Title Details

ABOUT THE EDITORS

Sam Willis is Lecturer in Paramedic Sciences at the University of Tasmania, Sydney, Australia.

Roger Dalrymple is Principal Lecturer for the Professional Education and Leadership Programmes at Oxford Brookes University, Oxford, UK.

About the series xvii

Contributors xviii

Preface xxi

Acknowledgements xxiii

How to use your textbook xxiv

About the companion website xxviii

Part One Theory and Background

Chapter 1 Professionalism in paramedic practice 3
Netta Lloyd-Jones

Introduction 4

Professionalism in paramedic practice 4

Defining professionalism 5

Professionalism as ethical practice 6

Professional identity, socialisation and culture 6

How do students learn professionalism? 7

Assessment and standards of professionalism 9

Regulatory areas, fitness to practise processes and outcomes 9

Conclusion 10

Activities 11

Glossary 11

References 12

Chapter 2 Human factors of paramedic practice 14
Sam Willis

Introduction 15

Background 16

Defining human factors 16

Human factors of paramedic practice 16

Hazardous attitudes 21

Crew resource management (CRM) 23

Conclusion 24

Activities 25

Glossary 27

References 28

Chapter 3 Communication skills for the pre-hospital professional 29
Sam Willis

Introduction 30

Background 31

The importance of effective communication 31

A model of communication 32

Non-verbal communication 33

Verbal communication 38

Effective listening 39

Empathy 40

Barriers to effective communication in the pre-hospital setting 40

Conclusion 42

Activities 42

Glossary 43

References 44

Chapter 4 Sociological aspects of paramedic practice 46
Kellie Tune

Introduction 47

The sociological imagination 47

Three sociological paradigms 48

The sociocultural context of health 51

Medicalisation and demedicalisation 52

Conclusion 53

Activities 53

Glossary 55

References 56

Chapter 5 Legal and ethical aspects of paramedic practice 58
Sam Willis, Nevin Mehmet

Introduction 59

Ethical aspects of paramedic practice 63

Conclusion 67

Activities 67

Glossary 67

References 68

Chapter 6 The psychology of paramedic care 70
Heather Knight, Helen Pocock

Introduction 71

Llewellyn’s core domains of clinical health psychology 71

Psychological concepts of health 75

Influences of a loss of control on health 75

Psychological considerations for the paramedic 77

The system 79

Conclusion 80

Activities 80

Glossary 82

References 83

Chapter 7 The role of leadership in paramedic practice 85
Roger Dalrymple

Introduction 86

Theories of leadership: a brief overview 88

Definitions of leadership 88

From leaders to leadership behaviours 88

Leadership styles and approaches 89

Leadership at the individual level 91

Leadership and the mentoring or supervisory role 92

Leadership and teamwork 93

Conclusion 95

Activities 95

Glossary 96

References 97

Chapter 8 Safeguarding vulnerable people 98
Rozz McDonald

Introduction 99

Background 99

Legislation and Policy 100

Types of abuse and neglect 101

Recognising abuse and neglect 103

How do you assess seriousness? 109

Practice principles of safeguarding 109

Paramedic responsibilities 109

Responding to abuse and neglect 111

Conclusion 112

Activities 112

Glossary 113

References 114

Chapter 9 Introduction to medicines in pre-hospital care 116
Edward England

Theories and principles 117

Cardiovascular system 121

Parasympathetic nervous system 122

Sympathetic nervous system 122

Antiarrhythmics 124

Angina and hypertension 124

Left ventricular failure (LVF) 125

Respiratory system 125

Endocrine system 126

Pain 128

Nausea and vomiting 131

Conclusion 133

Activities 133

Glossary 133

References 134

Chapter 10 The role of reflection in paramedic practice 136
Sally Markwell, Andrew Kerry

Introduction 137

‘Reflection’: what are we talking about? 138

Models and methods of reflection 139

From models to methods and skills 143

Becoming a reflective practitioner in paramedic practice 145

Conclusion 146

Activities 146

Glossary 148

References 148

Chapter 11 Research methods and paramedic practice 150
Jan Davison-Fischer, Catherine J. Davison-Fischer

Introduction 151

Qualitative and quantitative research 151

Ethics 152

Literature reviews 154

Case reports 155

Case control studies 155

Questionnaire studies 155

Interview studies 158

Focus group studies 158

Observational and participatory studies 159

Before-and-after studies and routinely collected data 159

Randomised controlled trials 159

Longitudinal cohort and panel studies 160

Conclusion 160

Activities 160

Glossary 161

References 162

Chapter 12 Using simulation to educate the pre-hospital healthcare professional 163
Clair Merriman

