Avoiding Common Prehospital Errors

Avoiding Common Prehospital Errors 9781451131598
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Publication Date: Sep 21, 2012
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ISBN/ISSN: 9781451131598
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Avoiding Common Prehospital Errors, will help you develop the deep understanding of common patient presentations necessary to prevent diagnostic and treatment errors and to improve outcomes.  Providing effective emergency care in the field is among the most challenging tasks in medicine. You must be able to make clinically vital decisions quickly, and perform a wide range of procedures, often under volatile conditions.

Written specifically for the prehospital emergency team, this essential volume in the Avoiding Common Errors Series combines evidence-based practice with well-earned experience and best practices opinion to help you avoid common errors of prehospital care.

Look inside and discover…

• Concise descriptions of each error are followed by insightful analysis of the “hows” and “whys” underlying the mistake, and clear descriptions of ways to avoid such errors in the future.

• “Pearls” highlighted in the text offer quick vital tips on error avoidance based on years of clinical and field experience.

• Focused content emphasizes "high impact" areas of prehospital medicine, including airway management, cardiac arrest, and respiratory and traumatic emergencies.

Features

• Concise descriptions of each error are followed by insightful analysis of the “hows” and “whys” underlying the mistake, and clear descriptions of ways to avoid such errors in the future.
• “Pearls” highlighted in the text offer quick vital tips on error avoidance based on years of clinical and field experience.
• Focused content
emphasizes "high impact" areas of prehospital medicine, including airway management, cardiac arrest, and respiratory and traumatic emergencies.

About the Author(s)

  • Benjamin J Lawner DO, EMT-P
  • Assistant Professor, Department of Emergency MedicineUniversity of Maryland School of MedicineDeputy Medical Director, Baltimore City Fire DepartmentBaltimore, Maryland</


  • Raymond Fowler MD, FACEP
  • Professor of Emergency Medicine, Surgery, Health Professions, and Emergency Medical EducationUniversity of Texas Southwestern Medical CenterAttending Emergency Medicine Faculty, Parkland Memorial Hospital

  • Paul Pepe MD, MPH, MACP, FCCM, FACE
  • Professor&#160;of the Division of Emergency Medicine, Surgery, Medicine, Pediatrics, and Public HealthRiggs Family Chair in Emergency MedicineUniversity of Texas Southwestern Medica

  • Amal Mattu MD
  • Professor and Vice ChairDepartment of Emergency MedicineUniversity of Maryland School of MedicineBaltimore, Maryland

Specs

  • Product Format: Softbound
  • ISBN: 9781451131598
  • Trim Size: 5 x 8
  • Pages: 452
  • Pub Date: Sep 21, 2012
  • Weight: 1.0

Table of contents

Section I  Airway Management

1         Don’t Have a Failed Airway Because You Failed to Prepare

Marianne Gausche-Hill

 

2         Don’t Forget to Properly Position the Patient Prior to Attempting Intubation!

Christopher Touzeau and Benjamin Kaufman

 

3         Which Patients Should Undergo RSI? It’s Not Just About the Clenched Jaw!

Benjamin Kaufman and Christopher Touzeau

 

4         If a Non-rebreather Is Not Cutting It, Slap on the PAP. Use Noninvasive Positive Pressure in Patients in Moderate to Severe Respiratory Distress

Steven Barmach

 

5         Cannulas Aren’t Just for Supplemental Oxygen Anymore: Use EtCO2 for Differentiating Causes of Respiratory Distress

Jonathan Wendell

 

6         Errors in Difficult Airway Assessment: Always Assess the Anatomy First

Jonathan Wenk

 

7         Problems Encountered with Movement and Airway Management: Confirm and Reconfirm Endotracheal Intubation

Scott H. Wheatley

 

8         High Pressure Airway? Lay Off the Cricoid!

Benjamin Lawner

 

9         Don’t Be So Quick to Throw Your Battery-Operated Laryngoscope Away!

Benjamin Lawner

 

10     Drop That Tube!

Stephen C. Andrews

 

11     It’s Not All About Intubation: New Perspectives on Prehospital Airway Management

Kevin G. Seaman

 

12     GCS Less Than 8? Don’t Automatically Intubate!

Benjamin Lawner

 

13     I Can’t See Cords! What to Do When You’re Already in Too Deep

Benjamin Lawner

 

