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Paramedic Principles and Practice: A Clinical Reasoning Approach

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Edited by expert academics and educators, Brett Williams and Linda Ross, and written by content specialists and experienced clinicians, this essential resource encourages readers to see the links between the pathophysiology of a disease, how this creates the signs and symptoms and how these should to be managed in the out-of-hospital environment. Additionally, Paramedic Principles and Practice 2e will arm readers with not only technical knowledge and expertise, but also the non-technical components of providing emergency care, including professional attitudes and behaviours, decision-making, teamwork and communication skills.

Case studies are strategically used to contextualise the principles, step readers through possible scenarios that may be encountered and, importantly, reveal the process of reaching a safe and effective management plan. The case studies initially describe the pathology and typical presentation of a particular condition and progress to more-complex and less-typical scenarios where the practitioner faces increasing uncertainty.

    • The only paramedic-specific text designed for Australian and New Zealand students and paramedics
    • Progressive case studies that bridge the gap from principles to practice
    • More than 40 essential pathologies covering common paramedic call-outs
    • Covers both technical and non-technical skills to develop the graduate into expert clinician
    • Includes an eBook with the purchase of the print book

    Additional resources on Evolve

      • An eBook on VitalSource

      Instructor/and Student resources:

        • Image collection
          • New chapters, including: Paediatric patients; Child abuse and intimate partner violence; Geriatric patients; Tropical conditions; Mass casualty; Interpersonal communication and patient-focused care; Evidence-based practice in paramedicine; Pharmacokinetics and pharmacodynamics
          • New case studies on major incidents and major trauma
          • Focused ‘Implications for’ boxes specific to considerations including geriatrics, cultural diversity, communication challenges
          • ‘Summary of therapeutic goals’ included with each case study
          • Learning outcomes added to open each chapter
          • Considered revision of pathophysiology across all chapters

          Author(s): Brett Williams, Linda Ross
          Edition: 2
          Publisher: Elsevier
          Year: 2020

