 93
Management of spinal injuries 93
Prevention of hypoxia 93
Prevention of hypoperfusion 94
Limit further spinal movement 94
Hospital selection 96
Further reading 96
Chapter 15 Trauma: Abdominal Injury???????????????????????????????????????????????????????????????????????????????????? 97
Introduction 97
Mechanisms of injury 97
Blunt trauma 97
Penetrating trauma 97
Assessment of the abdomen 98
Prehospital management of abdominal injuries 98
Resuscitation 98
Analgesia 98
Evisceration 98
Impalement 99
Triage 99
Further reading 99
Chapter 16 Trauma: Pelvic Injury?????????????????????????????????????????????????????????????????????????????? 100
Aetiology 100
Injury classification 100
Anteroposterior injuries 100
Vertical shear injuries 100
Lateral compression injuries 100
Haemorrhage 100
Pelvic binders 101
Avoiding iatrogenic injury 101
Further reading 102
Chapter 17 Trauma: Extremity Injury???????????????????????????????????????????????????????????????????????????????????? 103
Aetiology 103
Mechanism of injury and injury pattern 103
Injury assessment 103
Analgesia 103
Wound care 103
Reducing, splinting and packaging 104
Amputation 104
Further reading 105
Chapter 18 Trauma: Burns?????????????????????????????????????????????????????????????? 106
Introduction 106
Types of burns 106
Assessing the burn: extent and depth 108
How to assess burn extent 108
Burn depth 109
Initial management of burns 109
Management of minor burns 109
Management of significant burns 110
Cooling the burn, but not the patient 110
Selection of burn dressings 110
Who needs fluid resuscitation? 110
Mode of resuscitation: intravenous versus oral 110
Oral rehydration 110
The airway and burn injury (suspected inhalational injury) 110
Airway burns 110
Inhalational injury 111
Management of specific burns 111
Chemical burns 111
Electrical burns (Box 18.4) 111
Fasciotomy and escharotomy 111
Referral pathways: when to refer? 112
Mass casualties involving burn injury 112
Further reading 113
Chapter 19 Trauma: Suspension and Crush???????????????????????????????????????????????????????????????????????????????????????????? 114
Introduction 114
Rescue cardioplegia: the problem with uncontrolled limb release 114
Muscle and soft-tissue trauma: whole system effects 115
Acute kidney injury: an indirect effect of muscle damage 115
Management 116
Isolate and move to a place of safety 116
Resuscitate the system 116
Analgesia 117
Staged tourniquet release strategy 117
Management of hyperkalaemia 117
Alkaline diuresis 117
Triage 117
Future considerations 117
Further reading 118
Chapter 20 Trauma: Ballistic and Blast?????????????????????????????????????????????????????????????????????????????????????????? 119
Introduction 119
Firearm injuries 119
Blast injuries 119
Incident management 120
Personal protective equipment 120
Approach to scene 121
Dynamic risk assessment 121
Forensic considerations 121
Management of ballistic trauma 122
Catastrophic haemorrhage control 122
Airway management 123
Cervical spine immobilization 123
Breathing management 123
Circulation management 124
Disability 124
Exposure 124
Disclaimer 124
Further reading 125
Chapter 21 Trauma: Extrication of the Trapped Patient???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 126
Introduction 126
Describing the anatomy of the car 126
Casualty care team (and shared) tasks 126
Safety 126
Vehicle-specific hazards 127
Rapid access and assessment 127
Planning 128
Treatment and monitoring 128
Extrication team tasks 128
Stability 129
Glass management 129
Space-making 129
Large vehicles 130
Removal of the patient from the vehicle 130
A-plan casualty removal 130
B-plan casualty removal 131
Post-extrication care 132
Summary 132
Acknowledgements 133
Further reading 133
Chapter 22 Cardiac Arrest???????????????????????????????????????????????????????????????? 134
International Cardiac Arrest Guidelines 134
Introduction 134
Initial actions 134
Cardiac arrest considerations in the prehospital environment 136
Introduction 136
Prehospital cardiac arrest in the trauma victim 136
Introduction 136
Prehospital emergency thoracotomy 138
