Cover -- Title Page -- Copyright -- Contents -- Contributor list -- Foreword -- Preface -- Chapter 1 Prehospital Emergency Medicine -- Introduction -- Prehospital emergency medicine -- Training in PHEM -- Summary -- Further reading -- Chapter 2 Activation and Deployment -- Introduction -- Activation of prehospital services -- Call handling -- Call prioritization -- Dispatch -- Deployment of prehospital services -- Further reading -- Chapter 3 Personal Protective Equipment -- Introduction -- Legislation -- The role of PPE -- Essential personal protective equipment for prehospital practitioners -- Helmet -- Eye protection -- Ear protection -- Face masks -- Clinical gloves -- Extrication gloves -- High-visibility clothing -- Boots -- Additional items -- Specialist personal protective equipment -- Helicopter Emergency Medical Services operations -- Urban search and rescue -- Tactical operations -- Water operations -- CBRN/HAZMAT incidents -- Further reading -- Chapter 4 Scene Safety and Assessment -- Introduction -- Safety -- Where is the danger? -- Communicate -- Read the wreckage -- Fall from height -- Motor vehicle collisions -- Everyone found? -- Assessment of the patients -- Method of extrication -- Evacuation -- Right hospital -- Further reading -- Chapter 5 The Primary Survey -- Introduction -- Further reading -- Chapter 6 Airway Assessment and Management -- Introduction -- Airway assessment -- Look -- Listen -- Feel -- Difficult airway assessment -- Airway management -- Patient positioning -- Suction -- Foreign body removal -- Facial fracture reduction -- Manual airway manoeuvres -- Basic airway adjuncts -- Supraglottic airway devices -- Endotracheal intubation -- Cricothyroidotomy -- Further reading -- Chapter 7 Breathing Assessment and Management -- Introduction -- Respiratory failure -- Assessment of breathing -- Look -- Feel -- Listen.

Monitor -- Management of respiratory failure -- Oxygen administration -- Ventilation -- Patient positioning -- Life-threatening breathing problems: trauma -- Tension pneumothorax -- Open pneumothorax -- Massive haemothorax -- Flail chest -- Other chest injuries -- Life-threatening breathing problems: medical -- Further reading -- Chapter 8 Circulation Assessment and Management -- Introduction -- Hypovolaemic shock -- Hypovolaemia in trauma -- Cardiogenic shock -- Distributive shock -- Obstructive shock -- Assessment of the circulation -- Compensated shock -- Decompensated shock -- Aids to identifying shock -- Management of the shocked trauma patient -- Control of external haemorrhage -- Control of non-compressible torso haemorrhage -- Control of skeletal haemorrhage -- Control of maxillofacial haemorrhage -- Circulatory access -- Fluid resuscitation -- Minimal handling techniques -- Tranexamic acid -- Hypothermia mitigation -- Triage -- Management of the shocked medical patient -- Further reading -- Chapter 9 Prehospital Anaesthesia -- Introduction -- Evidence base -- The team approach -- Training and skills required -- Minimum monitoring standards -- Current recommended minimum standards for practice -- Drugs -- Procedural summary -- General principles -- Preparation -- Pre-induction -- Induction and intubation -- Post intubation -- Transfer -- Paediatrics -- Further reading -- Chapter 10 Prehospital Analgesia and Sedation -- Analgesia -- The problem with pain -- Physiology of pain -- Principles of management of acute pain -- Assessment of pain -- Treatment of pain -- Procedural sedation -- What is it? -- How much is the patient sedated? -- What is required for procedural sedation? -- Further reading -- Chapter 11 Prehospital Monitoring -- Introduction -- Prehospital monitoring -- The human-equipment interface.

The structured approach to monitoring -- Airway -- Breathing -- Circulation -- Disability -- Environment -- Monitoring in aircraft -- Future monitoring techniques -- Summary -- Further reading -- Chapter 12 Prehospital Ultrasound -- Introduction -- What is ultrasound? -- Prehospital uses of ultrasound -- A - the role of ultrasound in airway management -- B - The role of ultrasound in the assessment of breathing -- C - The role of ultrasound in the assessment of circulation -- D - The role of ultrasound in the assessment of disability? -- E - The role of ultrasound in the evaluation of other injuries -- Further reading -- Glossary -- Chapter 13 Trauma: Head Injury -- Introduction -- Pathophysiology -- Assessment -- Minor head injury -- Severe head injury -- Assessment and management -- Airway and ventilatory management -- Circulatory management -- Management of raised intracranial pressure -- Immobilization -- Transfer -- Further reading -- Chapter 14 Trauma: Spinal Injuries -- Introduction -- Spinal anatomy -- Pathophysiology -- Primary cord Injury -- Secondary cord injury -- Spinal shock -- Neurogenic shock -- Mechanism of injury -- Blunt Injury -- Penetrating Injury -- Clinical assessment -- Identification of those patients at risk of spinal injury -- Management of spinal injuries -- Prevention of hypoxia -- Prevention of hypoperfusion -- Limit further spinal movement -- Hospital selection -- Further reading -- Chapter 15 Trauma: Abdominal Injury -- Introduction -- Mechanisms of injury -- Blunt trauma -- Penetrating trauma -- Assessment of the abdomen -- Prehospital management of abdominal injuries -- Resuscitation -- Analgesia -- Evisceration -- Impalement -- Triage -- Further reading -- Chapter 16 Trauma: Pelvic Injury -- Aetiology -- Injury classification -- Anteroposterior injuries -- Vertical shear injuries -- Lateral compression injuries.

