Transition Guide

AAOS Emergency Care and Transportation of the Sick and Injured, 8^th Edition to the AAOS Emergency Care and Transportation of the Sick and Injured, 9^th

This guide is designed to assist instructors transitioning from the AAOS 8^th Edition to the AAOS 9^th Edition. It includes page references, brief chapter description, and any new material or features for each chapter in the new text. Progressive case studies with summaries are now included in each chapter.

Section 1: Preparing to be an EMT

Chapter 1: Introduction to Emergency Medical Care, pages 2-21 (AAOS 8^th Edition Chapter 1, pages 2-17)

A clear description of the EMT-Basic course, including a description of training goals, certification requirements, and the levels of Emergency Medical Technician certifications is provided. New material added to this chapter includes Emergency Medical Dispatch (EMD), GPS, and enhanced 9-1-1 systems.

Chapter 2: The Well-Being of the EMT-B, pages 22-69 (AAOS 8th Edition Chapter 2, pages 18-63)

This chapter provides an excellent section on death and dying. It also describes the grieving process, how EMT-Bs can handle critically ill patients, and how to sensitively interact with their caregivers and family members. Workplace issues, including cultural diversity and sexual harassment, are explored. New to this chapter are discussions on SARS, West Nile Virus, and Herpes Simplex. Definitive and presumptive signs of death have been added as well.

Chapter 3: Medical, Legal, and Ethical Issues, pages 70-89 (AAOS 8th Edition Chapter 3, pages 64-77)

An EMT-B’s role in regard to medical, legal, and ethical issues is discussed in detail. New information on HIPPA has been added to this chapter.

Chapter 4: The Human Body, pages 90-143 (AAOS 8th Edition Chapter 4, pages 78-125)

This chapter provides detailed and outstanding illustrations to help students develop a strong sense of anatomy. Special attention is paid to differences in pediatric patients and their specific needs.

Chapter 5: Baseline Vital Signs and SAMPLE History, pages 144-167 (AAOS 8th Edition Chapter 5, pages 126-145)

This chapter provides guidelines on interviewing patients, establishing the chief complaint, and using the AVPU scale to assess responsiveness. Information on OPQRST has been added to the SAMPLE history. Information on the Glasgow Coma Scale has been removed from this chapter.

Chapter 6: Lifting and Moving Patients, pages 168-207 (AAOS 8th Edition Chapter 6, pages 146-183)

This chapter focuses on giving directions and commands during patient moves. It provides a strong focus on rescuer safety and features an illustrated montage on rapid extrication from a car . This chapter has added information on geriatric and bariatric considerations.

Section 2: Airway

Chapter 7: Airway, pages 212-255 (AAOS 8th Edition Chapter 7, pages 184-223)

This chapter has been updated according to the 2002 U.S. DOT Airway Standard. An excellent introduction to pulmonary anatomy and physiology opens the chapter. The special consideration section highlights gastric distension, stomas, and tracheostomy tubes. Foreign body airway obstruction is examined with a focus on dental appliances and facial bleeding.

Section 3: Patient Assessment

Chapter 8: Patient Assessment, pages 260-311 (AAOS 8th Edition Chapter 8, pages 224-279)

This chapter integrates scene size-up and the initial, trauma, medical, and ongoing assessments into a logical, progressive sequence. Each topic is clearly defined with a bold new head-structure and colors that continue throughout the medical, trauma, and special populations modules. This feature allows the student to fully comprehend and apply the patient assessment process during the course and throughout his or her career.

Chapter 9: Communications and Documentation, pages 314-339 (AAOS Edition Chapter 9, pages 280-305)

Guidelines for developing communication skills with other healthcare professionals as well as special populations (pediatric, geriatric, hearing-impaired, and visually impaired patients) are discussed in this chapter. Information on minimum data set has been added. Also included is a helpful guide to writing the narrative report section of a PCR.

Section 4: Medical Emergencies

Chapter 10: General Pharmacology, pages342-363 (AAOS 8^th Edition Chapter 10, pages 306-321)

This chapter begins with an excellent introduction to pharmacology that identifies the pharmacologic terms that EMT-Basics need to know. It also includes a discussion of modes of administration and the abbreviations that the EMT-Basic must be familiar with. Pediatric and geriatric needs are highlighted andpolypharmacy is introduced. A chart on commonly prescribed medications has been added. Also, a discussion on herbal medications has been added.