Introduction 138
Indications and relative contraindications 138
Equipment 138
Operative technique 138
Paediatric resuscitation 138
The ethics of resuscitation: difficult and demanding decision 139
Introduction 139
Criteria for not starting CPR 139
Do Not Resuscitate orders 139
Advance directives, living wills and patient self-determination 139
Terminating resuscitative efforts 140
Further reading 141
Chapter 23 Acute Medical Emergencies?????????????????????????????????????????????????????????????????????????????????????? 142
Introduction 142
Respiratory emergencies 142
Asthma 142
COPD/COAD (chronic obstructive pulmonary/airway disease) 143
Pneumothorax 144
Cardiac emergencies 144
Acute coronary syndromes and myocardial infarction 144
Acute pulmonary oedema 144
Arrhythmias 145
Anaphylaxis 145
Neurological emergencies 145
The fitting patient 145
Cerebrovascular accident 146
Metabolic emergencies 146
High blood sugar including diabetic ketoacidosis and hyperosmolar states 146
Hypoglycaemia 146
Poisoning 146
Psychiatric emergencies/acute psychoses 147
Infection/sepsis 147
Further reading 148
Chapter 24 Environmental Injuries???????????????????????????????????????????????????????????????????????????????? 150
Introduction 150
Cold injury 150
Heat injury 153
Envenomation 154
Further reading 156
Chapter 25 Environmental: Altitude Injury???????????????????????????????????????????????????????????????????????????????????????????????? 157
Introduction 157
Physiology at altitude 157
Acute mountain sickness 157
Symptoms and signs of AMS 157
Treatment of AMS 157
High altitude cerebral oedema 158
Symptoms and signs of HACE 158
Treatment of HACE 158
High-altitude pulmonary oed 158
Symptoms and signs of HAPE 158
Treatment of HAPE 158
Essential drugs for altitude emergencies 159
Other medical problems associated with altitude 159
Cold Injury 159
Venous thromboembolism 159
Retinal haemorrhage 159
Ultravoilet keratitis 159
Further reading 159
Chapter 26 Environmental: Drowning and Near Drowning?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 160
Key points 160
Further reading 161
Chapter 27 Environmental: Diving Emergencies?????????????????????????????????????????????????????????????????????????????????????????????????????? 162
Introduction 162
Dive physics and physiology 162
Emergencies on descent 163
Barotrauma 163
Emergencies at depth 163
Nitrogen narcosis (rapture of the deep, Martini effect) 163
Oxygen toxicity 163
Emergencies on ascent 163
Decompression sickness 163
Type II (severe) decompression sickness 164
Pulmonary barotrauma 164
Arterial gas embolisation (AGE) 164
Management of decompression illness 164
Recompression therapy 165
Further reading 165
Chapter 28 Care of Special Groups: The Obstetric Patient?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 166
Introduction 166
Anatomical and physiological changes in pregnancy 166
Airway 166
Breathing 166
Circulation 166
Uterus 167
Assessment of the pregnant patient 167
Antenatal emergencies 168
Antepartum haemorrhage 168
Severe pre-eclampsia and eclampsia 168
Emergency prehospital delivery 168
First stage of labour 168
Second stage of labour 168
Third stage of labour 169
Intrapartum emergencies 169
Cord prolapse 169
Breech presentation 169
Shoulder dystocia 170
Postpartum emergencies 171
Postpartum haemorrhage 171
Uterine inversion 171
Trauma in pregnancy 171
Cardiac arrest in pregnancy 172
Prehospital perimortem Caesarean section (resuscitative hysterotomy) 172
Neonatal life support 172
Initial assessment 172
Airway 173
Breathing 173
Circulation 173
Drugs 173
Meconium aspiration 173
Further reading 174
Chapter 29 Care of Special Groups: The Paediatric Patient???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 175
Why treat children differently? 175
Anatomy and physiology 175
Size and weight 175
Body proportions 175
Airway 175
Breathing 176
Circulation 176
Disability 176
Psychosocial 176
Assessment of the seriously ill or injured child 176
A and B: airway and breathing 176
C – Circulation 176
D – Disability (neurological) 177
Initial management of the seriously ill or injured child 177
