acute appendicitis 157 acute pancreatitis 159 acute pyelonephritis 162 bowel obstruction 16 4 diagnosis 154, 155, 156 diverticular disease 166 gallbladder disease 158 gynecological ca uses 163 medical causes 167 mesenteric infarction 165 peptic ulcer disease 160 symptoms 155 ureteric colic 161 ambulance response times 56 ambulance safety officer angina 590 \200\2231 clinical features 72 glyceryl trinitrate 328 unstable 114 \200\22315 angiotensin converting ambulance service 56 \200\22357 ambulance dispatch 57 major incidents 590 \200\2231 NHS tru sts 56 organization 56 roles 56 vehicle item checklists enzyme (ACE) inhibitors 408 ankle fractures 265 \200\2236 ankle inversion/eversion 28 \200\2239 266 see also air ambulances; lateral ligament sprain acute medical patient, ABC transportation 265 approach 70 adder bite 409 amil nitrate 464 Maisonneuve fracture 265 INDEX 708 ankle injuries 278 anti-arrhythmics 311, 332 antibiotics 410 anticholinergic drugs 411 anti cholinergic syndrome bone and joint injuries automatic vehicle location system (AVLS) 57 AV nodal re-entrant tachy- cardia (AVNRT) 108 A VPU assessment 187, 194, 224 \200\2237 closed fractures 226 compound fractures 226 dislocations 224, 226 fracture classification 2 24 limb-threatening injuries 413, 403 303, 503, 538 anticholinesterases 386 anticoagulants 412 antiemetics 25, 335, 337, 225 B barbiturates 414 Basic Trauma Life Support management principles 369, 375 225 antifreeze see ethylene mechanism of injury 224 patient assessment 224 \200\2235 splintage 226 \200\2237 glycol antihistamines 317, 319, (BTLS) course 7 batteries, swallowing 415 bends, the 377, 569 \200\22371 benzine penicillin 356, 315 benzodiazepine 331, 378 413 boots 20 bradycardia 102 \200\2237, 314, anxiety disorders 487 aortic dissection 73 appendicitis 154 \200\22367, 658 armed forces 58 , 593 arrhythmias 398 500, 502 \200\2233 1st degree heart block 103 midazolam 336 poisons 403, 416 reversal 325 substance abuse 465 2nd degree heart block peri-arrest 97 \200\2239 104, 105, 106 artificial ventilation 87, 83 chest compressions 84, 3rd degree heart block 107, 107 children 529 Mobitz type 1 104 Mobitz type 2 105, 106 peri-arrest 100 sinus 102, 1 03 brain anatomy 192 brain injuries 200 \200\2231 contusion 200 extradural haematoma beta blockers 417 biological incidents 620, 87 mouth-to-mask 632 \200\2235 resuscitation 84 anthrax 635 biological agents 632 \200\2235 biological threats 633 biological weapons 632 c asualty management 11, mouth-to-mouth resuscitation 83 resuscitation, abandoning 84 aspirin 312 asthma 333 634 \200\2235 dissemination 634 recognition 634 acute exacerbations 200 128 \200\2239 generalized injury 201 intracerebral haematoma bites see venomous bites children 513 \200\22314 classifications 129 hydrocortisone 329 pneumothorax 126 pregnancy 6 58 salbutamol 348 and stings 200 bladder injuries 222 blast injuries 286 \200\2239 intracranial hemorrhage 200 \200\2231 blast injury mechanisms lacerations/penetrations 286 \200\2237 blast wind 287 burns 288 crush injuries 289 fragmentation 287 management 289 primary blast injuries 201 asystole/PEA arrest 94 \200\2236 subarachnoid 4 Hs and 4 Ts 94 ALS algorithm non- hemorrhage 201 subdural haematoma VF/pulseless VT 95 automated external defi- brillator (AED) 95 cardiac tamponade 95 childre n 529 hypo/hyperkalaemia 95 hypocalcaemia 95 hypothermia 95 hypovolaemia 94 hypoxia 94 pote ntially reversible 200 see also head injuries breaking and entering 38 breath, shortness of 76 \200\2237 288 psychological effects 289 secondary injuries 288 shock wave 286, 287 tertiary injuries 288 thermal injury 287 asthma 76 causes of 76 COPD 76 metabolic acidosis 76 \200\2237 pneumonia 77 pneumothorax 77 pulmonary embolism 77 pulmonary oedema 76 blast lung 288 bleach 418 blood glucose causes 97 dextrose 320 poisoned patients 399 unconscious patients 136, tension pneumothorax 95 thromboembolism 95 thrombolysis 94 toxins 95 British Association for Immediate Care (BASICS) 140 driving courses 696 Emergency Medicine Journal (EMJ) 64 blood pressure 500, 606 \200\2237 see also hypertension; atracurium 385 \200\2236 atropine 356, 314, 403, 406, hypotension BM Stix 70, 78, 152, 194 body temperature regulation 560 407, 529 \200\22331 insurance 40 record keeping 46 training 6 \200\2239, 62 automated external defibril- lator (AED) 92, 95 INDEX1 709 British Association for Immediate Care (BASICS) Scotland 6 \200\2239, 62 children 528, 529 \200\22331 defibrillation 82, 90, 92, individual chemicals 630 information gathering 95, 622 drowning, near 567 drugs in 90, 93 electromechanical asso- ciatiaon (EMD) 82 hypothermia fo llowing 90 monitor checks 90 patient assessment 82 patient handover 90 pulmonary embolism information sources 625 