          Language: English
          Pages: 1100
          City: Amsterdam

          Title page
          Table of Contents
          Copyright
          Foreword
          Preface
          About the editors
          Contributing authors
          Reviewers
          The key to improving your clinical practice
          Acknowledgements
          PART ONE: PARAMEDIC PRINCIPLES
          SECTION 1: INTRODUCTION TO PARAMEDIC PRINCIPLES AND PRACTICE
          Chapter 1: Introduction
          Professionalism
          Summary
          SECTION 2: FOUNDATION KNOWLEDGE
          Chapter 2: Introduction to: Foundation Knowledge
          Chapter 3: Perfusion
          Introduction
          What is perfusion?
          Factors leading to normal perfusion
          Disturbances of perfusion
          Assessment of perfusion
          Principles of medical management of perfusion
          Summary
          Chapter 4: The Autonomic Response
          Introduction
          The autonomic nervous system
          Assessment of ANS function
          Principles of management
          Summary
          Chapter 5: The Inflammatory Response
          Introduction
          What is inflammation?
          The basics of normal inflammation
          Abnormal inflammation
          Summary
          Chapter 6: Pharmacokinetics and Pharmacodynamics
          Introduction
          Definitions
          Pharmacodynamics (what the drug does to the body)
          Pharmacokinetics (what the body does to the drug)
          The effects of population variance on pharmacokinetics
          Summary
          SECTION 3: FOUNDATION CONCEPTS
          Chapter 7: Introduction to: Foundation Concepts
          Chapter 8: Evidence-Based Practice in Paramedicine
          Case 1
          Introduction
          Introduction to evidence-based practice
          Strengths of evidence-based practice
          Barriers and weaknesses of evidence-based practice
          So what does this all mean for paramedics?
          Chapter 9: The Clinical Reasoning Process
          Introduction
          How do paramedics make decisions?
          Theoretical and conceptual foundations of clinical reasoning
          Dual-process theory—a framework for reasoning
          Approaches to decision-making 'on the ground’
          Factors affecting the clinical reasoning process
          Strategies to enhance quality of clinical reasoning
          A step-by-step guide to clinical decision-making
          Summary
          Chapter 10: Introduction to: Communication and Non-technical Skills
          SECTION 4: COMMUNICATION AND NON-TECHNICAL SKILLS
          Chapter 11: Interpersonal Communication and Patient-Focused Care
          Introduction
          Fundamental concepts of communication
          Verbal and non-verbal communication
          The science and art of patient communication
          Effective listening
          Patient-centred communication
          Emotional and behavioural components of effective communication
          Summary
          SECTION 5: THE AUSTRALIAN AND NEW ZEALAND HEALTHCARE SYSTEMS
          Chapter 12: Introduction to: The Australian and New Zealand Healthcare Systems
          Chapter 13: The Paramedic Role in Healthcare
          Introduction
          The roles of ambulance services and paramedics in Australia and New Zealand
          Professionalism, regulation and professional standards
          The future paramedic role
          Summary
          Chapter 14: Characteristics of Ambulance Patients
          Introduction
          Who is using ambulance services?
          What factors can lead to people calling for an ambulance?
          From problem onset to the decision to call for an ambulance
          The process of calling for an ambulance
          Summary
          SECTION 6: PATIENT AND PARAMEDIC SAFETY
          Chapter 15: Introduction to: Patient and Paramedic Safety
          Chapter 16: Patient Safety and Paramedicine
          Introduction
          The harm caused by healthcare errors
          Types of medical error
          Models of error
          Reducing diagnostic errors
          Error defence
          Error management
          Evidence-based practice and patient safety
          EBP, individual patients and clinical reasoning
          Summary
          Chapter 17: Paramedic Health and Wellbeing
          Introduction
          Paramedic health and safety
          Definitions
          Stress
          Managing emotion
          Fatigue
          Shiftwork
          Occupational violence
          Getting help
          Physical injury, physical employment standards and physical activity
          Nutrition
          Alcohol and other drugs
          Summary
          SECTION 7: LEGAL, ETHICAL AND PROFESSIONAL CONSIDERATIONS
          Chapter 18: Introduction to: Legal, Ethical and Professional Considerations
          Chapter 19: Legal and Ethical Considerations in Clinical Decision-Making
          Introduction
          Ethics and the law
          Consent
          Refusal of treatment
          Elements of consent from a paramedic perspective
          Case study evaluation
          Documentation
          Summary
          Chapter 20: Introduction to: The Paramedic Clinical Approach
          PART TWO: PARAMEDIC PRACTICE
          SECTION 8: THE PARAMEDIC CLINICAL APPROACH
          Chapter 21: The Structured Clinical Approach
          Introduction
          The structured clinical approach
          Chapter 22: The Patient-Centred Interview
          Introduction
          The structured patient-centred interview
          Paramedic-patient interview structure
          Summary
          Chapter 23: Introduction to: The Paramedic Approach to the Patient With a Respiratory Condition
          SECTION 9: THE PARAMEDIC APPROACH TO THE PATIENT WITH A RESPIRATORY CONDITION
          Chapter 24: Airway Obstruction
          Introduction
          Pathophysiology
          ASSESS
          TREAT
          EVALUATE
          Ongoing management
          Hospital admission
          Follow-up
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          Chapter 25: Asthma
          Introduction
          Pathophysiology
          Gas trapping
          Airway remodelling
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Follow-up
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future directions
          Summary
          Chapter 26: Acute Pulmonary Oedema
          Introduction
          EVALUATE
          Hospital admission
          Long-term impact
          Acute pulmonary oedema across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Future research
          Summary
          Chapter 27: Chronic Obstructive Pulmonary Disease
          Introduction
          Pathophysiology
          Definitions
          ASSESS
          TREAT
          EVALUATE
          Hospital admission