Airway 177
Breathing 177
Circulation 177
Management of paediatric medical emergencies 177
Management of paediatric trauma emergencies 178
Scene assessment 178
Primary survey in trauma 179
Head and neck injury 179
Chest injury 179
Abdominal injury 179
Burns 179
Analgesia 179
Making life easier 180
Safeguarding 180
Further reading 180
Chapter 30 Care of Special Groups: The Elderly Patient?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 181
Introduction 181
Physiology 181
Presentation 182
1 Confounding effects of disease and heterogeneous system decline 182
2 Confounding effects of medications, especially polypharmacy 182
3 Cognitive impairment 182
4 Healthcare professional attribution error 182
Aggressive therapy 182
Appropriate drug doses 183
Trauma in elderly people 183
Elder abuse 183
Further reading 183
Chapter 31 Care of Special Groups: The Bariatric Patient?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 184
Introduction 184
Physiological changes in morbid obesity 184
Respiratory 184
Cardiovascular 184
Comorbidities 184
Management 185
Airway 185
Spinal immobilization 185
Breathing 185
Circulation 186
Disability and exposure 186
Drugs 186
Summary 187
Further reading 187
Chapter 32 Retrieval and Transport?????????????????????????????????????????????????????????????????????????????????? 188
Introduction 188
Definitions and terminology 188
Crewmix 188
Modes of retrieval 189
Tasking and coordination 190
Effects of transport 190
Preparation for transport and care enroute 191
Equipment 192
Specialized additions 193
Communication and handover 194
Key points 194
Further reading 194
Chapter 33 Emergency Preparedness: Major Incident Management?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 195
Introduction 195
Definitions 195
Identifying a MCI 195
A structured approach 195
First on scene 196
Access/egress 196
Attending after MCI declared 197
Type of incident 197
Triage 197
Categories 198
Red 198
Yellow 199
Green 199
Black 199
Expectant or T4 199
Special Circumstances 199
Triage Sort 199
Treatment 199
Transport 199
Certifying death 200
Summary 200
Further reading 200
Chapter 34 Emergency Preparedness: Chemical, Biological, Radiation and Nuclear Incidents?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 201
Introduction 201
Scene management 201
Assessment and safety 201
Scene organization 201
Provider protection 202
Patient decontamination 202
Chemical casualties 203
Biological casualties 204
Radiological and nuclear casualties 204
Dirty bomb 204
Summary 205
Further reading 205
Chapter 35 Emergency Preparedness: Mass Gatherings?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 206
Introduction 206
Nature of the event 207
Nature of the venue 207
Seated or unseated 207
Spectator profile 207
Past history of similar events 207
Expected number of spectators 207
Event duration 207
Seasonal consideration 207
Hospitals 208
Staffing models 208
Further reading 210
Chapter 36 Clinical Governance?????????????????????????????????????????????????????????????????????????? 211
Introduction 211
Service user involvement 211
Human resource management 212
Personal and professional development 212
Clinical effectiveness 213
Clinical audit 214
Risk management 215
Clinical information management 215
Summary 216
Further reading 216
Chapter 37 Medicolegal and Ethical Aspects of Prehospital Emergency Medicine?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 217
Ethics, morals and law 217
Ethical decision-making 217
Duties to treat 218
Case 1: A person in need 218
Case 2: Refusal of care 219
Case 3: Disclosing death at an accident scene 220
Case 4: Keeping secrets 220
Case 5: Duties to treat 221
In summary 221
Further reading 221
Chapter 38 Research and Development in Prehospital Emergency Medicine???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 222
Historical perspective 222
Research priorities 222
Barriers and facilitators 222
New technologies 223
Workforce 223
Systems 223
Drugs and devices 223
Future directions 223
Key points 224
Further reading 224
Index???????????????????????? 225
EULA 235