organizational manage- ment 622 \200\22330 patient transfer 630 per sonal protective equipment 622 British Red Cross 58, 593 bronchiolitis 512 burn injuries 296 \200\223305 analgesia 305 associated injuries 301 associated medical conditions 301 regional provider services resuscitation 628 \200\2239 scene safety 622, 625 terrorist inci dents 620, blast injuries 288 burn depth 298 \200\223299 burn extent 300, 301, 303 burn site 301 burn wound zones 296 carbon monoxide poisoning 305 chemical burns 296 children 541, 540 contact burns 296 deaths 296 dressings 305 electrical injury 298 erythema 298 explosive burns 296 f lame burns 296 flash burns 298 fluid loss 296 hypothermia 296, 303 immediate care 302 \200 \2234 infection 296 inhalation injuries 301 ionizing radiation burns 132 \200\2233 pulseless electrical activity 621 (PEA) 82 treatment 630 triage 626 \200\2237 chest drain kits 15 chest injuries 208 \200\22317 recovery position 83 safety 82 ventricular fibrillation (VF) 82, 90 \200\223100, 530 see also artificial ventila- tion; asystole/PEA arrest; bradycardia ; tachycardia cardiac tamponade 95 cardiogenic shock 184, 534 cardiological emergencies back examination 212 blast injuries 208 blunt injuries 208 cardiac tamponade 214 chest exam ination 211 clinical signs page 205 diaphragmatic ruptures 216 82 \200\2239 diffusion 211 flail chest 214 fractured ribs 216 fractured sternum 217 massive haemothorax carpal bone fractures 243 casualty clearing officer 588 \200\22390 casualty clearing station 586 \200\2237 214 CBRN incidents 620 \200\22321 presentation, mode of mechanism, of injury 208 open chest wounds 214 pain management 217 patient assessment 211 p enetrating injuries 208 pneumothorax, sim- ple/closed 216 primary survey 213 pulmonary cont usion 216 pulmonary perfusion 210 respiration, and anatomy 298 621 non-accidental injury structured response, need for 620 \200\22321 (NAI) 298 pain 296 pathophysiology 296 patient age 301 patient disposal 305 scalds 296 scene safety 3 02 smoke inhalation 304 see also biological incidents; chemical incidents; nuclear and radiological incidents cerebral odema 192 cerebrovascular accident (CVA) 144 208 \200\2239 butane 478 \200\22380 cervical spine injuries 205, secondary survey 216 \200\22317 stab wounds 209 surface landmarks 208 \200\22310 surgical e mphysema 217 tension pneumothorax 280 \200\2233 airway obstruction 172 \200\22388 children 534 \200\2235 suggested equipment 15 see also im mobilization; C caffeine 403 calcaneum fractures 267 calcium channel blockers 213, 212 \200\22313 spinal injuries trachea 208 ventilation 210 chest pain 72 \200\2235 causes of 73 chest wall pain 72 cholecy stitis 74 gastrointestinal causes of Chemdata 624 chemical burns 296 chemical incidents 620, 419 calcium chloride 406, 407 cannabis 466 carbamazepine 420 carbon monoxide 305, 622 \200\22330 advisory systems 622 \200\2237 clinical management 626 debriefing 630 decontamination 21, 6 28 definition of 622 \200\22330 documentation 630 hazardous materials 73 421 \200\2232 herpes zoster 74 ischaemic 72 pancreatitis 74 pericarditis 74 pulmonary pain 72 \200\2235 cardiac arrest 82 \200\2236, 483 adrenaline 309 atropine 314 basic life support 83, 84, emergencies 620, 622 85 INDEX 710 child abuse 548 cyanide 426, 464 cyclizine 319 cardiac arrest algorithm Chlamydia trachomatis (CPR) 567 515 chlorine 423 chlorpheniramine (chlor- phenamine) 317, 356 cardiorespiratory arrest 566 D deafness 288 death, pronouncement and certification 34 \200\2236, 594 cerebral protection 565 CPR 565 exhaustion 564 \200\2237 general 565 \200\2236 horizontal p ostion, of choking adults 88, 89 children 516 cholecystitis 74, 154 \200\22367 chronic obstructive pulmo- nary disease (COPD) 76, 130, 13 4 \200\2236, 342 \200\2233, 508 victim 565 hypothermia 564 \200\2237 hypoxic gap 565 management 565 \200\2236 prognosis 566 \200\2237 unconsciousness 564 \200\2237 deep vein thrombosis (DVT) common risk factors 128 pregnancy 658 pulmonary embolism 658 defibrillation 82, 90, 92, 95, dehydration 520, 560 depression 485 detergents, and related substances 427 dextrose 320, 4 06, 407 diabetic emergencies 152 diamorphine 321, 367 diazemuls 146 diazepam 322, 356, 403 diffuse axonal injury (DAI) Civil Aviation Authority 699 \200\223700 drug security 612 duty to act 34 DVT see deep vein thrombosis clavicular fractures 228 clothing, high-visibility 20 co-codamol 318 co-dydramol 318 co-proxamol 318 cocaine 403, 467 \200\2238 cold injury 558 c olic dystonia 335 E E. coli 515 ecstasy see methylenedi- oxymetamphetamine ectopic pregnancy 646 \200\2237 ED 2000 693 elbow dislocations 240 electrocution injuries 572 \200\2234 cardiorespiratory inj uries biliary 158 ureteric colic 161 201 digoxin 428 Diploma in Immediate