Table of Contents

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

About the Author

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.

Reviews

“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)