急救员培训课程

美国的急救员培训课程

1精选课件前言上世纪六十年代美国开始培养专业急救人员现今,美国大多数州的急救员主要从消防员（firefighter）中选拔和培养，分为初级急救员（EMT）和高级急救员（Paramedic）两个层次2精选课件前言洛杉矶急救员培训中心（PTI）成立于1969年,经过多年的教学实践，已经形成完善的教学体系每期培训需7个月，包括课程学习和现场实践培训内容包括基础知识、操作技能和该领域的最新进展每周有2-3次的考核和讲评，根据成绩进行筛选，最后的淘汰率超过1/3经过培训的高级急救员已经具备能应对绝大多数现场情况的急救知识和技能3精选课件院前急救人员培训重点内容4精选课件1、基础知识解剖学和生理学：循环系统、呼吸系统和神经系统药物学：药物的性质、分类和作用，药代动力学和药效学，胃肠道给药（口服、胃管、舌下黏膜、直肠），非胃肠道给药（经静脉、骨髓、气管导管、肌肉和皮下），急救药物的应用5精选课件2、临床知识诊断学：生命体征（vitalsigns）、病人评估和记录（patientassessmentanddocumentation），心电图学各系统急症：心血管急症和复苏药物，休克，呼吸急症，神经系统急症，腹部非创伤急症，肾脏和泌尿系统急症，内分泌急症，血液急症，传染性急症创伤性急症：损伤机制，现场分检，头面部、脊柱、胸部、腹部、肌肉和软组织创伤，烧伤6精选课件2、临床知识妇产科急症：紧急分娩，出血儿童急症：病情评估，各系统急症，儿童创伤特点，儿童气道管理，儿童虐待其它急症：急性中毒和药物过量，环境因素所致急症，精神行为异常所致急症核、生物和化学武器所致灾难7精选课件3、社会学知识与院前急救有关的法律法规急救专业特点和职业道德老年人的相关问题院外死亡犯罪现场的保护急救人员压力疏导8精选课件4、技能操作病人评估基本生命支持（BLS）：成人CPR，儿童CPR，呼吸道异物排除高级气道管理：气囊-活瓣-面罩辅助呼吸囊（BVM），气管内导管，食道气管双腔导管。电治疗：电除颤，同步电复律非胃肠道给药方法：经静脉、骨髓、气管导管、肌肉、皮下9精选课件4、技能操作胸腔针刺排气气管环穿刺夹板固定脊柱固定紧急分娩儿童复苏带抗休克裤现场急救药物10精选课件4、技能操作模拟急救现场临床见习参观大型教学医院急诊科参观病理解剖所11精选课件理论课程内容