Medical Care (DipIMC.RCSEd) 10 \200\22311, 60 coma 402 \200\2233 see also unconscious patients communications officer 591 compartmental syndrome 263 \200\2234, 272 confidentiality 33 consciousness, assessment disinfectants 429 distributive shock 534 diuretics, loop 326 diverticular disease 166 divin g emergencies 568 \200\22371 573 domestic incidents 572 electrophysiology 572 \200\2233 incident types 572 industrial/occupa tional incidents 572 injury patterns 573 lightening 572, 573 limbs/joints 573 management 57 4 nervous system 573 railroad incidents 572 skin 573 vascular injuries 573 of see AVPU assessment consent 32 constipation 155, 164 convulsions 517 COPD see chronic obstruc- tive pulmonary d isease corrosive substances - acids acute decompression illness 569 \200\22371 barotrauma 568 the bends 569 \200\22371 the chok es 569 \200\22371 clinical features 570 the creeps 569 \200\22371 mild 569 \200\22371 patho physiology 568, and alkalis 424 crack cocaine 467 \200\2238 cramp 561 CRAMS (Circulation, Respiration, Abdomen, Motor, Speech) scoring system 616 569 \200\22371 serious 569 \200\22371 the staggers 569 \200\22371 symptoms 569 \200\22371 Emergency Medicine Journal (EMJ) 64 crescendo angina 114 \200\22315 cricothyrotomy Emergency Planning Officer 593 driving, safe 42 cricothyroid membrane emergency services accidents en route 42 defensive driving 42 fend-off position 42, 44 parking at scene 42, 44 , 45 rights and responsibilities 179 kit 15 needle 178 \200\2239, 506 \200\2237, 526 possible arrangements 19 surgical 178 major incidents 590 see also ambulance service; armed forces; fire service; Her Majesty \200\231s Coastguard; police; Royal Nationa l Life- boat institution (RNLI); voluntary serv ices 42 croup (laryngotracheo- Roadcraft: the police bronchites) 503, 510, 511 driver \200\231s handbook 42 visibility, maximizing 42, crowd doctors 704 \200\2235 crush injuries 289 CS gas 425 Cullen \200\231s sign 159 endotracheal (ET) tubes 43 15, 506 \200\2237 drowning, near 564 \200\2237 rapid sequence induction airway management 565 assessment 564 387 INDEX1 711 tube size 532, 533, 525 gunshot injuries 290 \200\2234 fitting 140, 146 flumazenil 325, 406, 407, Entonox 340, 363, 377 entrapment 682 epilepsy 140, 146, 322, 517 epiphyseal fractures 237, bullets 177, 287 forensic considerations 416, 465 293 formulary 24 \200\2235, 308 \200\22354 anesthetic drugs 25 analgesic drugs 25 antidotes 25 antiemetic drugs 25 cardiac drugs 25 fluids 25 gasses 25 obstetric drugs 25 other drugs 25 pediatric doses 356, 357, fragmentation 291 high/low-energy transfer 242 equipment officer 591 ethanol 430, 458 ethylene glycol 431 etomidate 380, 381 extrication wounds 290 injury severity 290 management 292 \200\2233 missile tracks 291 missile types 29 2 temporary cavitation 291 wound ballistics 290 wound contamination extrication devices 693 methods of 693 \200\2235 principles of 682 scoop stretcher 694 spin al boards 694 stretchers 695 vacuum splints/mattresses 291 358 wound management 293 respiratory drugs 25 thrombolytic drugs 25 forward ambulance commander 590 H haematemesis 155 haematomas 192 haemolytic streptococci 695 from vehicles 682 \200\2233 forward medical eye injuries 206 \200\2237 eye protection 20 commander 588 \200\22390 fracture complications 272 closed to open fracture 272 515 F face masks 15 facial skeleton 204, 205 faciomaxillary injuries compartmental syndrome haemophilus 515 hemorrhage control, external 275 272 embolism syndrome 272 frost bite 558 frost nip 558 frusemide (furosemide) 326 fungi, poisonous 432 haemothorax 214, 288, 535, 536 204 \200\2237 hallucinations 463, 466, anatomy of 204, 205 epistaxis 206 \200\2237 eye injuries 206 \200\2237 hard tissue injuries 206 \200\2237 immediate management 473, 482, 484 hallucinogenic fungi 471 Hartmann \200\231s solution 537 HAZCHEM warning plate G Galeazzi fracture 241 gallbladder disease 158 gallbladder perforation 158 gammahydroxybut yric acid 624, 627 205 head injuries 140, 192 \200\2237 cerebral perfusion pressure 193 mechanism, of injury 204 soft tissue injuries 206 \200\2237 teeth injuries 206 \200\2237 fa ith communities 592 febrile convulsions 517 Fellowship in Immediate cerebrospinal fluid 192, (GHB) 470 gastroenteritis 520 genital injuries 222 genitourinary trauma 221 \200\2232 198 coup/contra-coup injuries 192, 193 Medical Care (FIMC.RCSEd) 11, 67 femur fractures 224, 255, Glasgow Coma Scale (GCS) 194, 195 anatomy 221 \200\2232 bladder injuries 222 genital injuries 222 mechanism, of injury helmet removal 196, 197 intracranial pressure 192 mechanism of injury 192 pathophysiology, of injury 256 fentanyl 362, 368 fibrinolytics 351 finger fractures 244 222 renal injuries 222 ureteric injuries 222 urethral injuries 222 Gillick