Textauszug

Contributor list

Peter Aitken

Associate Professor, Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University;

Senior Staff Specialist, Emergency Department, The Townsville Hospital, Townsville, QLD;

Acting Clinical Director Counter Disaster, Retrieval Services Queensland, QLD, Australia

 

Keith Allison

Consultant Plastic Surgeon, The James Cook University Hospital, Middlesbrough, UK

 

Peter Anthony Berlac

Medical Director of Prehospital Emergency Medicine, University of Copenhagen, Copenhagen, Denmark

 

Tracy-Louise Appleyard

Consultant in Obstetrics and Gynaecology, Southmead Hospital, Bristol, UK

 

Neil Ballard

Senior Staff Specialist, Aeromedical and Retrieval Services, Ambulance Service of New South Wales;

Senior Staff Specialist, Emergency Medicine, Prince of Wales Hospital, Randwick, NSW;

Medical Coordinator, Careflight Queensland, Robina, QLD;

Senior Lecturer, School of Public Health, James Cook University, Townsville, QLD, Australia

 

Jennifer Bard

Professor of Law and Director, Health Law Program and J.D./M.D. Dual Degree Program, Texas Tech University School of Law;

Professor (Adjunct), Department of Psychiatry, Texas Tech University School of Medicine, Lubbock, TX, USA

 

Anna Barnard

Plastic Surgery Specialist Trainee, The James Cook University Hospital, Middlesbrough, UK

 

Clare Bosanko

Specialty Doctor Emergency Medicine, University Hospital of North Staffordshire, Stoke-On-Trent;

Midlands Air Ambulance, Cosford;

West Midlands Ambulance Service Medical Emergency Response Incident Team (MERIT), UK

 

Martin Botha

Chairman, Resuscitation Council of Southern Africa, Regional Training Manager and part-time Lecturer, International SOS and University of the Witwatersrand, Johannesburg, South Africa

 

Matthew Boylan

Consultant in Military Emergency Medicine and Prehospital Care,

Royal Centre for Defence Medicine, University Hospitals Birmingham, Birmingham;

Midlands Air Ambulance, Cosford;

West Midlands Ambulance Service Medical Emergency Response Incident Team (MERIT), UK

Mercia Accident Rescue Service (MARS) BASICS, UK.

 

Adam Bystrzycki

Emergency Physician, Alfred Hospital;

Senior Lecturer, Monash University, Melbourne, VIC, Australia

 

Vic Calland

Independent General and Prehospital Practitioner;

Honorary Secretary, British Association for Immediate Care (BASICS), UK

 

Tudor A. Codreanu

Senior Medical Practitioner, Critical Care Directorate, Emergency Department, Bunbury and Busselton Hospitals, South West Health Campus, Bunbury, WA, Australia;

Professor of Disaster Medicine, Vrije Universiteit Brussels, Belgium

 

MAJOR R. J. Dawes

Specialist Registrar in Anaesthetics and Intensive Care, Defence Medical Services, UK

 

Tim Draycott

Consultant Obstetrician and Gynaecologist, Research into Safety & Quality Group, Southmead Hospital, Bristol, UK

 

Mark Elcock

State Medical Director, Retrieval Services, Queensland, Brisbane, QLD;

Associate Professor, Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, QLD, Australia

 

Anna Fergusson

Specialist Trainee in Anaesthetics, Birmingham School of Anaesthesia, Birmingham, UK

 

Lynn Gerber Smith

Clinical Nurse, Trauma Resusciatation Unit, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA

 

Clare Hammell

Consultant Anaesthetist, Leighton Hospital, Crewe, UK

 

Tim Harris

Consultant in Emergency Medicine and Prehospital Care, Royal London Hospital;

Consultant in Intensive Care Medicine, Newham University Hospital, London, UK

 

LT COL Jeremy Henning

Consultant in Anaesthesia & ICU, The James Cook University Hospital, Middlesbrough;

Defence Lecturer in Critical Care, Royal Centre for Defence Medicine, University Hospitals Birmingham, Birmingham, UK

 

Per Kristian Hyldmo

Consultant in Anesthesiology, Air Ambulance Department, Sorlandet Hospital, Kristiansand, Norway

 

Matt Hooper

Executive Director, MedSTAR Emergency Medical Retrieval Service;

Associate Professor, Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, QLD, Australia

 

Tim Hooper

Specialist Registrar, London HEMS & Defence Medical Services, London, UK

 

Jonathan Hulme

Consultant in Anaesthesia & Intensive Care Medicine, Sandwell & West Birmingham Hospitals NHS Trust, City Hospital, Birmingham;

Medical Director, West Midlands Central Accident Resuscitation & Emergency (CARE) Team, Birmingham;