ContentsofParamedicTraining

12精选课件MedicalTerminology医学名词PrefixesSuffixesRootwordAbbreviationsAcronyms13精选课件

SurfaceAnatomy大体解剖

AnatomicaldivisionsThetenhumansystems:integumentary,skeletal,muscular,cardiovascular,respiratory,digestive,renal,endocrine,nervous,reproductive14精选课件AppliedPhysiology应用生理CellMetabolism:acid-basebalance,fluidsandelectrolytesinflammation15精选课件CirculatorySystem循环系统WholebloodArteries,capillaries,veinsPressure,perfusionCirculatoryabnormalitis16精选课件Normalheart正常心脏StructureMechanismBloodflowthroughtheheartHeartvalvesCoronarycirculationConductionsystemElectricaleventCardiacoutput17精选课件RespiratorySystem呼吸系统UpperairwayandlowerairwayLungsGasexchangeprocessesMechanicsofbreathingRespiratorydistressRespiratoryassessmentAbnormalbreathsounds18精选课件TheNervousSystem神经系统NeuronCerebralspinalfluidBrain:cerebrum,hypothalamus,cerebellum,brainstemSpinalcordPeripheralnervoussystemSomaticnervoussystem19精选课件NeurologicalAssessment神经状态评估GCSCerebraldysfunctionInter-cranialpressure(ICP)Levelofconsciousness(LOC)AbnormalrespiratorypatternsSpinalcordinjury20精选课件VitalSigns生命体征TemperaturePulseVentilationBloodpressureSkinassessment21精选课件EMSReportFormTraining急救记录报告的书写Documentation文书ProfessionalismandEthics职业道德和伦理22精选课件PatientAssessment患者评估Scenesize-upInitialassessmentFocusedhistoryandphysicalOngoingassessmentDetailedphysicalexamRadioreport23精选课件AsepticTechniques控制感染技术MedicalasepsisSurgicalasepsisSterileconsciencePre-existingvascularassessdevice(PVAD)24精选课件IntravenousTherapy侵入性治疗技术IntravenousequipmentVenousaccesssitesIVcannulationtechniqueEquivalentsandConversion计量和换算25精选课件BasicPharmacology药物学基础Drugnames,sources,classificationDruglawsandregulationsSchedulesofdrugsFormsofdrugsParamedicresponsibilitieswithmedicationadministrationRoutesofdrugsadministration:enteralroutes,parenteralroutes26精选课件BasicPharmacology药物学基础Phasesofdrugactivity:pharmacokinetics,pharmacodynamicsActionsofdrugsResponsestodrugadministrationDrugresponserelationshipDrugprofileLAcountyapprovedmedications27精选课件MedicationAdministration给药途径Bodysubstanceisolation(BSI)AseptictechniquewithMASixrightsofMADICCEpriortoMA28精选课件MedicationAdministration给药途径Enteralroutes:oraldrugadministration,gastrictubeadministration,sublingual(SL)administration,buccal(TM)administration,rectaladministrationParenteralroutes:intravenous(IV)administration,intraosseous(IO)administration,endotracheal(ET)administration,intramuscular(IM)administration,subcutaneous(SQ)administration29精选课件IntroductiontoIVTherapy静脉疗法Types,packagingofIVfluidsTypesofIVtubingSettingupanIVlineCathetersVenousaccesssitesIVcannulationtechnique30精选课件IntroductiontoIVTherapy静脉疗法PeripheralIVaccessinanexternaljugularveinComplicationsofIVtherapyIVbolustechniqueIVpiggyback(IVPB)Drawingupmedications31精选课件AdvancedAirwayManagement高级气道管理ReviewofupperairwayAnatomyreviewBasicairwayreviewOxygendeliverySuctioningOPairwaysNPairwaysBag-valve-mask32精选课件AdvancedAirwayManagement高级气道管理Sellick’smaneuverDifficultairwayevaluationIntubationMulti-lumenairway(combi-tube)sMagillforcepsTracheostomy/LaryngectomyETmedicationadministrationNeedlecricothyroidology33精选课件IntroductiontoEKG心电图基础MusclephysiologyConductionsystemMonitorandleadsMorphology34精选课件SinusMechanisms窦性心律NormalsinusrhythmSinustachycardiaSinusbradycardiaSinusarrhythmiaSinusarrest35精选课件AtrialMechanisms房性心律Prematureatrialcontraction(PAC)Supraventriculartachycardia(SVT)ParoxysmalSupraventriculartachycardia(PSVT)Wolf-Parkinson-Whitesyndrome(WPW)AtrialflutterAtrialfibrillation36精选课件JunctionalMechanisms交界性心律Prematurejunctionalconreaction(PJC)JunctionalescapebeatsorcontractionsSpecificjunctionalrhythms:escapejunctionalrhythm,acceleratedjunctionalrhythm,junctionaltachycardia37精选课件VentricularMechanisms室性心律Prematureventricularcontraction(PVC)VentricularescapebeatsorcomplexesSpecificventricularrhythms:ventricularbigeminy,ventricularescaperhythm,acceleratedventricularrhythm,venrtriculartachycardiaTorsadesdepoint38精选课件VentricularMechanisms室性心律VentricularconductiondisturbanceVentricularfibrillationAgonalrhythmAsystole39精选课件HeartBlocks心脏传导阻滞1stdegreeheartblock2nddegreeheartblock:type1,type23rddegreeheartblock40精选课件ArtificialPacemakers/InternalDefibrillators人工起搏器/体内除颤Typesofpacemakers:trancutaneous,external,internalAutomaticinternalcardioverter/defibrillator(AICD)41精选课件Cardioversion/Defibrillation电复律/电除颤