competence 32 Glasgo w Coma Scale (GCS) 194, 195, 503 \200\2234, 606 \200\2237, 614 \200\22317 gloves 20 glucago n 152, 327, 356, 192 \200\2233 Bennett \200\231s fracture 244 metacarpal fractures 244 phalangeal fractures 244 patient assessment 194 primary/secondary injuries 192 \200\2233 fire 592 fire service 52 \200\2234 see also brain injuries Health Protection Agency Chief Fire Officer 52 equipment 54 organization 52 rank structure 52, 53 road traffic accid ent managment 52 \200\2234 624, 636 \200\2239 heat-related illness 560 \200\2233 cramp 561 exhaustion 561 heat adaptation 560 heat stroke 562 \200\2233 minor heat illness 5 61 oedema 561 risk factors 560 406, 407 glyceryl trinitrate 328 Gray-Turner \200\231s sign 159 Guide to Safety at Sports roles of 52 Grounds (Green Guide) 704 \200\2235 First Person on the Scene (FPOS) course 6, 60 INDEX 712 syncope 561 temperature regulation knee dislocations 261 knee injuries 277 \200\2238 rewarming 556, 557 surface rewarming 556 hypovolaemia 94, 185, 192, 560 tetany 561 ligament injuries 278 meniscal tears 277 patella tendon rupture 277 quadricepts tendon rupt ure 277 205, 253, 534 heat stroke 562 \200\2233 hypoxia 94, 133, 134 \200\2236, complications 562 \200\2233 heat stroke index 563 management 563 presentation 563 preventio n 562 sweating 562 helicopters see air ambulances 192, 280 \200\2232, 342 \200\2233, 500, 554 \200\2235 reduced lateral dislocatin/ subluxatin of patella 277 I ibuprofen 330, 357, 543 \200\2234 identity cards 21 immobilization 181, 202, knee replacements 258 L labor helmets 20 Henry \200\231s law 568, 569 \200\22371 Her Majesty \200\231s Coastguard 280 \200\2233, 686 \200\2238 from behind 688 blood loss 684 cervical collars 688 cervical s pine 686 \200\2238 fat emboli 685 from front 688 further injury, prevention 58, 593 heroin 475 herpes zoster (shingles) 74, abnormal 672 \200\2234 amniotic sac, rupturing of 664 \200\2235 124 Apgar score 668 \200\2239 birth canal 665 breech 672 \200\2234 Caesarian section 674 cervix , dilation of 664 \200\2235 face presentations 673, hip dislocations 254 hip replacements 256 history taking, pediatric of 684 indications 688 manual 686 neck injury 202 pain relief 684 principles of 684 \200 \2235 from side 688 splints, effective 685 see also limb immobili- 496 \200\2238 ABCDE questioning 497 \200\2238 674 AMPLE history 496 \200\2238 patient handover, MIST first stage 664 \200\2235 head, delivery of 667 meconium, passage of system 498 humeral fractures proximal 234 shaft fractures 235 664 misrepresentations 672 \200\2234 normal 664 \200\2239 obstructed 676 patient examination 66 4 patient history 664 preterm 660 prolapsed cord 672 second stage 666 \200\2238 shoulder dy stocia 672 urge to push 666 \200\2238 laryngeal mask airway (LMA) 15, 172 \200\2233, 176 \200\2237, 525 zation infection 192, 483 inhalation injuries 301 inhaled foreign body 516 Injury Severity Score (ISS) hydrocortisone 356, 329 hyperglaecemia 518 hyperkalaemia 95 hypertension 657, 656 \200\2237 hyperthermia 402 \200\2233 hyperventilation syndrome 618 Institute for Health Care 77, 138 development (IHCD) 6 hypocalcaemia 95 hypoglycaemia 140, 152, insulin 434 insurance 40 intracerebral catastrophe 192, 320, 327, 433, 483, 508, 518 hypokalaemia 95 hypotension 220, 381, 382, 383, 384, 402 \200\2233, 500, 534 \200\2238 140 laryngotracheobronchites intraosseous needles 15 intravenous cannulation 15, 503, 510, 511 larynx injuries 203 left iliac fossa pain 166 legal issues 32 \200\2233 187 iron 435 hypothalmus 554 \200\2237, 560 hypothermia 95, 402 \200\2233, 508, 538, 554 \200\2237 cardi opulmonary breaking and entering 38 confidentiality 33 consent 32 death, pronouncement J joint injuries see bone and resuscitation 557 cold temperatures 555 definition of 554 diagnosis of 555 effects of 556 e xacerbating factors 554 hypothalmus 554 \200\2237 management of 555 \200\2237 mechanisms 55 4 physiological effects and certification 34 \200\2236 joint injuries living wills 34 negligence 34 parental responsibility 33 police, dealing with 34 restraint 38 resuscitation 34 K Kemler Plate, 624 Kendrick extrication device life support, pediatric (KED) 693 524 \200\22331 ketamine 331, 357, 378, 380 \200\2233, 472, 543 \200\2234 554 \200\2235 airway management predisposing factors 554 524 \200\2237 ketoacidosis 152 INDEX1 713 basic life support algorithm 527 Major Incident Medical Management and Support (MIMMS) 8 major incidents 576 \200\2237 diagnostic pouch 16 miscellaneous equipment breathing 528 circulation 528 nasopharyngeal airway 16 pediatric equipment ambulance service 590 \200\2231 assessment 581 command and control 579 command structures 16 524 medical roles and responsi- needle and surgical crico- thyroidotomy 526 oropharyngeal