          Investigations
          Follow-up
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research and trends
          Summary
          Chapter 28: Pneumothorax
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Hospital admission
          Long-term impact
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          Chapter 29: Pulmonary Embolism
          Introduction
          Pathophysiology
          Risk factors
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Research
          Summary
          SECTION 10: THE PARAMEDIC APPROACH TO THE PATIENT WITH A CARDIAC CONDITION
          Chapter 30: Introduction to: The Paramedic Approach to the Patient With a Cardiac Condition
          Chapter 31: Chest Pain
          Introduction
          Pathophysiology
          Myocardial perfusion and myocardial workload
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Investigations
          Ongoing management
          Hospital admission
          Follow-up
          ACS across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
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          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 32: Arrhythmias
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Hospital admission
          Arrhythmias across the lifespan
          Wolff-Parkinson-White
          Long QT syndrome
          Commotio cordis
          ASSESS
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          TREAT
          EVALUATE
          ASSESS
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          TREAT
          EVALUATE
          Summary
          Chapter 33: Cardiac Arrest
          Introduction
          Chain of survival
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Long-term outcomes
          ASSESS
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          Future research
          Summary
          SECTION 11: THE PARAMEDIC APPROACH TO THE PATIENT WITH A MEDICAL CONDITION
          Chapter 34: Introduction to: The Paramedic Approach to the Patient With a Medical Condition
          Chapter 35: Hypoglycaemia and Hyperglycaemia
          Introduction
          Hypoglycaemia
          Hyperglycaemia
          Diabetic ketoacidosis
          Euglycaemic DKA
          Hyperglycaemic hyperosmolar states
          ASSESS
          CONFIRM
          What else could it be?
          TREAT
          EVALUATE
          Summary
          Chapter 36: Stroke
          Introduction
          Pathophysiology
          Clinical manifestations
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Investigations
          Hospital admission
          Stroke across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
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          TREAT
          EVALUATE
          ASSESS
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          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 37: Overdose
          Introduction
          Pathophysiology
          Methamphetamine
          Opioids
          Quetiapine
          Tricyclic antidepressants
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing treatment
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 38: Anaphylaxis
          Introduction
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Investigations
          Ongoing management
          Hospital admission
          Post-discharge management
          Anaphylaxis across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 39: Seizures
          Introduction
          Pathophysiology
          Seizure classification
          Management
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          ASSESS
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          TREAT
          EVALUATE
          Future research and trends
          Summary
          Chapter 40: Pain
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 41: Acute Abdominal Pain
          Introduction
          Pathophysiology
          Specific conditions
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management in hospital
          Hospital admission
          ASSESS
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          TREAT
          EVALUATE
          ASSESS
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          TREAT
          EVALUATE
          ASSESS
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          TREAT
          EVALUATE
          Ongoing management
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Bowel obstruction across the lifespan
          Summary
          Chapter 42: Sepsis
          Introduction
          Definitions
          Pathophysiology
          ASSESS
          TREAT
          EVALUATE
          Ongoing management
          Sepsis across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 43: Bleeding From the Gastrointestinal and Urinary Tract
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
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          TREAT
          EVALUATE
          Hospital management
          Summary
          SECTION 12: THE PARAMEDIC APPROACH TO THE TRAUMA PATIENT
          Chapter 44: Introduction to: The Paramedic Approach to the Trauma Patient
          Chapter 45: Head Injuries
          Introduction
          Anatomy
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Investigations
          Hospital admission
          Hospital discharge
          Head injuries across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 46: Chest Injuries
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Investigations
          Hospital admission
          Long-term role
          Chest trauma across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 47: Musculoskeletal Injuries
          Introduction
          Pathophysiology
          ASSESS
          2 CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Investigations
          Ongoing management of uncomplicated injuries
          Torn muscle repair
          Management of specific fractures
          Complications of MSIs
          Rehabilitation
          Long-term impact
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          2 CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 48: Traumatic Spinal Injuries
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Long-term issues and care
          Life expectancy for SCI survivors
          ASSESS
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          TREAT
          4 EVALUATE
          1 ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 49: Burns
          Introduction
          Anatomy of the skin
          Pathophysiology of burn injury
          Burn injury severity
          The inflammatory response to burn injury
          ASSESS
          CONFIRM
          TREAT AND EVALUATE
          ASSESS
          TREAT
          ASSESS
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          TREAT