Defibrillation:concepts,procedureSynchronizedcardioversion:indications,procedure42精选课件Cardiovascularemergencies心血管急症Coronaryarterydisease(CAD):anginapectoris,myocardialinfarctionCardiogenicshockAorticaneurysmAcutearterialocclusionHypertensionandhypertensiveemergencies43精选课件CardiacArrestDrugs心脏复苏药物EpinephrineAtropineLidocaineCalciumchlorideSodiumbicarbonate44精选课件CardiacArrestDrugs心脏复苏药物Pulselesselectricalactivity(PEA)Pulselessventriculartachycardia/ventricularfibrillationPostresuscitationgoalsCongestiveheartfailure:rightsided,leftsided45精选课件Shock休克MechanismsStages:compensated,decompensated,irreversibleHypovolemicCardiogenicObstructiveDistributive:septic,neurogenic/spinal,anaphylacticPneumaticanti-shockgarments(MASTsuit)46精选课件RespiratoryEmergencies呼吸急症

RespiratorystructureandfunctionreviewUpperairwayobstruction/lowerairwayobstructionEpiglotitisAsthmaChronicobstructivepulmonarydisease(COPD)PneumoniaPleurisy47精选课件RespiratoryEmergencies呼吸急症AllergicreactionPulmonaryembolismHyperventilationsyndromeSpontaneouspneumothoraxAcuterespiratorydistresssyndrome(ARDS)LaryngectomyTracheotomy48精选课件NeurologicalEmergencies神经急症Glasgowcomascale(GCS)Alteredlevelofconsciousness(ALOC)SyncopeSeizureTransientischemicattack(TIA)Cerebralvascularaccident(CVA)Symptomatichypertension/hypertensivecrisisAcutealcoholwithdrawal49精选课件AbdominalEmergencies腹部急症GIsystemoverviewTypesofabdominalpainInitialassessmentFocusedassessmentGIbleedingAcutegastroenteritis50精选课件AbdominalEmergencies腹部急症ColitisDiverticulitisAppendicitisPepticulcerdiseaseBowelobstructionCrohn’sdisease51精选课件AbdominalEmergencies腹部急症PancreatitisEsophagealvaricesHemorrhoidsCholecystitis/cholelithiasisCirrhosisAcutehepatitisDissectingaorticaneurysmKinneystonesUrinarytractinfectionPelvicinflammatorydiseaseEctopicpregnancy52精选课件RenalandUrologicalEmergencies肾脏和泌尿系统急症UrologicalandkidneyanatomyPhysicalassessmentAcuterenalfailureChronicrenalfailureDialysis:hemodialysisandperitonealdialysisRenalcalculi(kidneystones)53精选课件RenalandUrologicalEmergencies肾脏和泌尿系统急症Urinarytractinfection(UTI)TesticulartorsionPriaprismParaphimosisFourniergangreneUrinaryretention54精选课件EndocrineEmergencies内分泌系统急症

Diabetesmellitus(type1andtype2)Glucose,carbohydrate,fatandproteinmetabolismDiabeticketoacidosis(DKA)Hyperosmolarhyperglycemicnonketoticsyndrome/coma(HHNK)Hypoglycemia55精选课件EndocrineEmergencies内分泌系统急症Disorderofthethyroidgland:Graves’disease,thyrotoxiccrisisandhypothyroidismDisordersoftheadrenalglands:hyperadrenalism(Cushing’ssyndrome),adrenalinsufficiency(Addison’sdisease)56精选课件HematologyEmergencies血液系统急症

BloodtypesAnemiaSicklecelldiseasePolycythemiaLeukopenia/neutropeniaLeukocytosisLeukemia57精选课件HematologyEmergencies血液系统急症LymphomaThrombocytopeniaThrombocytosisHemophiliaVonWillebrand’sdiseaseDisseminatedintravascularcoagulation(DIC)Multiplemyeloma58精选课件CommunicableDisease传染病ChainoftransmissionTetanusLymediseaseRabiesImmunesystemHumanimmunodeficiencyvirus(HIV)/AIDS59精选课件CommunicableDisease传染病HepatitisTuberculosisMeningitisChildhooddisease:chickenpox,mumps,rubeola,rubellaPrevention60精选课件SubstanceAbuse/Overdose