airway 524 paedriatic resuscitati on bilities 588 \200\22390 mefenamic acid 437 melaena 155 meningitis 148 \200\2239, 315 mening ococcal meningi- 584 \200\2236 communications 580 \200\2231 compensated/ 380 lignocaine (lidocaine) 309, 310, 332, 357, 543 \200\2234 limb immobilization 689 \200\22393 uncompensated 576 \200\2237 tis/septicaemia 148 \200\2239 cordons 584 \200\2236 dead, dealing with 594 declaration of 596 \200\2238 definition of 576 disasters/catastrophes benzyl penicillin 146, 148 \200\2239 box splints 689 Donway splint 690 \200\2231, 692 FRAc straps 689 hare splint 691 inflatable splints 689 military antishock trouser (MAST) suit 692 neighbor strapping 689 pneumatic an tishock contact prophylaxis 146 meiningococcal septi- caemia 148 \200\2239 meningitis 148 \200\2239 , 315 Mental Health Act (1983) 576 \200\2237 emergency services 590, 592 \200\2233 admission for assessment equipment 578 further information, sources of 600 gold command 584 health service response 490 admission for treatment 490 garment (PASG) 692 emergency admission for assessment 490 relevant sections 491 removal to a place of Sager splint 691, 692 Trac3 splint 691 traction splints 689, 692 triangular bandages 689 589, 586 \200\2237 incident commanders, recognition of 587 manmade incidents 577 natural incidents 577 phases 578 \200\22383 planning 578 preparation 578 \200\2239 recovery 584 \200\22394 response 579 \200\22382 safety 579 transportation 581 \200\2232 treatment 581 triage 581 safety (by police) 491 Lisfranc injury 270 lithium 436 living wills 34 local anesthesia 389 \200\22390, removal to a place of safety (via magistrate) 490 restraint 38 391 \200\2232, 393 \200\2234 mesenteric infarction 165 metatarsal fractures 270 methanol 438, 474 methionine 357, 334 me thylenedioxymetam- altered clinical assess- ments 390 bupivicaine 392 femoral nerve block 393 \200\2234 phetamine (MDMA) 469 hypersensitivity reactions metoclopramide 335, 439 midazolam 336, 357 midtarsal injuries 268 Military Aid to the Civil 390 mania 486 Marine and Coastguard Agency (MCA) 58 lignocaine 391 metacarpal digital nerve blocks 393 \200\2234 nerve damage 390 pharmacology 389 prilocaine 392 specific blocks 393 \200\2234 toxity 389 \200\22390 wound blockade 393 \200\2234 Maritime Rescue Powers (MAC) scheme 593 Co-ordination Centers (MRCC) 58 Maritime Rescue Sub- miscarriage 648 anti-D prophylaxis 649 immediate management centers (MRSC) 58 mass gatherings medicine 648 704 \200\2236 presenting features 648 risk factors 648 septic abortion 648 mobile medical/surgical teams 588 \200\22390 local authority 592 \200\2233 lysergic acid diethylamide contingency planning 705 \200\2236 (LSD) 473 legal requirements 704 \200\2235 MDMA see methylenedi- oxymetamphetamine monoamine oxidase inhibi- tors (MAOIs) 440 Monteggia fracture 241 morphine 305, 319, 337, 3 57, 363, 543 \200\2234 M Madingly Immediate Care medical commander 588 \200\22390 medical equipment 14 \200\22319 airway equipment 15 ancilliary equipment 16 breathing equip ment 15 cervical spine control 15 circulation equipment Course 8 mouth-to-mask magnesium (magnesium resuscitation 84 sulfate) 333 Major Incident Medical mouth-to-mouth resuscitation 83 Murphy \200\231s sign 158 Management and Suport (MIMMS) course 578 \200\2239 15 \200\22316 INDEX 714 muscle relaxants 384 \200\2236 depolarizing 384 \200\2235 nondepolarizing 385 \200\2236 myc oplasma pneumonia nuclear and radiological incidents 620, 636 \200\2239 osteoporosis 224 neck of femur fracture accident types 638 clinical assessment 639 dealing with 638 emergency reference 224, 255 supracondylar femur fracture 258 515 myocardial infarction clinical features 72 non-Q wave 114 \200\22315 tenecteplase 351 myoca rdial ischaemia overalls 20 oxygen 15, 342 \200\2233 levels (ERLs) 636 \200\2239 exposure risks 638 monitoring 636 \200\2237 NAIR assistance 636 \200\2237 press 637 protect ion 638 \200\2239 radiation types 637 radioactive materials administration 128 \200\2239 cylinder sizes 343 pulse oximetry 80 \200\2231 rapid sequence induction 114 \200\22321 acute anterior MI 119 acute inferior MI 120 acute myocardial infarction 116 388 trauma 180 see also Entonox oxygenation see pulse 636 \200\2239 pre-hospital thrombolysis oximetry 117 \200\22321, 132 \200\2233 unstable angina 114 \200\22315 O obstetric emergencies analgesia 346, 370 antepartum hemorrhage P packaging 22 pediatric emergencies N NAIR (National arrange- ments for incidents involving radioactivity) 636 \200\2237 ABC system 502 \200\2234, 506 \200\2238 airway 502, 506 \200\2237 analgesia 542 \200\2234 a natomy and physiology 652 \200\2235 eclampsia 657 hypertensive disorders 656 \200\2237 naloxone 338, 357, 373, 406, 407, 475, 543 \200\2234 532 multiple birth 676 neonatal