          EVALUATE
          Other types of burns
          Future research
          Summary
          Chapter 50: Mass-Casualty Incidents
          Introduction
          The 'all-hazard’ response to MCIs
          Managing the scene at an MCI
          Summary
          SECTION 13: THE PARAMEDIC APPROACH TO THE PATIENT WITH AN ENVIRONMENTAL CONDITION
          Chapter 51: Introduction to: The Paramedic Approach to the Patient With an Environmental Condition
          Chapter 52: Hypothermia and Hyperthermia
          Introduction
          Hypothermia
          ASSESS
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Chapter 53: Decompression Injuries
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          Chapter 54: Snakebite Envenoming
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Hospital management
          Investigations
          Hospital admission
          Long-term impact
          Snake bites across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 55: Spider Bites
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing hospital management
          Hospital admission
          Long-term impact
          Spider bites across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          Chapter 56: Marine Envenoming
          Introduction
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Hospital management
          Long-term impact
          Envenoming across the lifespan
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Hospital management
          ASSESS
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          TREAT
          EVALUATE
          Future research
          Summary
          Chapter 57: Tropical Medicine
          Introduction
          General approach
          Guidelines
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Malaria and other vector-borne diseases
          Tuberculosis
          Human immunodeficiency virus
          Other tropical and emerging diseases
          Future research
          Summary
          SECTION 14: THE PARAMEDIC APPROACH TO COMPLEX CASES: SPECIFIC CHALLENGES TO PARAMEDIC REASONING AND MANAGEMENT
          Chapter 58: Introduction to: The Paramedic Approach to Complex Cases: Specific Challenges to Paramedic Reasoning and Management
          Chapter 59: The Socially Isolated Patient
          Introduction
          Background
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Hospital admission
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          Chapter 60: The Dying Patient
          Introduction
          Death and dying across the lifespan
          Pathophysiology
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Ongoing management
          Hospital admission
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          Chapter 61: Older Patients
          Introduction
          Pathophysiology
          Approach to assessment
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          Chapter 62: Indigenous Australian Patients
          Introduction
          Kinship
          Culture
          Distribution
          Epidemiological profile
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          Chapter 63: Māori Patients
          Introduction
          Specific aspects of healthcare for Mori
          Epidemiological profile
          Mental health
          Delayed access to healthcare
          Death among Mori populations
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
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          TREAT
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          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          TREAT
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          Summary
          Chapter 64: Family Violence
          Introduction
          Background to family violence
          The role of paramedics and ambulance services
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Summary
          SECTION 15: THE PARAMEDIC APPROACH TO THE PATIENT DISPLAYING CHANGES IN BEHAVIOUR: MENTAL HEALTH AND MENTAL ILLNESS
          Chapter 65: Introduction to: The Paramedic Approach to the Patient Displaying Changes in Behaviour: Mental Health and Mental Illness
          Chapter 66: Mental Health Conditions
          Introduction
          Prevalence of out-of-hospital and emergency department mental health presentations
          The mental health system: why the increase in the out-of-hospital attendance to those with mental health concerns
          Concepts of recovery and the biopsychosocial model of care
          Pathophysiology
          ASSESS
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          Summary
          Chapter 67: De-Escalation Strategies
          Introduction
          Aggression
          De-escalation
          Summary
          SECTION 16: THE PARAMEDIC APPROACH TO OBSTETRIC, NEONATAL AND PAEDIATRIC PATIENTS
          Chapter 68: Introduction to: The Paramedic Approach to Obstetric, Neonatal and Paediatric Patients
          Chapter 69: Imminent Birth
          Introduction
          Physiology
          ASSESS
          CONFIRM
          TREAT
          Hospital admission
          Investigations
          Follow-up
          ASSESS
          TREAT
          ASSESS
          TREAT
          ASSESS
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          Further research
          Summary
          Chapter 70: Neonatal Resuscitation
          Introduction
          Pathophysiology
          Identifying the newborn at risk of disorders during transition
          Failure to breathe effectively at birth
          Failure to establish effective ventilation after birth
          Preparing for the birth of a baby
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Newborn airway management
          Ongoing management
          Documentation
          Birth during transport
          Discontinuing resuscitation
          Hospital admission
          Investigations
          Follow-up
          The preterm baby
          ASSESS
          CONFIRM
          TREAT
          EVALUATE
          Long-term role
          ASSESS
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          EVALUATE
          ASSESS
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          TREAT
          EVALUATE
          Hospital management
          Future research
          Summary
          Chapter 71: Paediatric Patients
          Introduction
          Important differences in children
          Respiratory distress
          ASSESS
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          TREAT
          EVALUATE
          ASSESS
          CONFIRM
          TREAT
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          ASSESS
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          Summary
          Medications Commonly Encountered in Community Emergency Health
          Glossary
          Index