中毒/药物过量CNSdepressants:alcoholCNSstimulantsHallucinogensDesignerdrugsPharmaceuticalagentsTricyclicantidepressants61精选课件SubstanceAbuse/Overdose

中毒/药物过量Industrial/agriculturalchemicalcaustics:strongacidsorbases,hydrocarbons,metals,non-potablealcoholandglycols,organophosphates,cyanidePlantpoisoningPhenothiazinereactionFoodpoisoningBiologicalagents62精选课件MechanismsofInjury创伤机制BluntPenetratingLoadandGoCriteria“搬-运”原则TraumaArrest/VolumeResuscitation创伤性心脏骤停/容量复苏63精选课件Facial-HeadandSpinalTrauma

头-面部和脊柱创伤Ear:acuteotitismedia,laceration/avulsion,Perforatedeardrum,BasilarskullfractureNose:epistaxis,nosalfractureFaceandneck:facialfracture,impaledobjects,severefacialinjury,tracheal/laryngealfractureSkull:scalpinjuries,skullfracture64精选课件Facial-HeadandSpinalTrauma

头-面部和脊柱创伤Meningealandvesselinjury:hematoma,hemorrhage,concussion,cerebralcontusion,anoxicbraindemageSpinalinjurySpinalimmobillzation65精选课件OcularEmergencies眼部急症ConjunctivitisCataractsGlaucomaDetachedretinaCentralretinalarteryocclusionAnisicoria(unequalpupils)SubconjunctivalhemmorhageOcularforeignbodyChemicalexposuresLacerations66精选课件ChestandAbdominalTrauma

胸部和腹部创伤

LeadingmechanismsofchestandabdominaltraumaTracheobronchialrupture/laceration/fractureOpenpneumothoraxTensionHemothoraxFlailchestCardiactamponadeThoracicaorticdisruptionSimplepneumothorax67精选课件ChestandAbdominalTrauma

胸部和腹部创伤

MyocardialcontusionDiaphragmatictear/herniaEsophagealinjuriesPulmonarycontusionOrgansofabdomen:solid,hollowEviscerationMustsuit68精选课件MusculoskeletalInjuries肌肉骨骼损伤

AssessmentNeurovascularcompromisePulse-motor-sensation(PMS)Muscles:tendons,ligaments,jiontsBones:fracture,strains,sprainsDislocationsClassificationsoffractures69精选课件MusculoskeletalInjuries肌肉骨骼损伤AmputationsSofttissueinjuriesSplintingFractures:femur,pelvic,hip,tibiaandfibula,clavicle,ribDislocations:hip,kneeInjuries:upperextremity,shoulder,elbow,footandankle70精选课件CrushingTraumaandItsAftermath挤压创伤和处理Burns烧伤Classification:1,2,3,4degreeRuleofninesThermalElectricalChemicalRadiationFrictionInhalationinburies:COpoisoningBurnshock71精选课件

MultipleCasualtyIncident

突发灾难事件应对

disasterincidentcommandsystemclassificationsystems(initialtriage):SimpleTriageandRapidTreatment,S.T.A.R.Tplan72精选课件Gynecological/OB/TraumaEmergencies妇产科创伤急症Pelvicinflammatorydisease(PID)OvariancystCystitisReviewofobstetricalanatomyandphysiologyTraumainpregnancyVaginalbleeding73精选课件Gynecological/OB/TraumaEmergencies

妇产科创伤急症EctopicpregnancyThirdtrimesterbleeding:placentaprevia,abruptioplacenta,uterinerupturePre-termlaborPostpartumhemorrhage74精选课件EmergencyChildbirth急产AnatomyandphysiologyCharacteristicsoflaborStagesoflaborProgressionoflaborDeliveryprocessTheAPGARscore75精选课件EmergencyChildbirth急产NeonatalresuscitationAdditionalcareformotherComplicationsofpregnancyComplicationsoflaboranddeliveryComplicateddeliveries76精选课件Pediatric:Newborn/Toddler/SIDS儿童：新生儿/幼儿/婴儿猝死综合征