Introduction 164

Definition of simulation 164

History of simulation 165

Simulation and paramedic practice 166

The simulated learning environment 166

Pedagogic principles of simulation 167

Types of simulation and equipment 170

Getting the most out of simulated sessions 172

Conclusion 175

Activities 175

Glossary 176

References 177

Part Two Assessment and Application

Chapter 13 Trauma 181
Charlie McGurk, Sam Willis

Introduction 182

Head injuries 182

Facial injuries 185

Neck and back injuries 186

Chest injuries 187

Abdominal injuries 188

Pelvic injuries 190

Limb injuries 190

Upper limb injuries 191

Conclusion 192

Activities 192

Glossary 193

References 194

Chapter 14 Pre-hospital electrocardiography 195
Nathan Puckeridge

Introduction 196

What is an ECG? 196

The P, Q, R, S and T waves 197

Evaluating the ECG 198

Heart rate 198

Heart rhythm 198

The ‘P’-wave 198

The ‘QRS’ complex 199

The ‘T’-wave 200

The ‘PR’ interval 200

Atrioventricular (AV) heart blocks 200

Performing and reviewing a 12-lead ECG 201

Acute coronary syndromes and the ECG 203

Idioventricular rhythm 204

Bundle branch blocks 204

Conclusion 205

Activities 205

Glossary 206

References 207

Chapter 15 Assessing the cardiac system 208
Mark Ives, Sam Willis

Introduction 209

The heart 209

Common cardiac conditions 211

Patient assessment 215

Conclusion 220

Activities 221

Glossary 221

References 222

Chapter 16 Assessing the nervous system 223
Clair Merriman

Introduction 224

The nervous system: structure and function 224

Central nervous system 225

Peripheral nervous system 228

Upper and lower motor neurones 230

The history and physical examination 231

Detecting increased in intracranial pressure (ICP) 239

Conclusion 240

Activities 240

Glossary 240

References 241

Chapter 17 Assessing the abdomen 242
Matthew Faulkner

Introduction 243

Abdominal anatomy and physiology 243

History-taking 247

Abdominal physical assessment 251

The nature of abdominal pain 253

The acute abdomen 256

Important abdominal pathologies 256

Conclusion 258

Activities 259

Glossary 260

References 261

Chapter 18 Respiratory assessment 262
Dan Staines

Introduction 263

Anatomy of the respiratory system 263

Lungs and pleural membranes 265

Mechanism of breathing 265

Pathophysiology of respiratory conditions 266

Respiratory system assessment 266

‘Eyeballing’ the scene (also known as a global overview) 267

‘Eyeballing’ the patient (patient assessment triangle) 267

Primary survey 269

Subjective history 269

Secondary survey 270

Chest examination 273

Conclusion 279

Activities 279

Glossary 280

References 280

Chapter 19 Paramedic skills 281
Roshan Raja

Introduction 282

Airway 282

Ventilation 291

Circulation 292

Conclusion 296

Activities 296

Glossary 298

References 298

Chapter 20 Pre-hospital obstetrics 300
Robb Kightley

Introduction 301

Normal (physiological) birth 301

Birth phases 302

Preparing for the birth 304

Paramedic intervention following normal childbirth 306

Birth complications 307

Conclusion 311

Activities 311

Glossary 312

References 313

Chapter 21 Paediatrics 314
Sam Whitby

Introduction 315

Paediatric anatomy and physiology 315

Pediatric examination 317

Paediatric assessment triangle (PAT) 318

Paediatric emergencies 320

Conclusion 327

Activities 327

Glossary 327

References 328

Chapter 22 Managing medical emergencies 329
Bonita Baber, Sam Willis

Introduction 330

Respiratory emergencies 330

Cardiac emergencies 338

Neurological emergencies 341

Metabolic disorders 344

Immunological emergencies 348

Conclusion 349

Activities 349

Glossary 349

References 350

Chapter 23 Managing the older adult 352
Helen Pocock, Heather Knight

Introduction 353

Physiology of ageing 353

Ageing and health psychology 355

Long-term conditions in the ageing population 357

Poly-pharmacy and pharmacology in ageing 359

Conclusion 361

Activities 361

Glossary 361

References 362

Chapter 24 Managing minor injuries in the pre-hospital setting 364
Craig Barlow

Introduction 365

Background 366

The importance of history-taking 366

Examination 367

Minor head injury 370

Nose injury 371

Wound care and assessment 372

Ankle injury 374

Minor burn 375

Conclusion 376

Activities 376

Glossary 377

References 379

Chapter 25 Mental capacity and pre-hospital care 380
Sue Putman

Introduction 381

What is mental capacity? 381

How do we make decisions? 382

The five principles 383

Additional mental capacity safeguards 387

Legal aspects of mental capacity 388

Conclusion 390

Activities 391

Glossary 391

References 392

Chapter 26 Mental health and pre-hospital care 393
Sue Putman

Introduction 394

What is ‘mental health’? 394

What are ‘mental disorder’ and ‘mental illness’? 395

Emotions (mood) and behaviour 397

ABC model of emotion 397

Brief outline of common mental illnesses 398

General strategies to help all mental health conditions in the pre-hospital environment 403

Mental Health Act 1983 (amended 2007) England and Wales (MHA) 403

Conclusion 404

Activities 404

Glossary 404

References 405

Chapter 27 Supporting people with learning disability as a pre-hospital professional 407
Jenny Begley, Mark Begley, Sam Willis

Introduction 408

Background 408

Conditions and syndromes associated with learning disability 409

Dispelling common assumptions relating to LD patients 411

Pre-hospital management considerations for the patient with an LD 413

Conclusion 414

Activities 414

Glossary 415

References 416

Chapter 28 Attending major incidents in paramedic practice 417
Gail Rowntree

Introduction 418

Civil Contingency Act 2004 419

Reality vs. theory: interview with A 420

How to manage a site 421

First attendant crew 422

What a major incident scene looks like 422

Reality of attending a major incident: interview with B 423

Triage 424

Media 425

Self-care 425

Building resilience 426

Conclusion 427

Activities 427

Glossary 428

References 429

Answers to activities 430

Index 451

“Overall this is packed with goodies: interactive resources, photographs, illustrations, glossaries of terminology, references, additional suggested reading and supplementary information in tabular format. The ability of the editors to combine all of these into a coherent whole is commendable in itself. Positive stuff.”  (Journal of Paramedic Practice, 1 June 2015)