resuscitation asthma 513 \200\22314 blood pressure 500 breathing 502, 503, 508 bronchiolitis 512 burns 54 0, 541 child abuse 548 choking 516 circulation 502 \200\2233, 508 consent 546 convulsions 5 17 croup 503, 510, 511 diarrhea and vomiting nasopharyngeal airway placement 172 \200\2233, 506 \200\2237 678 \200\2239 placenta praevia 652 \200\2233 placental abruption National Poisons Informa- tion Service 626 National Radiological Protection Board (NRPB) 63 6 \200\2239 654 \200\2235 postpartum hemorrhage 670 pre-eclampsia 656, 657 retained placenta 670 risk factors 656 see also labor; pregnancy obs tructive shock 184, 534 oedema 561 nausea and vomiting 319 see also antiemetics neck injury 202 \200\2233 cervical collar 202, 203 immobilization 202 penetration 202 upper airway, blunt trauma to 2 03 vital structures at risk 520 disability 503, 508, 538 doses 543 \200\2234 environment 508 epiglottitis 511 exposure, and pulmonary 76, 126 oesophageal reflux/ oesophagitis 73 olecranon fractures 238 ondansetron 3 41 Operational Research Con- sultants (ORCON) 56 202 \200\2233 environment 538 febrile convulsions 517 heart rate 500 inhaled foreign body 516 meningitis 521 meningococcal neck of femur fracture 224, 255 opiate abuse 475 opiate overdose 338, 373, needle cricothyrotomy 178 \200\2239, 506 \200\2237, 526 needle thoracocentesis 374 opioids 364 \200\22375 212 \200\22313 negligence 34 neurogenic shock 184, septicaemia 522 metabolic emergencies agonists 364 \200\22375 antagonists 364 \200\22375 antiemetics 375 contraindications 366 mo rphine 364 \200\22375 naloxone 373 partial agonists 364 \200\22375 receptor activity 365 si de-effects 366 518 534 monitoring 503 \200\2234, 539 pneumonia 515 poisoning 523 psychology 532 pyrexia 517 respir atory emergencies neuromuscular blocking agents see muscle relaxants NHS trusts 56 nitrus oxide/oxygen 50:50 see Entonox 510 organophosphates 442, 403 oropharyngeal airway non-Q wave myocardial infarction 114 \200\22315 respiratory rate 501 resuscitation chart 533 172 \200\2233, 175, 506 \200\2237, 524 INDEX1 715 secondary survey 539 trauma 532 \200\22341, 552 triage 550 unconscious child 519 vital sign s 500, 501, 503 \200\2234 weight 500 see also history taking, pethidine 346, 370 petroleum distillates 446 phalangeal fractures 271 phencyclidine 403, 47 6 phenothiazines 403, 447 phenytoin 448 plant toxins 449 \200\22351 cotoneaster 449 dieffen bachia 449 foxglove 449 hemlock 450 hogweed 450 holly 450 honeysuckle 450 mistletoe 450 yew 451 local police authorities 48 organization of 48 police forces 48 rank structure 48, 49 speci al operations 50 Traffic Department 50 Pre-hospital Emergency pediatric; life support, pediatric pediatric trauma Care (PHEC) diploma 6, 12, 60 Pre-hospital Pediatric airway 534 breathing 535 cervical spine control Life Support (PHPLS) course 7 Pre-hospital Trauma 534 \200\2235 disability 538 flail chest 535, 536 life-threatening conditions Course (PHTC) 7 Pre-hospital Trauma Life Support (PHTLS) course 7 pneumoccocus 515 pneumothorax 72, 73, 77, 126, 209, 216, 246, 288, 340, 377, 514 chest drai nage 135 open 535, 536 signs of 134 \200\2236 types of 134 \200\2236 535 pregnancy 644 \200\22350 massive haemothorax airway 642 appendicitis during 658 asthma during 658 blunt trauma 663 breathing 642 circula tion 642 DVT, and pulmonary embolism 658 535, 536 open pneumothorax 535, 536 shock 534, 537, 538 tension pneumothorax 535, 536 poisoned patient 398 \200\2239 Pediatric Trauma Score ABCDE approach 398 \200\2239 advice/information 399 airway 398 antidotes 398 \200\2239 brea thing 398 circulation 398 disability 398 exposure 399 glucose 399 pupil assessment 398, 399 617 ectopic 646 \200\2237 fibroids 658 fundal height, and gestation 647 history taking 644 obst etric examination Pediatrics for Pre- hospital Professionals (PEPP) course 8 pain management 360 burn injury 296 chest injuries 217 children 542 immobilization 684 see also analgesics panc reatitis 74, 159 pancuronium 385 \200\2236 Panda eyes 198 paracetamol 345, 357, 443, 644 patient management 662 pelvic fracture 662 \200\2233 penetrating trauma 663 placental abrup tion 662 pyelonephritis 658 resuscitation during 645 shock 645 toxic shock syndrome poisoning 523 anticholinergic syndrome 403 antidotes 406 \200\2237 benzodiazepine syndrome 543 \200\2234 403 checks 401 children 523 cholinergic syndrome 403 decontamination 404 diagnosis 400 \200 \2231 opioid syndrome 403 poisons 408 \200\22360 scene assessment 400 \200\2231 sympathomim etic syndrome 403 symptom assessment overdose 334 650 paranoid delusions 484 paraquat 444 parental responsibility 33 patella dislocations 260 pat ella fractures 259 patella tendon rupture 277 pathological fractures 256 pelvic injuries 25 0 \200\2233 