West Midlands Ambulance Service Medical Emergency Response Incident Team (MERIT);

Midlands Air Ambulance, Cosford, UK

 

Fiona Jewkes

Clinical Author, NHS Pathways Connecting for Health, Leeds, UK

 

Alex Jones

Plastic Surgery Specialist Trainee, The James Cook University Hospital, Middlesbrough, UK

 

Dennis Jones

Critical Care Flight Nurse, The Johns Hopkins Hospital, Baltimore, MD, USA

 

Christopher A. Kahn

Assistant Professor of Clinical Emergency Medicine,

Director, Emergency Medical Services and Disaster Medicine Fellowship

Base Hospital Medical Director

Emergency Preparedness and Response Medical Co-Director

Department of Emergency Medicine

University of California, San Diego, CA, USA

 

Damian Keene

Specialist Trainee, Department of Anaesthetics, Royal Centre For Defence Medicine, University Hospitals Birmingham, Birmingham, UK;

West Midlands Ambulance Service Medical Emergency Response Incident Team (MERIT);

Midlands Air Ambulance, Cosford, UK

 

David Kloeck

Paediatric Intensive Care Fellow, Paediatric Intensive Care, Chris Hani Baragwanath Academic Hospital, Soweto;

University of the Witwatersrand, Johannesburg, South Africa

 

Walter Kloeck

Hon Adjunct Professor of Emergency Medicine, University of the Witwatersrand, South Africa

Chairman, Resuscitation Council of Southern Africa

 

Craig M. Klugman

Professor and Chair, Department of Health Sciences, DePaul University, Chicago, IL, USA

 

Kristi L. Koenig

Professor of Emergency Medicine, Director, Centre for Disaster Medicine, Director of Public Health Preparedness, Director, International Disaster Medical Sciences Fellowship, University of California at Irvine, Orange, CA, USA

 

Efraim Kramer

Adjunct Professor and Head, Division of Emergency Medicine, University of the Witwatersrand, Johannesburg, South Africa

 

Mark Little

Emergency Physician and Clinical Toxicologist, Cairns Base Hospital, Cairns, QLD;

Associate Professor, Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, QLD, Australia

 

David Lockey

Consultant, North Bristol NHS Trust and London's Air Ambulance, Hon Professor, University of Bristol, Bristol, UK

 

Adam Low

Specialist Registrar in Anaesthetics, West Midlands Deanery, Birmingham;

West Midlands Ambulance Service Medical Emergency Response Incident Team (MERIT), UK

 

Rod Mackenzie

Consultant in Emergency Medicine and Prehospital Emergency Medicine, Clinical Director, Major Trauma Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

 

Assiah Mahmood

Clinical Governance Manager, Magpas Helimedix, St. Ives, UK

 

Kristyn Manley

Registrar Obstetrics and Gynaecology, Southmead Hospital, Bristol, UK

 

Suzanne Mason

Professor of Emergency Medicine, Health Services Research, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK

 

Stefan Mazur

Prehospital and Retrieval Physician and Operations Lead Consultant, MedSTAR, South Australian Emergency Medical Retrieval Service;

Emergency Physician, Royal Adelaide Hospital, Adelaide, QLD;

Associate Professor, School of Public Health and Tropical Medicine, James Cook University, Townsville, QLD, Australia

 

Lucas A....

Produkt-Details

• Erscheint lt. Verlag: 11.7.2013
• Reihe/Serie: ABC Series
• Reihe/Serie: ABC Series
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe ► Rettungsassistent / -sanitäter
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Notfallmedizin
• Themenwelt: Medizin / Pharmazie ► Pflege
• Schlagworte: ABC • Allgemeine u. Innere Medizin • between hospitals • broad • comprehensive overview • Conditions • Delivery • Deployment • Emergency • Emergency Medicine & Trauma • evolving • Field • First • General & Internal Medicine • Intensive/Critical Care • Intensivpflege • Matthew • Medical • Medical Science • Medicine • Medizin • New • Notfallmedizin • Notfallmedizin u. Traumatologie • phem • Physical • prehospital • Range • SAFE • Text • thurgood • Transfer
• ISBN-10: 1-118-59228-X / 111859228X
• ISBN-13: 978-1-118-59228-1 / 9781118592281