Chapter 11: Respiratory Emergencies, pages 364-397 (AAOS Edition Chapter 11, pages 322-343)

This chapter provides an excellent chart listing and describing infectious diseases associated with dyspnea. Extensive description of the causes of dyspnea, including anaphylaxis, pulmonary edema, asthma, spontaneous pneumothorax, and more are discussed as well. This chapter integratesthe Patient Assessment flowchart specifically geared toward respiratory emergencies. An Assessment and Emergency Care summary also has been added.

Chapter 12: Cardiovascular Emergencies, pages 402-437 (AAOS 8th Edition Chapter 12, pages 344-373)

The chapter opens with an excellent cardiac anatomy and physiology section. Illustrations of ECGs (sinus tachycardia, bradycardia, ventricular tachycardia, and asystole) are included. New to this chapter are discussions on aspirin administration and updated pediatric AED guidelines. This chapter integrates the Patient Assessment flowchart specifically geared toward cardiovascular emergencies. An Assessment and Emergency Care summary also has been added.

Chapter 13: Neurologic Emergencies, pages 438-463 (AAOS 8th Edition Chapter 13, pages 374-391)

This is a dedicated chapter on stroke, seizures, and other causes of altered mental status. This chapter integrates the Patient Assessment flowchart specifically geared toward neurologic emergencies and includes separate flowcharts for both stroke and seizure. An Assessment and Emergency Care summary also has been added.

Chapter 14: The Acute Abdomen, pages 464-479 (AAOS 8th Edition Chapter 14, pages 392-401)

This chapter reinforces the anatomy and physiology of the abdomen, discusses the signs and symptoms of the acute abdomen, and introduces urinary and gynecologic problems as well. This chapter integratesthe Patient Assessment flowchart specifically geared toward the acute abdomen. An Assessment and Emergency Care summary also has been added.

Chapter 15: Diabetic Emergencies, pages 480-497 (AAOS 8th Edition Chapter 15, pages 402-413)

This is a dedicated chapter covering physiology and treatment of diabetic emergencies. This chapter now includes updated terminology and explanation of concepts according to the American Diabetes Association. The chapter integrates the Patient Assessment flowchart specifically geared toward diabetic emergencies.. An Assessment and Emergency Care summary also has been added.

Chapter 16: Allergic Reactions and Envenomations, pages 498-515 (AAOS 8th Edition Chapter 16, pages 414-431)

This chapter introduces emergencies involving allergens and envenomations. The human and animal bites have been moved to Chapter 24 (Soft Tissue Injuries). The chapter integrates the Patient Assessment flowchart specifically geared toward allergens and envenomations.. An Assessment and Emergency Care summary also has been added.

Chapter 17: Substance Abuse and Poisoning, pages 516-541 (AAOS 8th Edition Chapter 17, pages 432-451)

This chapter includes detailed sections covering illicit drugs by categories, including opioids, abused inhalants, etc. Food and plant poisoning also are discussed. The chapter integrates the Patient Assessment flowchart specifically geared toward substance abuse and poisoning. An Assessment and Emergency Care summary also has been added.

Chapter 18: Environmental Emergencies, pages 542-581 (AAOS 8^th Edition, Chapter 18, pages 452-475)

This chapter covers lightning injuries and injuries from marine life. It also contains spider, snake, and tick envenomation information covered in Chapter 16 in the previous edition. The chapter integrates the Patient Assessment flowchart and includes separate heat, cold, and diving emergencies flowcharts. An Assessment and Emergency Care summary also has been added.

Chapter 19: Behavioral Emergencies, pages 582-597 (AAOS 8th Edition Chapter 19, pages 476-489)

This chapter contrasts organic brain syndromes from functional disorders and medicolegal considerations in behavioral emergencies. The chapter integrates the Patient Assessment flowchart specifically geared toward behavioral emergencies. An Assessment and Emergency Care summary also has been added.

Chapter 20: Obstetric and Gynecologic Emergencies, pages 598-625 (AAOS 8th Edition Chapter 20, pages 490-513)

This chapter covers pre-birth, delivery emergencies, complications, and fetal demise topics. Information on spinal bifida has been added. The chapter integrates the Patient Assessment flowchart specifically geared toward obstetric and gynecologic emergencies. An Assessment and Emergency Care summary also has been added.