14     Pediatric Airway Management: Don’t Underestimate the Value of a Stepwise Approach

Spencer C. Smith

 

15     Practice Makes Perfect: There’s Never Enough Practice

Jessica Manka and Cynthia Shen

 

16     RSI Without Paralytics? Just Don’t Do It

Benjamin Lawner

 

17     Tantalizingly Tangible Techniques for Telegraphing the Tough Tube

P. Marc Fischer and Kevin G. Seaman

 

Section II  Respiratory Emergencies

18     Avoid Becoming a Patient When Transporting One

Jeremy Brywczynski and Jared McKinney

 

19     Avoid Hyperventilation and Know the Downfalls of Positive Pressure in the Intubated Patient

Jeffrey M. Goodloe

 

20     Be Careful of Just a Little Blood!

Benjamin W. Webster

 

21     Fear the Tracheostomy Patient!

Christopher B. Colwell

 

22     Common Pitfalls in the Use of Pulse Oximetry

Karen Wanger

 

23     Beware the Intubated Patient!

Jared McKinney and Jeremy Brywczynski

 

24     Don’t Underestimate Waveform Capnography in the Intubated Patient

Jeffrey M. Goodloe

 

25     The Dos and Don’ts of Nitroglycerin in Acute Respiratory Distress

James V. Dunford

 

26     Fear the Elderly Patient With New Onset Wheezing

Marc Eckstein

 

27     The Perils and Pitfalls of Needle Decompression

Jullette M. Saussy

 

28     Don’t Forget CPAP in Prehospital Respiratory Distress

Kathleen Schrank

 

29     Use Caution With Morphine in Treatment of Acute Cardiogenic Pulmonary Edema

       Neal Richmond and Jesse Yarbrough

 

30     To PE or Not to PE? Don’t Forget Embolism in the Patient With Shortness of Breath!

Neal Richmond and Jesse Yarbrough

 

31     Avoid Inappropriate Administration of Furosemide

Jullette M. Saussy

 

32     Shortness of Breath: It’s Not Always the Lungs

Corey M. Slovis

 

33     Adults Get Stridor Too

Jeff Beeson

 

34     The Perils of Treating a Patient in Status Asthmaticus

John P. Freese

 

35     Toxic Inhalation Pitfalls

J. Brent Meyers

 

36     Don’t Administer Too Much or Too Little Oxygen to the COPD Patient

       Terence Valenzuela and Jarrod Mosier

 

 

Section III  Cardiac Emergencies and ECG

37     Don’t Fail to Interpret Tachycardia

        Sean Covant and Ray Fowler

 

38     Don’t Fail to Interpret Bradycardia

Sean Covant and Ray Fowler

 

39     Don’t Be Fooled by These ECG Mimics

       Sean Covant

 

40     Don’t Forget That There Are Many Causes of Chest Pain

David Lehrfeld

 

41     Don’t Forget to Analyze Wide Complex Tachycardias

       David Lehrfeld

 

42     Don’t Miss the Subtle ECG Findings of STEMI

              A. J. Kirk

 

Section IV  Management of Cardiac Arrest

43  Don’t Overlook the Role of Hands-Only CPR in Community-Based Strategies for Survival

         Jennifer Triaca

44  Don’t Overlook the Uses of Capnography in Cardiac Arrest

Max Patterson and Jonathan C. Wendell

45  Do Not Interrupt CPR for More Than 10 Seconds: It Can Be the Difference Between Staying Alive and Biting the Dust

Jonathan Wenk

46  Pay Close Attention to BLS Intervention!

              Joel Higuchi

47  Refer Your Patients With ROSC to the Most Appropriate Facility

             Bruce G. VanHoy

48  It’s a Cold Day on the Horizon: Chill Your ROSC Patients Out!

            Rick Leonard and Kevin G. Seaman

49  Chest Compressions Are Your Most “Advanced” BLS Technique

           Gregory R. Valcourt and Kevin G. Seaman

50  CPR Devices: Don’t Believe Everything You Hear

           Sam Matta

51  Confirmation Is About More Than Direct Visualization, Especially in Cardiac Arrest

           Scott H. Wheatley and Elizabeth Moye

52  Know When to Say “When!”: Termination of Resuscitation Efforts in Cardiac Arrest

           Thomas G. Chiccone

53  Noninvasive Airway Management in Cardiac Arrest: Think Beyond Intubation

           Alexander J. Perricone

54  Do Not Fail to Ensure Quality Chest Compressions!

          Cerisa C. Speight and Dale E. Becker

55  Involve Your Community in Cardiac Arrest: Together You Can Make a Difference

           Cassandra M. Chiras and Kevin G. Seaman

56  Teamwork in Cardiac Arrest: No One Codes Alone

            Elizabeth L. Seaman and Kevin G. Seaman

57  Think About Where to Begin Your Resuscitation!

            Gregory R. Valcourt and Kevin G. Seaman

 