uterine rupture 663 vena caval compression 643 see also miscarriage primary survey (trauma) 172 \200\22388 ABCDE sequence 172 \200\22388 airway adjuncts 175 airway clearance 173, avulsion fractures 252 major fractures 253 mechanisms of 250 \200\2233 pubic ramus 250 \200 \2231 174, 188 400 \200\2231 airways, surgical 178 \200\2239 breathing 182 \200\223183, 211 cervical spine immobili- see also substance abuse pelvic splints 221 pepper spray 445 peptic ulcer 73, 160 peri-prosthetic fractures police 48 \200\22350, 592 chief constable 48 Criminal Investigation Department 50 zation 181 circulation 184 \200\2237 disability 187 orotracheal intubation 256 dealing with 34 duties of 48 evidence, preservation of pericarditis 74, 122 \200\2233 pericardium 209 peritonitis 160 personality disorders 487 176 \200\2237 oxygen therapy 180 50 propofol 382 protective equipment 20 \200\2231 Home Office 48 INDEX 716 psychiatric conditions 484 \200\2238 anxiety disorders 487 common organic causes repeating 597 replying to calls 597 shorthand terms 596 radiological incidents see Roadcraft: the police driver \200\231s handbook 42 rocuronium 385 \200\2236 Royal College of Surgeons of Edinburgh 6 \200\2239, 66 \200\2237 483 depression 485 mania 486 personality disorders 487 psychosis 484 nuclear and radiological incidents rapid sequence induction (RSI) 380, 387 \200\2238 cricoid pressure 388 endotracheal (ET) tu bes Royal National Lifeboat institution (RNLI) 58 psychiatric emergencies RSI see rapid sequence legal/ethical issues 490 \200\2231 management plan 482 \200\2233 Mental Health Act 482 \200 \2233 mental state examination induction 387 rugby injuries 229, 230 Russell extrication device indications for 387 induction 388 intubation 388 \200\2237 operators required for (RED) 693 482 physical examination 482 suicide risk 483, 485 S Safety at Sports Grounds Act (1975) 704 \200\2235 salbutamol 348, 358 salicylates 453 sca lds 296 scaphoid fracture 243 scene assessment 52, 387 \200\2238 psychosis 484 orotracheal intubation behavioral abnormalities 176 \200\2237 oxygen 388 pre-oxygenation 388 preparation 388 484 delusions 484 management 484 presentation 484 risk assessment 484 sedation 484 rash 148 \200\2239 re-accreditation 12 reading, suggested 64 general texts 64 journals 64 s pecialized texts 64 pulmonary embolism 73, 400 \200\2231 132 \200\2233 scene safety 52, 286, 302, pregnancy 658 shortness of breath 77 pulmonary irritants 452 pulmonary oedema 76, 126 pulse oximetry 80 \200\2231 applications 80 hemoglobin-oxygen 622, 625 record keeping 46, 614 \200\22318 regional injuries ankle 278 knee 277 \200\2238 lower limb 254 \200\22371 pelvis 250 \200\2233 thorax 246 \200\2238 upper limb 228 \200\22344 scoop stretcher 253, 255 secondary survey 190 \200\2231 burn injury 304 chest assessment 190 \200\2231, 216 \200\22317 extremities, assessment of dissociation curve 81 191 limitations 80 head assessment 190, 195 neck assessment 190 pelvic assessment 191 soft tissue injuries 274 spinal injuries 282 \200\2233 trauma, in children 539 pupil assessment 141, 195, renal injuries 222 renal stones 161 respiratory rate 501, 398, 399, 402 \200\2233 pyelonephritis 162, 658 pyrexia 517 606 \200\2237 respiratory syncytial virus (RSV) 515 secondary triage officer Q qualifications 10 \200\22311 restraint 38 resuscitation 34 588 \200\22390 septic shock 184 serotonin uptake inhibitors cardiopulmonary 557 legal issues 34 neonatal 678 \200\2239 pediatric 524 \200\22331, 533 du ring pregnancy 645 see also artificial ventilation (SSRIs) 454 shaft of femur fracture 256 shingles (herpes zoster) 74, R radial fractures 239, 241 radiation see nuclear and radiological incidents 124 shock 184 \200\2235 Revised Trauma Score (RTS) 614 \200\22317 rib fractures 246 \200\230right-stick \200\231 f racture 241 road traffic accidents 52 \200\2234, in pregnancy 645 primary survey 184 \200\2235 trauma 184, 534, 537, 538 see also hypovolaem ia shortness of breath see breath, shortness of radio voice procedure 596 \200\2238 corrections 597 ending calls 597 making calls 596 \200\2237 messages, key features of 682 glass management 53 scene assessment/safety shoulder dislocations anterior 231, 232 inferior (luxatio erecta) 52 596 \200\2238 space creation/full access 233 NATO phonetic aphabet 53 posterior 233 side-effects 308 \200\22354 Simmonds test 278 sinus bradycardia 102, 103 597 stabilization/initial access numbers, for radio messages 597 radio checks 598 52 see also major incidents INDEX1 717 skull fractures 198 talus fractures 267 tarsometatarsal dislocations substance abuse 462 \200\22380, basal skull fractures 198 compound fractures 198 depressed skull fractures 483 269 aggressive behavior teeth injuries 206 \200\2237 Telford extrication device 