Section 5: Trauma

Chapter 21: Kinematics of Trauma, pages 630-647 (AAOS 8^th Edition Chapter 21, pages 514-527)

This chapter presents the EMT-Basic with an understanding of the physics involved in trauma, including deceleration, blunt and penetrating trauma, comprehending MOIs by assessing crashes, and contrasting suspected injuries from different types of car crashes (frontal, rollover, lateral and rear-end).

Chapter 22: Bleeding, pages 648-675 (AAOS 8th Edition Chapter 22, pages 528-545)

This chapter reviews the anatomy and physiology of the circulatory system, pathophysiology, and perfusion. The chapter integrates the Patient Assessment flowchart and includes both external and internal bleeding considerations. An Assessment and Emergency Care summary also has been added.

Chapter 23: Shock, pages 676-695 (AAOS 8th Edition Chapter 23, pages 546-561)

This chapter, dedicated solely to shock, begins with an in-depth look at the body’s compensatory mechanisms to maintain homeostasis. A clear explanation of perfusion and the compensatory mechanisms to maintain perfusion in a challenged state leads to a comprehensive description of types of shock and the progression of shock. Treatment for shock is differentiated by shock type. The chapter integrates the Patient Assessment flowchart specifically geared toward shock. An Assessment and Emergency Care summary also has been added.

Chapter 24: Soft-Tissue Injuries, pages 696-733 (AAOS 8th Edition Chapter 24, pages 562-585)

This chapter discusses information on small animal bites, rabies, and human bites. This information was covered in Chapter 16 in the previous edition. The chapter integrates the Patient Assessment flowchart and separately covers open and closed injuries. An Assessment and Emergency Care summary also has been added.

Chapter 25: Eye Injuries, pages 734-755 (AAOS 8th Edition Chapter 25, pages 586-599)

This chapter covers eye anatomy and physiology, burns, blunt trauma, foreign objects, and contact lenses. The chapter integrates the Patient Assessment flowchart specifically geared toward eye injuries. An Assessment and Emergency Care summary also has been added.

Chapter 26: Face and Throat Injuries, pages 756-775 (AAOS 8th Edition Chapter 26, pages 600-611)

This chapter covers special considerations for trauma care of throat and facial structures. The chapter integrates the Patient Assessment flowchart specifically geared toward face and throat injuries. An Assessment and Emergency Care summary also has been added.

Chapter 27: Chest Injuries, pages 776-795 (AAOS 8thEdition Chapter 27, pages 612-623)

This chapter covers the mechanics of ventilation and the implications in chest injury, traumatic asphyxia, cardiac tamponade, and laceration of great vessels. The chapter integrates the Patient Assessment flowchart specifically geared toward chest injuries. An Assessment and Emergency Care summary also has been added.

Chapter 28: Abdomen and Genitalia Injuries, pages 796-817 (AAOS 8th Edition Chapter 28, pages 624-637)

This chapter covers injuries from seat belts and airbags, eviscerations, genitourinary trauma, and rectal bleeding. The chapter integrates the Patient Assessment flowchart specifically geared toward abdomen and genitalia injuries . An Assessment and Emergency Care summary also has been added.

Chapter 29: Musculoskeletal Care, pages 818-869 (AAOS 8th Edition Chapter 29, pages 638-679)

This chapter covers a review of musculoskeletal anatomy and physiology and discusses all types of injury and treatment considerations. The chapter integrates the Patient Assessment flowchart specifically geared toward musculoskeletal injuries. An Assessment and Emergency Care summary also has been added.

Chapter 30: Head and Spine Injuries, pages 870-911 (AAOS 8th Edition Chapter 30, pages 680-713)

This chapter covers a review of nervous and skeletal system anatomy and physiology and injury and treatment considerations. The chapter integrates the Patient Assessment flowchart specifically geared toward head and spine injuries. An Assessment and Emergency Care summary also has been added.

Section 6: Special Populations

Chapter 31: Pediatric Emergencies, pages 914-939 (AAOS 8th Edition Chapters 31, 32, and 33, pages by topic listed below)

The pediatric considerations, emergencies, and the assessment/management are now presented in two chapters.