Section V   Trauma Emergencies

58  Neglecting to Take a Thorough Patient History

           Patrick Brady

59  Failure to Fully Assess the Patient

           Patrick Brady

60  Pitfalls in Confirming Death at Scene

           Patrick Brady

61  Failure to Document

          Patrick Brady

62  Transporting a Patient to an Inappropriate Facility

           Patrick Brady

63  Pitfalls in Spinal Immobilization for Trauma Patients

          Patrick Brady

64  Don’t Forget to Look for a “Cardiac Cause” of an Accident

         Stephen Bock

65  Don’t Underestimate Hemorrhage From Pelvic and Long Bone Fractures

          Stephen Bock

66  Pitfalls in Vascular Access in the Trauma Patient

          Stephen Bock

67  Failure to Adequately Manage the Patient’s Airway

          A. J. Kirk

68  Don’t Fail to Control Hemorrhage If Possible

            A. J. Kirk

69  Don’t Forget to Treat Pain

A. J. Kirk

70  Failure to Recognize Penetrating Trauma

A. J. Kirk

 

Section VI  Pediatric Emergencies

71  Don’t Wait for Hypotension to Diagnose Shock

              Brian S. Bassham

72  Kids With Altered Mental Status Need a Glucose Check

             Timothy E. Brenkert

73  Refusing Pediatric Refusals: Beneath the Surface of the Iceberg

        Eric Clauss and Lee Blair

74  Don’t Intubate That Child!

        Patrick Drayna

75  Weight-Based Care Is Essential in the Care of Children

       Cristina Estrada

76  Think Intraosseous, Not Intravenous

        Laurie MacPherson Lawrence

77  Pain Management Is Not Just for Adults

        Matthew R. Locklair

78  If You Are Missing the Vital Signs, You Are Missing the Point!

        Julie Phillips

79  Not Are Pediatric Seizures Are Status

        Valerie N. Whatley

80  All That Wheezes Is Not Asthma

        Abby M. Williams

 

Section VII  Aeromedical/Critical Care Considerations

81  Trauma Transport: Don’t Forget You Can Drive!

       Chris Touzeau and Ben Kaufman

82  Don’t Be Afraid to Use Existing Central Venous Catheters!

       Chris Touzeau and Ben Kaufman

83  The Dynamic Environment of a Helicopter Landing Zone: Always Remain Aware!

       Matt Messinger

84  Know Your HEMS Providers: They’re Not All Alike!

       Kevin High

85  Requesting a Helicopter Is a Medical Decision: Choose the Right Patient for Aviation Utilization

      Roger M. Stone

86  Don’t Wait for the Helicopter! Pitfalls in Aviation Selection

      Roger M. Stone

87  Pearls and Pitfalls of Interhospital Transport: It’s About Much More Than Paperwork!

      Robert Dice and Kevin G. Seaman

88  Sedation During Transport: Think Beyond Paralysis!

       Jill D. Smith and Cynthia S. Shen

89  Understand the Spectrum of Sepsis: How to Identify, Monitor, and Treat!

       Jill D. Smith and Cynthia S. Shen

90  Don’t Fear the Pressor!

      Sam Matta

 

Section VIII   Incident Command/Disaster

91  Avoid Being the Modern Day Canary: Ensure Scene Safety When Responding to a Mass Casualty Event

     Frederick W. Smith

92  Prepare, Prepackage, and Pre-plan the Disaster Pack You Need

     Brian Froelke

93  Don’t Forget the Special Populations That Require Special Response

     Brian Froelke and Hawnwan Philip Moy

94  From the Hot Zone to Hospitals: Transport Your Patients Safely and Efficiently

     Frederick W. Smith

95  Understand How Your PPE Works Before the Big Day

     Michael T. Lohmeier

96  Know the Value of Stakeholder Communications

     Mark D. Levine and Jacob B. Keeperman

97  Know the Principles of Disaster Management Before an Event Occurs

     Mario Luis Ramirez

98  Know How to Interact With the Media

     Greg Taggard

99  Ensure Optimal Communication Between All Parties

     Jacob B. Keeperman

100  Use an Appropriate Triage System to Guide Decision Making in the Mass Casualty Setting

     Michael T. Lohmeier

 

