Critical Care Transport, Third Edition: Essential Guidance For Healthcare Providers.pdf

CHAPTER 1 Introduction and Overview of Critical Care Transport
Expanded discussion of transport choreography
Added description of the National EMS-ID number system developed in 2020 by the National Registry of Emergency Medical Technicians
Expanded discussion of quality assurance and improvement efforts in CCT

CHAPTER 2 Medical-Legal Issues
Extensively reorganized and streamlined content to meet the learning needs of CCTP students without undue repetition of concepts learned in previous EMS training
Updated discussion of the Emergency Medical Treatment and Active Labor Act (EMTALA) and the Health Insurance Portability and Accountability Act (HIPAA)
Reinforcement of documentation and communication skills required to ensure a safe, effective patient transport that protects providers and services from claims of unlawful conduct

CHAPTER 3 Patient Safety
Updated discussion of medical errors and reduction efforts in EMS, including error reporting requirements and databases, trigger tools that prompt investigation into systemic problems, and quality measures that review performance across the EMS industry

CHAPTER 4 Aircraft Fundamentals and Flight Physiology
Updated discussion of incidence and causes of air medical crashes and of air medical safety initiatives

CHAPTER 5 Patient Assessment
Reorganized and streamlined discussion of the assessment process used to establish the initial care plan, make appropriate treatment decisions, and assess the effects of treatments
Problem-focused review of the systems included in the primary assessment
NEW discussion of assessing the hemorrhaging patient
Updated discussion of key assessment tools, including the Richmond Agitation–Sedation Scale (RASS), cranial nerve assessment, exposure assessment, and Sequential [Sepsis-related] Organ Failure Assessment (SOFA)
Expanded discussion of ongoing assessment tools available to the CCT team, including imaging (eg, ultrasonography) and electrocardiography

CHAPTER 6 Respiratory Emergencies and Airway Management
Improved discussion of the fundamentals of gas exchange and the patient breathing assessment, including use of tools such as point-of-care lung ultrasonography
Extensive reorganization to clearly focus on assessment and management of both routine and difficult airway, including pearls to facilitate better monitoring and support of airways and breathing
NEW skill drill to review i-gel airway insertion

CHAPTER 7 Ventilation
NEW chapter devoted entirely to the skill of ventilatory support
Advanced review of the fundamentals and mechanics of ventilation
Broad-to-specific approach to the various modes of mechanical ventilation
Review of noninvasive methods of ventilatory support, such as high-flow nasal cannula and continuous positive airway pressure (CPAP)
Detailed discussion, complete with photographs, of mechanical ventilatory equipment, modes, parameters, and alarms
Updated overview of calculations used to assess and maintain adequate oxygenation and ventilation

CHAPTER 8 Critical Care Pharmacology
Revised discussion of pharmacodynamics and dosing considerations
Closely reviewed and updated information on a wide variety of critical care medications the CCTP may encounter

CHAPTER 9 Laboratory Analysis and Diagnostic Studies
Expanded discussions of lab analysis processes, such as specimen culture, phosphate monitoring, white blood cell count differential, and inflammatory markers
Expanded discussion of coagulation system assessment, including new information on factor Xa levels and use of thromboelastography
Up-to-date overview of diagnostic imaging modalities, including new sections on positron emission tomography (PET), CT polytrauma (pan scan), cardiac imaging (eg, echocardiography, myocardial perfusion imaging, coronary angiography), and expanded coverage of ultrasonography

CHAPTER 10 Resuscitation, Shock, and Blood Products
Expanded discussion of management of cardiogenic shock
Updated discussion of sepsis recognition (eg, National Early Warning Score [NEWS]) and management (eg, current recommendations from the Surviving Sepsis Campaign, use of glucocorticoid steroids)
Updated guidelines for large-volume resuscitation, blood transfusion, and administration of blood products
Updated guidelines for emergency reversal of oral anticoagulants

CHAPTER 11 Trauma
Revised overview of trauma center levels and criteria for determining the appropriate patient destination
Updated discussion of the lethal triad of hypothermia, acidosis, and coagulopathy, including revised recommendations for volume resuscitation
Updated discussion of the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for patients in hemorrhagic shock with massive blood loss

CHAPTER 12 Neurologic Emergencies
Added description of the role of the thrombolytic agent tissue plasminogen activator (tPA) for patients who have experienced a stroke
Updated discussion of the ever-expanding criteria for stroke activations
Discussion of technologic advances that have made endovascular interventions for reperfusion therapy the gold standard for large vessel occlusion (LVO) strokes
Discussion of the need for organized and coordinated stroke systems to provide the time-sensitive interventions needed to improve patient outcomes
NEW section on ICP waveform interpretation

CHAPTER 13 Burns
Discussion of ketamine as a pain control option for the burn patient
Expanded discussion of fluid management in the burn patient