462 \200\22380 amil nitrate 464 amphetamines 463 benzodiazepines 465 butane 478 \200\22380 cannabis 466 cocaine/crack cocaine 198 intracranial bleeding 198 linear fractures 198 smoke inhalation 304 snake bite 455 (TED) 693 temazepam 403 temperature regulation 560 tenecteplase 351 tension pneumothorax 95 , 126, 134 \200\2236, 212 \200\22313, 514, 535, 536 tetany 561 tetracyclic antidepressants see also adder bite sodium bicarbonate 407 soft tissue injuries 274 \200\2238 closed wounds 275 externa l hemor rhage 467 \200\2238 ecstasy (MDMA) 469 gammahydroxybutyric acid (GHB) 470 hallucinations 463, 466, control 275 injury types 274 ischaemia, features of 456 theophyllines 457 thiopentone 352, 383 thoracostomy 212 \200\22313 thorax injuries 246 \200 \2238 473 hallucinogenic fungi 471 heroin 475 ketamine 472 lysergic acid diethylamide 275 ligament injuries 276 muscle injuries 276 nerve injuries 276 patient assessment 274 RICE (r est, ice, compres- sion, eleva tion) 274 flail chest 247 rib fractures 246 sternal fractures 248 thromboembolism 95 thrombolysis 94, 117 tibial and fibula shaft fractures 263 \200\2234 (LSD) 473 methanol 474 opiates 475 phencyclidine 476 street names, for drugs of skin injuries 275 tendon injuries 276 vessels 275 abuse 478 \200\22380 volatile solvents 477 tibial plateau fractures 262 toiletries and cosmetics spinal injuries 280 \200\2233 sudden infant death anatomical landmarks 281 assessment 280 \200\2232 cervical spine injury 458 syndrome (SIDS) 524 torsade de pointes 333 training courses 6 \200\2239 tramadol 353, 372 transportation 696 \200\223701 suicide risk 483, 485 supracondylar fractures 280 \200\2233 hypoxia 280 \200\2232 immobilization 280 \200\2233 motor and sensory levels adults 236 children 237 femur 258 checks 30 \200\2231 driving law 30 \200\2231 lights and sirens 30 major incidents, suxamethonium (succinyl- 281 choline) 384 \200\2235 patient positioning 283 primary survey 282 \200\2233 secondary survey 282 \200\2233 spinal concussion 281 thoracolumbar fractures syncope 561 syntocinon (oxytocin) 350 systolic blood pressure ambulance circuit 581 medical transportation 696 patient packaging and loading 697, 698 patient transfer vehicles 606 \200\2237 280 \200\2233 transportation 283 see also cervical spine T tachycardia 97 \200\2239, 108 \200\22312, 696 Road Traffic Act (1976) injuries splintage 226 \200\2237 696 transportation mode, effects of 314 see also limb immobili- 696, 697 \200\2238 atrial fibrillation 109 atrial flutter 110 defibrillation 92 peri-arrest tachycardias zation vehicle limitations 697 see also air ambulances; ambulance service; driving, safe Transport ation Emergency (TREM) Cards 624 sports events 704 \200\2236 St Andrew \200\231s Ambulance Service 58, 593 St John \200\231s Ambulance 58, 94, 97 \200\2239 pulseless ventricular 593 (pulseless VT) 82, 90 \200\223100 Staphyloccocus aureus 515 status epilectus 146 sternoclavicular dislocations trauma trauma scoring 614 \200\22318 supraventricular tachy- anatomical systems 618 combined systems 618 physiological systems cardia 108 229 torsades de pointes 112 ventricular fibrillation 91 ventricular tachycardia (VT) 91, 94, 11 1 witnessed/unwitnessed stings see venomous bites and stings 614 \200\22317 stroke 144 sub-arachnoid hemorrhage triage 602 chemical incidents 626 \200\2237 children 550, 608 \200\22311 major incidents 581 (SAH) 145 arrest 92 tachypnoea 402 \200\2233 subdural haematoma 483 INDEX 718 primary triage 602 priorities 602 secondary triage 602 triage labeling 612 triage sieve 604 triage sort 606 \200\2237 violent behavior 462 \200\22380, diabetic emergencies 492 \200\2233 152 volatile solvents 477 voltarol 323 voluntary aid societies diagnosis 140, 142 drowning, near 564 \200\2237 pupil assessment 141 teeth injuries 206 \200\2237 see also AVPU assess- 593 tricyclic antidepressants voluntary services 58 398, 407, 459, 465, 403 ment; Glasgow Coma Scale TRISS (TRauma Score- W warfarin 412 waterproofs 20 whiplash injury 280 \200\2233 windlass technique 257 Women \200\231s Royal Voluntary Service (WRVS) 58, 593 Injury Severity Score) system 618 ureteric colic 161 ureteric injuries 222 urethral injuries 222 tube thoracocentesis 212 \200\22313 tube thoracostomy 135 turpentine 446 V vecuronium 385 \200\2236 venomous bites and stings U unconscious patients 140 \200\2232 airway obstruction 172 \200\2233 approach to 140 blood glucose 136, 140 children 498, 519 consent, treatment without 32 460 wrist fractures 242 jellyfish stings 460 sea urchins 460 spider bites 460 see also adder bite; Colles \200\231 fracture 242 epiphyseal fractures, children 242 Smith \200\231s fracture 24 2 Volar Barton \200\231s fracture snake bite ventilators 15 ventricular tachycardia 333 242 wrist injuries 277