NewbornInfantsToddler77精选课件Pediatric:Newborn/Toddler/SIDS儿童：新生儿/幼儿/婴儿猝死综合征

Neurologicalemergencies:seizures,meningitis,acutelifethreateningepisode(ALTE)Croup,bronchiolitis,acutegastroenteritis(AGE),vomiting/diarrhea,motorvehicletrauma,drowningChildabuse/neglect:indicationsSuddeninfantdeathsyndrome(SIDS)78精选课件ThePediatricAssessmentTriangle(PAT)儿童评估分类PediatricCardiovascularEmergencies儿童心血管急症PediatricRespiratoryEmergencies儿童呼吸急症NewbornAssessment新生儿评估79精选课件PediatricReview(part1)儿童急救复习1newborn,infants,toddler,preschooler,school-age,adolescent,pediatricassessment:appearance,breathing,circulation,vitalsigns80精选课件PediatricReview(part2)儿童急救复习2

PediatricmedicalemergenciesNeurological:seizures,meningitisRespiratory:croup,epiglottitis,asthma,bronchiolitisCardiovascular:shock(hypovolemic,distributive,cardiogenital),congenitalheartdisease,dysrhythmia,cardiacarrestdrugs81精选课件PediatricReview(part2)儿童急救复习2Gastrointestinal/genitourinary:hypoglycemia,gastroenteritis,appendicitis,vomiting/diarrhea,diabetesmellitusIIntegumentary:burnsGenitourinary:urinarytractinfection,testiculartorsionSkeletal:strains/sprains,fructures82精选课件PediatricReview(part3)儿童急救复习3

Pediatrictrauma:motorvehicletrauma,drowning,burns,gswChildabuse:physical,emotional,sexual,neglect83精选课件PediatricAirwayManagement

儿童气道管理DifferencesbetweenpediatricandadultairwaysUpperairwayobstructionLowerairwayobstructionOropharyngealairway(OP)Nasopharyngealairway(NP)Bag-valve-maskventilation84精选课件PediatricAirwayManagement

儿童气道管理Foreignbodyobstruction-infant/childPediatricendotrachealintubation/extubation/ETmedfluidadministrationComplicationsofBVMventilationComplicationsofETintubationCO2detectors85精选课件EnvironmentalEmergencies

环境因素所致急症Heatemergencies:cramps,exhaustion,strokeColdemergencies:hypothermia,frostbiteWateremergencies:drowning,neardrowningDivingemergencies:airembolism,decompressionsicknessAltitudesickness:acutemountainsickness,highaltitudepulmonaryedema,highaltitudecerebraledema86精选课件EnvironmentalEmergencies

环境因素所致急症InsectstingsSnakebitesSpiderbitesHazardousaquaticlife87精选课件BehavioralEmergencies行为所致急症

NormalandabnormalbehaviorBiological/organiccausesCognitivedisorders:delirium,dementia,Alzheimer’sSchizophreniaAnxietydisordersPanicdisordersPhobiasPosttraumaticstresssyndrome88精选课件BehavioralEmergencies行为所致急症DepressionBipolardisordersPersonalitydisordersImpulsecontroldisordersManagementofpatientsRestraintsStressAnxietySuicide89精选课件SpecialNeedsPatients/ChronicCareChemotherapeuticAgents特殊/老年人急症Hearingimpairments:conductive,sensorineuralVisualimpairmentsSpeechimpairments:language,articulation,voiceproduction,fluencyObesityParalysis90精选课件SpecialNeedsPatients/ChronicCareChemotherapeuticAgents特殊/老年人急症DevelopmentallydisabledDownsyndromeFetalalcoholsyndromeOstroarthritisCerebralpalsyCysticfibrosisMultiplesclerosisMusculardystrophy91精选课件SpecialNeedsPatients/ChronicCareChemotherapeuticAgents特殊/老年人急症PoliomyelitisSpinabifidaMyasthemiagravisCulturallydiversepatientsCancerChemotherapyAcu