- Anatomy and physiology /Growth and Development, pages 914-920 (8th Edition Chapter 31, pages 714-722)

- Family Matters, page 921 (8th Edition Chapter 31, page 728)

- Pediatric Emergencies, pages 921-923 (8th Edition Chapter 32, pages 747-755)

- Pediatric Trauma, pages 924-925 (8th Edition Chapter 33, pages 772-777)

- Injuries to Specific Body Systems, pages 925-927 (8th Edition Chapter 33 pages 774- 777)

- Child Abuse, pages 927-929 (8th Edition, Chapter 33, pages 779-783)

- SIDS, pages 930-932 (8th Edition Chapter, pages 763-764)

- Infants and Children with Special Needs, pages 933-936 (8th Edition Chapter 31, pages 726-728)

Chapter 32: Pediatric Assessment and Management, pages 940-983 (AAOS 8th Edition Chapters 31, 32, and 33, pages by topic listed below)

This chapter introduces the American Academy of Pediatrics Pediatric Assessment Triangle (PAT), BLS review of pediatric CPR, and using AEDs on children. Also included is the Patient Assessment flowchart and Assessment and Emergency Care table.

- Pediatric Assessment and Management, pages 940-950 (8th Edition Chapter 31, pages 722-724)

- The Pediatric Airway, pages 950-954 (8th Edition Chapter 32, pages 735-738)

- Oxygen Delivery Devices, pages 954-958 (8th Edition Chapter 32 pages 738-741)

- Airway Obstruction, pages 958-962 (8th Edition, Chapter 32, page 742)

- Neonatal Resuscitation, pages 963-964 (8th Edition Chapter 32, pages 755-756)

- BLS Review, pages 964-970 (8th Edition Chapter 32, pages 757-763)

- Pediatric Trauma, pages 971-975 (8th Edition Chapter 33, pages 772-781)

- Pediatric Medical Emergencies, pages 975-978 (8th Edition Chapter 32 pages 747-754)

Chapter 33: Geriatric Emergencies, pages 984-1001 (AAOS 8th Edition Chapter 34, pages 786-803)

This chapter introduces the use of the GEMS Diamond for thorough assessment of geriatric patients, physiologic changes that occur in aging, and their relevance in prehospital care. It also includes discussion on polypharmacy and elder abuse.

Chapter 34: Geriatric Assessment and Management, pages 1004-1019 (AAOS Chapter 34, pages 786-803)

Like the pediatric chapters, assessment and care is covered in a separate chapter.. The chapter integrates the Patient Assessment flowchart specifically geared toward geriatric considerations.

Section 7: Operations

Chapter 35: Ambulance Operations, pages 1024-1055 (AAOS 8th Edition Chapter 35, pages 804-829)

In this chapter, phases of an ambulance call, defensive ambulance driving techniques, and expanded information on air medical operations are discussed.

Chapter 36: Gaining Access, pages 1058-1071 (AAOS 8th Edition Chapter 36, pages 830-841)

This chapter discusses vehicle safety systems, fundamentals of extrication, and specialized rescue situations.

Chapter 37: Special Operations, pages 1072-1097 (AAOS 8th Edition Chapter 37, pages 842-863)

This chapter covers the National Incident Management System (NIMS) as well as mass casualty incidents (MCI), disaster management, and hazardous materials.

Chapter 38: Response to Terrorism and Weapons of Mass Destruction, pages 1098-1127 (New Chapter)

This chapter includes discussions on weapons of mass destruction including the EMT-Basic’s response to terrorism. Chemical agents, biological agents, and radiological/nuclear devices are also discussed.

Section 8: ALS Techniques

Chapter 39: Advanced Airway Management, pages 1130-1163 (AAOS 8th Edition Chapter 38, pages 864-891)

This chapter discusses advanced airway techniques including anatomy and physiology, basic airway management, gastric tubes, endotracheal intubation, and multilumen airways.

Chapter 40: Assisting with IV Therapy, pages 1164-1179 (New Chapter)

This chapter provides detail on IV therapy, terminology relating to IV insertion, and tools and techniques. Complications of IV therapy, troubleshooting IV problems, and pediatric and geriatric considerations are also discussed.

Chapter 41: Assisting with Cardiac Monitoring, pages 1180-1195 (New Chapter)

This chapter provides and EMT-Basics with an introduction to cardiac monitoring and ECG formation and arrhythmias.

Appendix A: BLS Review, pages A1-A31 (AAOS 8th Edition Appendix A, pages 920-928)

This appendix provides a comprehensive review of basic life support techniques for adults, children, and infants.