Section IX   Customer Service/Medicolegal

101  Never Forget: EMS Is Mostly About Great Customer Service!

     Kevin G. Seaman

102  Don’t Forget to Keep an Open Mind With Each New Call

     Roger M. Stone

103  Don’t Fail to Manage the Difficult But Still Manageable Consumer

      Roger M. Stone

104  The Buck Has to Stop at Quality Assurance/Leadership Offices

     Roger M. Stone

105  Don’t Leave High-Risk Chief Complaints on the Scene!

     Roger M. Stone

106  Don’t Drop the Ball in the Dispatch Center

     Roger M. Stone

107  Avoid Engaging in Conflict When Responding to Health Care Facilities

     Roger M. Stone

108  Don’t Fail to Consider the Family

     Jeff Beeson

109  Don’t Post Patient or Family Info on Social Media

     Jeff Beeson

110  Consent and Confidentiality in EMS

     R. Jack Ayres, Chris Ayres, and Wendy Ruggeri

111  Don’t Be Guilty of Showing Negligence

     R. Jack Ayres, Chris Ayres, and Wendy Ruggeri

112  Don’t Confuse Roles in the EMS

     R. Jack Ayres, Chris Ayres, and Wendy Ruggeri

113  Don’t Make These Common Errors in Managing Medications and Maintaining a Clear Patient Care Environment

     Brad London

 

Section X   Behavioral/Psychiatric

114 Know the Pros and Cons of Chemical Restraint

     C. Crawford Mechem

115 Consider Physical Restraint as a Last Resort Option for the Combative Patient

     Sabina Braithwaite and Jon E. Friesen

116  Do Not Overdose Anxiety

     David Persse

117  Don’t Assume the Intoxicated Patient Is Just Drunk

     Corey M. Slovis

118  Consider Neuroleptic Malignant Syndrome and Serotonin Syndrome in Psychiatric Patients

     Elizabeth M. LiCalzi and Amanda G. Wilson

119  Don’t Miss the Diagnosis of Excited Delirium

     Joseph Eugene Holley, Jr.

120  Keep Yourself Safe on the Scene

     Amanda G. Wilson

121  Recognize the Malingerer!

     Amanda G. Wilson

122  Be Wary of the Suicidal Patient!

     Amanda G. Wilson

 

Section XI   OB/GYN Emergencies

123    Don’t Miss Pulmonary Embolism in the Pregnant Patient!

Anders Apgar

124  Don’t Get Tangled Up in a Cord Emergency

     Morgan M. Walker

125  Don’t Throw Your Hands Up Just Yet: What You Need to Know About Hyperemesis

     Morgan M. Walker and Benjamin Lawner

126  Don’t Dismiss Headaches in the Postpartum Patient

Anders Apgar

127  It Can Still Be a Surprise, Even After Nine Months! Do Not Fail to Prepare for the Emergent Delivery

     Theresa Gallo and Kevin G. Seaman

128  Don’t Be Shocked When It’s Occult Birth!

     Azher Merchant

 

Section XII   Neurologic Emergencies

129  Failure to Consider Child Abuse in Pediatric AMS

     Gilberto Salazar

130  Failure to Consider Drugs, Toxins, and Meds in AMS

     Gilberto Salazar

131  Failure to Consider Excited Delirium

     Gilberto Salazar

132  Failure to Consider Hypoglycemia

     Gilberto Salazar

133  Failure to Consider Hypoxia Causing AMS

     Gilberto Salazar

134  Failure to Diagnose or to Transfer to a Stroke Center

     Gilberto Salazar

135  Failure to Evaluate Headache

     Gilberto Salazar

136  Failure to Immobilize CNS Injuries

     Gilberto Salazar

137  Failure to Suspect a Cord Problem in Back Pain

     Gilberto Salazar

138  Failure to Suspect Increased ICP and Manage Airway

     Gilberto Salazar

Index