Haemorrhage -- Pelvic binders -- Avoiding iatrogenic injury -- Further reading -- Chapter 17 Trauma: Extremity Injury -- Aetiology -- Mechanism of injury and injury pattern -- Injury assessment -- Analgesia -- Wound care -- Reducing, splinting and packaging -- Amputation -- Further reading -- Chapter 18 Trauma: Burns -- Introduction -- Types of burns -- Assessing the burn: extent and depth -- How to assess burn extent -- Burn depth -- Initial management of burns -- Management of minor burns -- Management of significant burns -- Cooling the burn, but not the patient -- Selection of burn dressings -- Who needs fluid resuscitation? -- Mode of resuscitation: intravenous versus oral -- Oral rehydration -- The airway and burn injury (suspected inhalational injury) -- Airway burns -- Inhalational injury -- Management of specific burns -- Chemical burns -- Electrical burns (Box 18.4) -- Fasciotomy and escharotomy -- Referral pathways: when to refer? -- Mass casualties involving burn injury -- Further reading -- Chapter 19 Trauma: Suspension and Crush -- Introduction -- Rescue cardioplegia: the problem with uncontrolled limb release -- Muscle and soft-tissue trauma: whole system effects -- Acute kidney injury: an indirect effect of muscle damage -- Management -- Isolate and move to a place of safety -- Resuscitate the system -- Analgesia -- Staged tourniquet release strategy -- Management of hyperkalaemia -- Alkaline diuresis -- Triage -- Future considerations -- Further reading -- Chapter 20 Trauma: Ballistic and Blast -- Introduction -- Firearm injuries -- Blast injuries -- Incident management -- Personal protective equipment -- Approach to scene -- Dynamic risk assessment -- Forensic considerations -- Management of ballistic trauma -- Catastrophic haemorrhage control -- Airway management -- Cervical spine immobilization -- Breathing management.

Circulation management -- Disability -- Exposure -- Disclaimer -- Further reading -- Chapter 21 Trauma: Extrication of the Trapped Patient -- Introduction -- Describing the anatomy of the car -- Casualty care team (and shared) tasks -- Safety -- Vehicle-specific hazards -- Rapid access and assessment -- Planning -- Treatment and monitoring -- Extrication team tasks -- Stability -- Glass management -- Space-making -- Large vehicles -- Removal of the patient from the vehicle -- A-plan casualty removal -- B-plan casualty removal -- Post-extrication care -- Summary -- Acknowledgements -- Further reading -- Chapter 22 Cardiac Arrest -- International Cardiac Arrest Guidelines -- Introduction -- Initial actions -- Cardiac arrest considerations in the prehospital environment -- Introduction -- Prehospital cardiac arrest in the trauma victim -- Introduction -- Prehospital emergency thoracotomy -- Introduction -- Indications and relative contraindications -- Equipment -- Operative technique -- Paediatric resuscitation -- The ethics of resuscitation: difficult and demanding decision -- Introduction -- Criteria for not starting CPR -- Do Not Resuscitate orders -- Advance directives, living wills and patient self-determination -- Terminating resuscitative efforts -- Further reading -- Chapter 23 Acute Medical Emergencies -- Introduction -- Respiratory emergencies -- Asthma -- COPD/COAD (chronic obstructive pulmonary/airway disease) -- Pneumothorax -- Cardiac emergencies -- Acute coronary syndromes and myocardial infarction -- Acute pulmonary oedema -- Arrhythmias -- Anaphylaxis -- Neurological emergencies -- The fitting patient -- Cerebrovascular accident -- Metabolic emergencies -- High blood sugar including diabetic ketoacidosis and hyperosmolar states -- Hypoglycaemia -- Poisoning -- Psychiatric emergencies/acute psychoses -- Infection/sepsis.

Further reading.